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目的探讨基于活体造影数据重建股深动脉穿动脉穿支皮瓣血供三维数字化模型的可行性,为临床股深动脉穿动脉穿支皮瓣的应用提供解剖学依据。方法选择8例需行皮瓣移植的患者作为研究对象,采用DSA结合CT血管成像技术获取一侧大腿二维断层图像数据,应用Mimics软件对股深动脉穿动脉及其穿支进行三维可视化重建,利用软件自带测量工具筛选合适穿支。结果利用Mimics软件成功重建了股深动脉穿动脉及其穿支的三维可视化模型,能清晰显示股深动脉穿动脉及其穿支的分布、走行及穿支穿出深筋膜位置。8例患者中6例发现3支穿动脉,2例发现4支穿动脉。这些穿动脉共发出66支皮肤穿支(以大于0.5 mm为标准),穿支在穿深筋膜平面内径(0.9±0.26)mm,穿支浅出深筋膜点主要分布于坐骨结节与股骨外上髁的连线附近。结论基于活体造影数据可以重建清晰股深动脉穿动脉及其穿支血管的3D立体影像,可为临床股深动脉穿动脉穿支皮瓣的术前设计与皮瓣切取提供解剖学依据。
Objective To investigate the feasibility of reconstructing the blood supply of deep perforating femoral artery flaps based on live biopsy data and to provide an anatomical basis for the clinical application of deep perforators. Methods Eight patients with skin flap transplantation were selected as the study objects. Two-dimensional tomography images of the thigh were obtained by DSA combined with CT angiography. Mimics software was used to reconstruct the perforating branches of the deep femoral artery and its perforator. Use the software comes with measuring tools to filter the appropriate perforating. Results The three-dimensional visualization model of perforating artery and perforating branch of deep femoral artery was successfully reconstructed with Mimics software. The distribution of perforating veins and its perforating branches in deep femoral artery can be shown clearly. Of the 8 patients, 3 were found in 6 of the 6 patients, 4 in the 2 patients were found to have penetrated the artery. These arteries were perforated with a total of 66 perforation of the skin (greater than 0.5 mm as the standard). The perforating branch penetrated the deep fascia with an internal diameter of (0.9 ± 0.26) mm. The deep perforation of the perforating branch was mainly located in the ischial tuberosity Femoral epicondyle near the connection. Conclusions 3D stereoscopic images of deep perforating arteries and their perforating branches can be reconstructed based on live biopsy data, which can provide anatomical basis for the preoperative design and flap dissection of deep perforators.