基于活体造影数据的股深动脉穿动脉穿支血管的数字解剖学研究

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。

Digital anatomical study of perforator flap based on the perforating arteries of profunda femoris artery in vivo

Objective　To explore the feasibility of three-dimensional visualization of the profunda femoris artery perforator flap and provide the anatomical data for clinical application of profunda femoris artery perforator flap.　Methods　A series of DICOM images were obtained from eight patients by DSA and dual source CTA. Then Mimics 16.0 was used for three-dimensional reconstruction of perforating artery and perforators of profunda femoris arteryies. Results　The 3D visualization models of perforating arteries of the profunda femoris artery and their perforators could be successfully achieved by using Mimics. The 3D reconstruction models showed variable origin, location, presence, volume and course of the profundafemoris artery, perforating arteries as well as their perforators clearly. Three perforating arteries which derived from the profunda femoris artery were found in six patients and four perforating arteries displayed in two patients. 66 cutaneous perforators (>0.5 mm) have been found in the eight patients. The average internal diameter of perforator was (0.9±0.2) mm. Cutaneous perforators can be found on a line extending from the ischium to the lateral femoral condyle.　Conclusion　The 3D reconstruction models can provide perfect dynamic visualization of perforating arteries of profunda femoris artery and their perforators. It can provide the anatomical basis for clinical application of perforator flap base on perforating arteries of profunda femoris artery, and may be used for its individualized design.