三维重建技术在腓肠肌皮瓣临床手术中的应用

目的 探讨腓肠肌皮瓣的三维重建技术在临床中的初步应用.方法 2007年至2008年间.对需腓肠肌皮瓣创面修复的7例患者,术前注射造影剂后采用CT或MR扫描,应用Amira4.1软件对腓肠肌皮瓣结构进行三维重建.构建患者个性化皮瓣.根据患者创面缺损大小,进行个性化皮瓣三维构建,于患者小腿部后侧进行腓肠肌皮瓣的点、线、面描记,用以指导手术切取.结果 三维重建患者个性化皮瓣7例,所重建个性化腓肠肌皮瓣,能够清晰显示血管、皮肤及其毗邻结构的三维关系.并根据术前创面缺损大小,对皮瓣进行精确设计.其中6例病人所显示的皮瓣主要穿支及主干.与术中检查相符;1例显示皮瓣主干血管.但穿支显示不清,术中探查穿支血管平均约0.5 mm.最小穿支均小于0.3mm.术后7例皮瓣全部成活.结论 通过血管造影下肢CT或MR扫描,采用数字化三维重建技术可以提供腓肠肌皮瓣的三维动态解剖,重建的肌皮瓣能够地准确标示术中切取范围.避免术中血管的副损伤,保证了皮瓣较好的存活率.

Three-dimensional reconstruction technique in gastrocnemius flap surgery:initial clinical application

Objective To discuss the experience with three-dimensional reconstruction technique in initial clinical application in gastrocnemius muscle flap surgery. Methods From 2007 to 2008, 7 patients received gastrocnemius muscle flap surgeries to repair the wounds. Preoperative CT angiography or magnetic resonance imaging (MRI) was performed after injection of the contrast media for individualized three-dimensional gastrocnemius muscle flap reconstruction using Amira4.1 software. According to the size of the defec...