THREE DIMENSIONAL VISUAL RESEARCH OF THORACIC DORSAL ARTERY BASED ON CT ANGIOGRAPHY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SHENMeihua ¹ , RENPeng ¹ , XIAOHu ² ,  Aihemaitijiang·Yusufu ¹ , Maihemuti·Yusufu ¹ , WANGYanlin ² , Muhangmude·Yalike ¹

1. Department of Microsurgery Repair, the First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830054, P. R. China;
2. Department of the Image Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830054, P. R. China;

Corresponding?author：

Aihemaitijiang·Yusufu, Email: ahmtjang@163.com

Keywords：

Thoracic dorsal artery; Perforator flap; CT angiography; Three dimensional reconstruction

DOI：

10.7507/1002-1892.20150069

Video：

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Objective To study the digital anatomy and application value of the thoracic dorsal artery based on CT angiography (CTA). Methods Between September 2012 and June 2014, aorta CTA images were chosen from 10 cases (20 sides) undergoing aorta CTA. By using Mimics 17.0 software for three dimensional (3D) reconstruction of image post-processing, the digital vascular anatomical information were obtained after observing and measuring the origin of the thoracic dorsal artery, the number of perforators, type, inner diameter, and pedicle length; and the body surface location of perforator vessel was determined, and then the thoracic dorsal artery perforators tissue flap harvesting was simulated. Results 3D reconstruction images showed that the thoracic dorsal artery originated from subscapular artery, 76 perforator vessels were found, including 32 perforators (42.1%) from the medial branch of the thoracic dorsal artery and 44 perforators (57.9%) from the lateral branch of the thoracic dorsal artery, of which 69 were intramuscular perforators (90.8%) and 7 were direct skin artery (9.2%). The inner diameter of the thoracic dorsal artery was (1.69±0.23) mm, and its pedicle length was (2.12±0.64) cm. The first lateral perforator of the thoracic dorsal artery located at (1.65±0.42) cm above the horizontal line of the inferior angle of scapula and at (1.68±0.31) cm lateral to vertical line of the inferior angle of scapula. The first medial perforator located at (1.43 ±0.28) cm above the horizontal line of the inferior angle of scapula and at (1.41±0.28) cm lateral to vertical line of the inferior angle of scapula. The thoracic dorsal artery perforators flap harvesting was successfully simulated. Conclusion CTA is a more intuitive method to study the thoracic dorsal artery in vivo, it can clearly display 3D information of the main blood supply artery course and distribution after flap reconstruction, so it can effectively and accurately guide the design of the flap.

Citation： SHENMeihua, RENPeng, XIAOHu, Aihemaitijiang·Yusufu, Maihemuti·Yusufu, WANGYanlin, Muhangmude·Yalike. THREE DIMENSIONAL VISUAL RESEARCH OF THORACIC DORSAL ARTERY BASED ON CT ANGIOGRAPHY. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(3): 326-330. doi: 10.7507/1002-1892.20150069 Copy

