CT血管造影在血管化髂骨肌瓣临床设计中的应用

目的:探讨CT血管造影(CT angiography,CTA)在血管化髂骨肌瓣临床设计中的应用价值。方法:选取2014年8月~2015年9月,收治的12例拟行血管化髂骨肌瓣修复手术的患者。术前行CT 血管造影,利用影像工作站(Philips Medical Systems),观察并测量旋髂深动脉(deep circumflex iliac artery,DCI)起始管径、起始点与双侧髂前上棘连线的成角以及起始点至髂前上棘的距离。依据成角的角度及距离行旋髂深动脉起始点体表定位,并模拟血管化髂骨肌瓣切取。结果:旋髂深动脉起始管径(2.8±0.61) mm,旋髂深动脉起始点与双侧髂前上棘连线的成角(55±1.7)°,旋髂深动脉起始点距髂前上棘的距离为(65.1±1.24) mm。依据重建影像可以成功模拟血管化髂骨肌瓣的切取。结论:CT 血管造影可以准确显示旋髂深动脉的解剖位置,能够指导血管化髂骨肌瓣的制备。

Application of CT Angiography in the Clinical Designing of Vascularized Iliac Crest Flap.

Objective:To investigate the applicative value of CT angiography in the clinical designing of vascularized iliac crest flap. Methods:From August 2014 to September 2015,12 patients with mandibular defects were treated with vascularized iliac crest flap. Preoperative CTA was conducted. Imaging workstation (Philips Medical System) was used to observe and measure the diameter of deep circumflex iliac artery (DCI) at the starting point,the angle between the starting segment of DCI and the line from one anterior superior iliac spine to the other,and the length from the starting point of DCI to anterior superior iliac spine. The body surface location of the starting point of DCI was determined according to the angle and the length,and then iliac crest flap harvesting was simulated. Results:The diameter of DCI at the starting point was (2.8±0.61) mm,the angle and the length were (55±1.7) degree and (65.1±1.24) mm, respectively.Iliac crest flap harvesting was simulated successfully according to the reconstructed image. Conclusion:CTA can accurately determine the anatomical location of DCI,and it can effectively guide the designing of the iliac crest flap.