小型猪皮瓣模型的影像解剖学研究

目的:研究小型猪躯干主要皮动脉血液供应,为皮瓣的相关研究提供动物模型和充分的解剖学依据。方法:(1)小型猪5头放血处死,动脉灌注明胶-氧化铅混悬液,运用CT扫描三维重建全身动脉系统。解剖观测躯干主要皮动脉的起源、行程、营养范围以及相互之间的吻合情况,并取下皮肤筋膜组织拍摄X线片。(2)活体小型猪1头静脉注射泛影葡胺,CT扫描三维重建全身动脉系统,与明胶-氧化铅灌注的三维重建行对照观察。结果:在动脉显影X线图像上,可见双侧的腹壁上动脉、肋间动脉穿支、旋髂深动脉构成腹前、侧壁的主要营养链,两两之间有丰富的吻合支,而腹壁下动脉、腹壁浅动脉和胸背动脉均未见粗大的皮肤穿支。全身动脉三维重建图像上,可见躯干主要皮动脉的来源、走行,管径相对大小,并可动态观察血管树的三维结构和相互关系。结论:小型猪躯干体被血运丰富,腹壁上动脉、肋间动脉穿支、旋髂深动脉皮支两两之间有丰富的吻合支,构成躯干体被组织的主要营养链,并可以此设计不同类型的皮瓣。

A radioanatomic study of minipig skin flap model

Objective: To investigate the arterial system of minipig torso integument and develop flap models of minipig for animal experiment related to flap research. Methods:(1) 5 minipigs sacrificed by bloodletting were injected arterially gelatin-lead oxide mixture and underwent CT-scanning to provide three-dimensional reconstruction. Dissections were performed to investigate and analyze the characteristics of principal arteries of torso integument including source, course, territories and osculation. The integument of torso were also dissected and radiated by X-ray to provide cutaneous angiograms. (2) Another minipig was injected cardiografin through veins and underwent 3D reconstruction for making a comparable observation with the images of gelatin-lead oxide injection. Results: The torso integument arteries of minipig included deep superior epigastric artery, deep inferior epigastric artery, superficial epigastric artery, perforators of intercostal artery and cutaneous branches of deep iliac circumflex artery. It was found in X-ray images that there were many rami anastomoticus among deep superior epigastric artery, perforators of intercostal artery and cutaneous branches of deep iliac circumflex artery and they formed the dominant trophic chain of torso integument. However, large perforators of deep inferior epigastric artery, superficial epigastric artery and thoracodorsal artery were not seen in X-ray images. In 3-D reconstruction images, the source, course and the caliber of the dominant integument arteries could be observed. 3-D structure of the vessel trees and their correlation were also shown in the 3-D reconstruction images. Conclusions: Deep superior epigastric artery, cutaneous branches of deep iliac circumflex artery and perforators of intercostal artery are the dominant arteries of torso integument of minipig. They form an arterial rete and nourish the torso integument. Many kinds of flaps can be designed according to the anatomic structure of integument arteries.