1.	Santanelli F, Longo B, Germano S, et al. Total breast reconstruction using the thoracodorsal artery perforator flap without implant. Plast Reconstr Surg, 2014, 133(2):251-254.
2.	Amin AA, Rifaat M, Ellabban MA, et al. Transaxillary thoracodorsal artery perforator flap:a versatile new technique for hypopharyngeal reconstruction. J Reconstr Microsurg, 2014, 30(6):397-404.
3.	Kim SW, Kwon YH, Kim JT, et al. Foot reconstruction using a serratus anterior muscle flap from the same donor site after failure of a thoracodorsal artery perforator flap. Microsurgery, 2014, 34(2):153-156.
4.	Hamdi M, Decorte T, Demuynck M, et al. Shoulder function after harvesting a thoracodorsal artery perforator flap. Plast Reconstr Surg, 2008, 122(4):1111-1119.
5.	沈鵬, 高志強. 胸背動脈穿支皮瓣的解剖研究和臨床應用進展. 中國美容整形外科雜志, 2009, 20(6):369-372.
6.	張功林, 郭翱, 章鳴, 等. 胸背動脈穿支游離皮瓣修復前臂創面部分壞死一例. 中華整形外科雜志, 2008, 24(6):485.
7.	肖海濤, 時瑩瑜, 王懷勝, 等. 高頻彩色多普勒超聲檢測穿支血管在股前外側穿支皮瓣手術中的應用. 中國修復重建外科雜志, 2013, 27(2):178-181.
8.	Lin CT, Huang JS, Hsu KC, et al. Different types of suprafascial courses in thoracodorsal artery skin perforators. Plast Reconstr Surgery, 2008, 121(3):840-848.
9.	Malhotra A, Chhaya N, Nsiah-Sarbeng P, et al. CT-guided deep inferior epigastric perforator (DIEP) flap localization-better for the patient, the surgery, and the hospital. Clin Radiol, 2013, 68(2):131-138.
10.	陶友倫, 陳紹鶴, 徐世敏, 等. 大鼠皮動脈外徑與其營養范圍的定量測量和回歸分析. 中國臨床解剖學雜志, 2009, 27(5):558-562.
11.	Tao Y, Hu S, Lui KW, et al. Quantitative regression analysis of the cutaneous vascular territories in a cat modal. Surg Radiol Anat, 2011, 33(9):789-799.
12.	唐茂林, 徐達傳. 穿支皮瓣解剖學研究中存在的問題及對策. 中國臨床解剖學雜志, 2006, 24(2):225-227.
13.	樓新法, 梅勁, Christopher R.Geddes, 等. 明膠-氧化鉛血管造影術的優化. 中國臨床解剖學雜志, 2006, 24(2):259-262.
14.	崔磊, 胡春洪, Sanjeev PS, 等. 下肢動脈64層CT血管成像兩種成像方法圖像質量的比較. 中華放射學雜志, 2009, 43(3):284-289.
15.	馬春梅, 宮鳳玲, 陳偉彬, 等. 自動跟蹤與手動觸發技術在256層CT冠狀動脈成像中的應用. 實用放射學雜志, 2013, 29(11):1844-1846.
16.	付傳明, 徐霖, 陳倫剛, 等. MSCT對不同體重注射不同對比劑量在主動脈CTA中的探討. CT理論與應用研究, 2011, 20(2):251-258.
17.	Su W, Lu L, Lazzeri D, et al. Contrast-enhanced ultrasound combined with three-dimensional reconstruction in preoperative perforator flap planning. Plast Reconstr Surg, 2013, 131(1):80-93.
18.	陳世新, 丁茂超, 崔懷瑞, 等. 腹壁下動脈穿支皮瓣的3D可視化研究. 解剖學報, 2011, 42(2):269-273.
19.	Chiu WK, Lin WC, Chen SY, et al. Computed tomography angiography imaging for the chimeric anterolateral thigh flap in reconstruction of full thickness buccal defect. ANZ J Surg, 2011, 81(3):142-147.
20.	Grover R, Nelson JA, Fischer JP, et al. The impact of perforator number on deep inferior epigastric perforator flap breast reconstruction. Arch Plast Surg, 2014, 41(1):63-70.
21.	Angrigiani C, Rancati A, Escudero E, et al. Propeller thoracodorsal artery perforator flap for breast reconstruction. Gland Surg, 2014, 3(3):174-180.

