The Three-dimensional Reconstruction And Anatomy Study Of Anterolateral Perforators Flap

Obejective:1. Three-dimensional computerized reconstructions of lateral femoral circumflex artery were conducted From these data by means of continuous thin-layer CTA;2. Application of digital three-dimensional technology on anterolateral perforators flap, to explore the anatomical basis of ALPF, to guide design and harvestation of ALPF.Methods:1、Materials:The personal computer system:platform:CPU:IntelCore3i7-3610QM, graphics card:Nvidia GeForce GT650M, System memory:4GB DDR3; Storage:750GB hard disk drive; monitor:LG15.3LED; Operation system:Windows8Chinese Version; software:Amira5.4.3.2、Methods:Three dimensional reconstruction of ALFP on low limb CTA:Data:15patient(27limbs) low limbs CTA dataset in Nanjing Drum Tower hospital, The dataset were tube tension120kV, tube current70mA, tube slice thickness0.125mm, the data were exported in.DICM format, and conducted on personal computer. The segmented areas for skin, muscle, vessels, bone of flap were displayed in different colors using tools of Brush, Lasso and Magic Wand. The reconstructed images of muscles, blood vessels, bones and skin were fit different colors according to human body which could be multiply exhibited to show other adjacent structures by rotation. Result:On the anterolateral area of thigh58lateral femoral circumflex artery perforators were observed in these specimens, averagely there were2.15±0.95cutaneous perforators in each flap. The mean distance from the anterior superior iliac spine(ASIS) to patella was calculated as43.64±2.93cm (38.90～48.28cm).The mean distance of a given perforator from the AS IS was calculated as22.86±3.17cm (17.84～31.82cm).The mean ratio of the ASIS-patella distance to the distance of a given perforator from the ASIS(AP rate) was calculated as52.41%±6.52%(42.14%～69.78%).58perforators were identified,14(24.13%) septocutaneous vessels and44(75.86%)musculocutaneous perforators. One perforators were observed on7(25.93%) low limbs, two perforators were observed on13(44.44%) low limbs, three perforators were observed on5(18.52%) low limbs, four perforators were observed on4(11.11%) low limbs.Conclusion:1.There are constant vascular anatomy, enough length go vascular pedicle, large-caliber perforators that supply the skin of the lateral thigh near the midpoint between the anterior superior iliac spine and the superolateral corner of the patella。2.Preoperation CTA provides accurate perforators parameters, including the course, location, type of the perforators and three-dimensional graphics. It’s convenient, fast to choose and locate optimal donor site and perforators, which makes flap dissection easier, decreases the injuries caused during operation and donor site morbidity, shorten the operation time.