手部皮支皮瓣造影及三维可视化

3D visualization of hand perforator flap by angiography

目的:利用放射造影术,实现手部皮瓣血管的三维可视化,探讨手部动脉皮支供血分布。方法:应用以乳胶-羧甲基纤维素混合填充剂为氧化铅造影剂的载体,配制成乳胶、羧甲基纤维素-氧化铅填充剂,选择上肢新鲜标本进行尺动脉灌注,然后经普通X线摄片和CT扫描。结果:标本造影扫描可得到清晰的动脉成像。以0.5 mm层距行CT连续扫描显示动脉及细小分支显影均匀,最小显示血管达0.1 mm左右,利用Mimics 17.0获得非常清晰的手部皮瓣血管三维重建图像,边缘光滑、层次分明。结论:以乳胶、羧甲基纤维素-氧化铅作填充剂的灌注技术可使X线摄影和CT扫描在标本上获得高质量的手部皮瓣血管影像,并以此构建出清晰的手部皮瓣血管的三维图像,该技术可为临床外科手部皮瓣移植提供详细的数据支持。

Objective： To build 3D visualized hand flap using radiographic techniques and to investigate the distribution of blood supply to the arterial branches of the hand. Methods. Radial artery and ulnar artery of the fresh hand samples were injected using the carboxymethyl cellulose-lead oxide injection technique, and ordinary X-ray and CT scan. Results. Specimen scan could obtain clear arterial imaging. CT scan with 0. 5 mm layer interval showed uniform arteries and small branches, and the smallest display of blood vessels up to about 0. 1 mm. There were no barbs and vacuoles of blood vessel image. With Mimics 17. 0, very clear 3-dimensional reconst＇ruc-on images of the blood vessel with smooth margins and clear layers could be obtained. Conclusion： The perfusion technique with latex, carboxymethylcellulose-lead oxide as fillers allows high-quality images of the flap to construct a clear three-dimensional image of the blood vessels of the hand flap, which provides detailed data support for clinical hand flap transplantation.