自制简易定位器在腹壁下动脉穿支皮瓣CT血管成像中的应用

Application of self-made simple locator in CT angiography of deep inferior epigastric artery perforation

目的探讨自制简易定位器在腹壁下动脉穿支皮瓣(DIEAP)CT血管成像(CTA)中的应用。方法选取2019年1—12月于本院乳腺外科行DIEAP皮瓣再造乳房的15例女性患者作为研究对象,术前2周内均行腹部CTA检查。采集图像发送到Philips工作站进行三维重建后处理,利用定位器在皮肤表面显影标记,定位腹壁动脉穿支的体表位置,测量下腹壁穿支穿过肌肉层的位置、深度及其在肌肉层行走的距离,以此确定下腹壁血管信息。结果利用体表显影标记和CTA后处理图像的冠状位、矢状位、横轴位可准确定位穿支穿过肌肉层的体表定位点,15例患者CTA均能清晰显示腹壁动脉穿支血管构造及与周边结构的毗邻关系。结论简易定位器制作简单,使用方便,在腹壁下动脉CTA血管造影三维重建时提供腹壁下动静脉及其穿支及腹壁浅静脉数量、位置及走行等精准信息,可有效指导腹壁下动脉穿支皮瓣的术前设计及术中切取,为精准手术打下基础。

Objective To explore the application of self-made simple locator in CT angiography of deep inferior epigastric artery perforation(DIEAP)CT angiography(CTA)examination.Methods A total of 15 female patients who underwent breast reconstruction with DIEAP flap in our hospital from January to December 2019 were selected as the research subjects,and abdominal CTA examinations were performed within two weeks before surgery.All images were send to Philips workstation for 3D reconstruction and post-processing,the mark of the locator on the skin surface was used to locate the body surface position of the perforating branch of the abdominal wall artery,and the position,depth and distance of the perforating branch of the inferior abdominal wall through the muscle layer were measured respectively.Result The body surface positioning points of the perforators through the muscle layer can be accurately located by using the body surface development markers and the coronal,sagittal and axial positions of the CTA post-processing images,CTA of 15 patients can clearly show the vascular structure of the perforators of the abdominal wall artery and its adjacent relationship with the surrounding structures.Conclusions The simple locator is simple to make and easy to use,it provides accurate information such as the number,location and course of the inferior epigastric artery and vein and its perforators and superficial epigastric vein during the three-dimensional reconstruction of the inferior epigastric artery CTA angiography,it can effectively guide the preoperative design and intraoperative resection of the inferior epigastric artery perforator flap,and lay the foundation for the precise operation.