数字化解剖方法定位小腿穿支研究

Localization of perforators in the lower leg by digital antomy imaging methods

目的以螺旋CT数据三维重建小腿穿支，对比常规X线片，观测小腿穿支分布特点，为临床提供精确化的立体解剖信息以及为设计穿支皮瓣提供形态学基础。方法对15具尸体行一次性全身动脉明胶一氧化铅混合液造影，先行X线摄片，应用图像分析软件Photoshop及ScionImage对各穿支体进行分割显示及测量，再行螺旋CT扫描并进一步应用MIMICS10．01软件行三维重建。结果小腿共有外径大于0．5mm的穿支（27±4）支，平均外径（0．8±0．2）mm，平均浅筋膜段蒂长（37．3±18．6）mm，单穿支平均供血面积（49．5±25．5）cm2。数字化小腿穿支模型能够准确地反映穿支之间、穿支与源动脉之间的形态学结构和空间关系。结论数字化小腿穿支可清晰地反映穿支的几何特征及局部细节，显示穿支的来源与分布特点，不失为研究人体小腿穿支的形态特点及术前设计穿支皮瓣的较好途径。

Objective To offer both the accurate three-dimensional anatomical information and algorithmic morphology of perforators in the lower leg for perforator flaps design. Methods The cadaver was injected with a modified lead oxide-gelatin mixture. Radiography was first performed and the images were analyzed using the software Photoshop and Scion Image. Then spiral CT scan was also performed and 3-dimensional images were reconstructed with MIMICS 10.01 software. Results There are （27 ± 4） perforators whose outer diameter≥0. 5 mm（ average, 0. 8 ±0. 2 mm）. The average pedicle length within the superficial fascia is （ 37.3 ±18.6） mm. The average supplied area of each perforator is （49.5±25.5 ） cm2. The three-dimensional model displayed accurate morphology structure and three-dimensional distribution of the perforator-to- perforator and perforator-to-source artery. Conclusions The 3D reconstruction model can clearly show the geometric, local details and three-dimensional distribution. It is a considerable method for the study of morphological characteristics of the individual perforators in human calf and preoperative planning of the perforator flap.