1. Santanelli F, Longo B, Germano S, et al. Total breast reconstruction using the thoracodorsal artery perforator flap without implant. Plast Reconstr Surg, 2014, 133(2):251-254.
2. Amin AA, Rifaat M, Ellabban MA, et al. Transaxillary thoracodorsal artery perforator flap:a versatile new technique for hypopharyngeal reconstruction. J Reconstr Microsurg, 2014, 30(6):397-404.
3. Kim SW, Kwon YH, Kim JT, et al. Foot reconstruction using a serratus anterior muscle flap from the same donor site after failure of a thoracodorsal artery perforator flap. Microsurgery, 2014, 34(2):153-156.
4. Hamdi M, Decorte T, Demuynck M, et al. Shoulder function after harvesting a thoracodorsal artery perforator flap. Plast Reconstr Surg, 2008, 122(4):1111-1119.
5. 沈鵬, 高志強. 胸背動脈穿支皮瓣的解剖研究和臨床應用進展. 中國美容整形外科雜志, 2009, 20(6):369-372.
6. 張功林, 郭翱, 章鳴, 等. 胸背動脈穿支游離皮瓣修復前臂創面部分壞死一例. 中華整形外科雜志, 2008, 24(6):485.
7. 肖海濤, 時瑩瑜, 王懷勝, 等. 高頻彩色多普勒超聲檢測穿支血管在股前外側穿支皮瓣手術中的應用. 中國修復重建外科雜志, 2013, 27(2):178-181.
8. Lin CT, Huang JS, Hsu KC, et al. Different types of suprafascial courses in thoracodorsal artery skin perforators. Plast Reconstr Surgery, 2008, 121(3):840-848.
9. Malhotra A, Chhaya N, Nsiah-Sarbeng P, et al. CT-guided deep inferior epigastric perforator (DIEP) flap localization-better for the patient, the surgery, and the hospital. Clin Radiol, 2013, 68(2):131-138.
10. 陶友倫, 陳紹鶴, 徐世敏, 等. 大鼠皮動脈外徑與其營養范圍的定量測量和回歸分析. 中國臨床解剖學雜志, 2009, 27(5):558-562.
11. Tao Y, Hu S, Lui KW, et al. Quantitative regression analysis of the cutaneous vascular territories in a cat modal. Surg Radiol Anat, 2011, 33(9):789-799.
12. 唐茂林, 徐達傳. 穿支皮瓣解剖學研究中存在的問題及對策. 中國臨床解剖學雜志, 2006, 24(2):225-227.
13. 樓新法, 梅勁, Christopher R.Geddes, 等. 明膠-氧化鉛血管造影術的優化. 中國臨床解剖學雜志, 2006, 24(2):259-262.
14. 崔磊, 胡春洪, Sanjeev PS, 等. 下肢動脈64層CT血管成像兩種成像方法圖像質量的比較. 中華放射學雜志, 2009, 43(3):284-289.
15. 馬春梅, 宮鳳玲, 陳偉彬, 等. 自動跟蹤與手動觸發技術在256層CT冠狀動脈成像中的應用. 實用放射學雜志, 2013, 29(11):1844-1846.
16. 付傳明, 徐霖, 陳倫剛, 等. MSCT對不同體重注射不同對比劑量在主動脈CTA中的探討. CT理論與應用研究, 2011, 20(2):251-258.
17. Su W, Lu L, Lazzeri D, et al. Contrast-enhanced ultrasound combined with three-dimensional reconstruction in preoperative perforator flap planning. Plast Reconstr Surg, 2013, 131(1):80-93.
18. 陳世新, 丁茂超, 崔懷瑞, 等. 腹壁下動脈穿支皮瓣的3D可視化研究. 解剖學報, 2011, 42(2):269-273.
19. Chiu WK, Lin WC, Chen SY, et al. Computed tomography angiography imaging for the chimeric anterolateral thigh flap in reconstruction of full thickness buccal defect. ANZ J Surg, 2011, 81(3):142-147.
20. Grover R, Nelson JA, Fischer JP, et al. The impact of perforator number on deep inferior epigastric perforator flap breast reconstruction. Arch Plast Surg, 2014, 41(1):63-70.
21. Angrigiani C, Rancati A, Escudero E, et al. Propeller thoracodorsal artery perforator flap for breast reconstruction. Gland Surg, 2014, 3(3):174-180.

Chinese Journal of Reparative and Reconstructive Surgery

THREE DIMENSIONAL VISUAL RESEARCH OF THORACIC DORSAL ARTERY BASED ON CT ANGIOGRAPHY

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