Evaluation And Application Of Digital Three-dimensional Reconstruction Technology Of Typing FDMA

Objective：Explore the accuracy and practicability of preoperative digitalthree-dimensional reconstruction technology applied on FDMA typing；Explorethe value of preoperative digital three-dimensional reconstruction technologyapplied on thumb and finger reconstruction surgery for assessing blood vesselsin foot donor site.Methods：From January2011to March2014, our hospital conducted free toetransplantation for thumb and finger for79in-patient cases with158feet,51male cases and28female cases, aging from3to45years old. As for the reasonof hand injury, there were26cases crushed by machine,29cases injured bypanel planer and24cases by chainsaw. Before operation, use computedtomography angiography (CTA) to assess blood supply in foot donor site andcompare it with intra operative anatomical study. Use CT self-equipped imageworkstation analyze feet axial images, MPR (multi-planar reformation), MIP(maximum intensity projection) and VR (volume rendering) reconstructedimages and assess FDMA typing, origin, course and anatomical relationships.Image evaluation criteria: Is divided into A+、A-、B、C class. A+: vascularstructure displayed is very clear, continuous, and coarse. The branches of thevessel are fully reflected; A-: vessels are clearly displayed with good continuityand gets to clinical diagnostic requirements; B: the blood can be seen but thereare obvious artifacts and despite the poor vascular continuity, clinical diagnosis can be carried out still; C: indicates poor visibility or blood that hardly can beseen, so it can not provide correct clinical diagnosis.Result: Among the79cases with158feet, there were68feet ranking A,16feet ranking B and12feet ranking C. All A+patients’ origin, course, andthree-dimensional anatomical relationship with surrounding muscles bones ofFDMA are well displayed. The A+or A-foot Digital three-dimensionalreconstruction technology images are highly in accordance with what can beseen during the operation. The satisfaction rate of the vessel images of footdorsal, FDMA and webbed toe artery shown by Digital three-dimensionalreconstruction technology is100%,89.24%,63.29%respectively. The highestsatisfaction rate is dorsalis pedis artery and FDMA. All of these three partsvessel use multiple independent samples for non-parametric test and thedifference was statistically significant.Conclusion:1、Digital three-dimensional reconstruction technology can helpto acquire three-dimensional images based on patient’s individual extremitiesarterioles in donor site, thus realizing the critical step of “vivisection”.2、Digitalthree-dimensional reconstruction technology can chang thetraditional“Open-Observation-Surgery”to“observe-Open-Operation”.3、Digitalthree-dimensional reconstruction technology can guide the choice for designingdonor site and proactively know the thumb and finger reconstruction surgeryeffect to avoid unnecessary damage on the donor site, shorten operation time andreducing complications.