Preliminary applications of the 3D-CTA assisted digital designing of the second toe transfers for the reconstruction of finger / 中华显微外科杂志

Objective To investigate the clinical significance of the 3D-CTA (three-dimensional computed tomography angiography)assisted design of finger reconstruction the second toe.Methods Between June 2010 and January 2013,five patients with finger defect received 3D-CTA assisted finger reconstruction surgeries using the second toe.Preoperative ipsilateral foot and hand 3D-CTAs were conducted and the 3D digital models were analyzed.The accurate positions and adjacent relations of vessels in both donor and recipient site were precisely marked and then the calibers of the vessels were measured.Four cases received thumb reconstructions and 1 case received little finger reconstruction.All of these surgeries were second-stage.According to Gu Yudong's classification of finger defect:second degree 2 cases,third degree 2 cases,five degree 1 case(little finger).Results With the help of 3D-CTA,five patients in this group had no vascular crisis,and all fingers survived successfully.With 4-12 months' follow-up,the algesthesia and thalposis of the reconstructed fingers gained good recoveries.The two-point discrimination was 5-10 mm.Tthe range of flexion of interphalangeal joint was 10 °-30 °.The range of flexion of the metacarpophalangeal joints was 35 °-80 °.And all patients restored walking and bearing functions with 3 months after surgeries.Conclusion The 3D-CTA reconstruction based digital model of ipsilateral foot and hand can objectively reflect the real situation of the vessels in both donor sites and recipient sites (exist of variations,routes and the calibers of the vessels),thus improve the success rate of surgery.

A Rare Case of Spontaneous True Aneurysm of the Occipital Artery

A 51-year-old man presented with a pulsatile scalp mass over the right occipital region, which had increased in size over the previous 1 month. He had no previous history of head trauma. Three-dimensional computed tomography (3D-CT) angiography of the brain revealed a 3.0 x 1.5 cm occipital artery aneurysm arising from the occipital artery. The occipital artery aneurysm was removed following the ligation of the proximal and distal portion of the occipital artery aneurysm. The histological diagnosis was true aneurysm. To the best of our knowledge, this is the first reported case in the literature.

Persistent Hypoglossal Artery

The persistent hypoglossal artery(PHA) is a rare anomaly that belongs to the group of embryonic carotid-basilar artery anastomoses that may occur in adults. The most commonly reported type of such an anastomosis is the primitive trigeminal artery, followed by the PHA. We report a 35-year old man, hospitalized because of an intraventricular hemorrhage, who was found to have a right persistent PHA. Three-dimensional computed tomography(CT) angiography provided excellent anatomical topology of the anomaly. To our knowledge, this patient is the first case of a PHA identified by this means in Korea.

Diagnosis and managements of intracranial aneurysms with three-dimensional CT angiography / 重庆医科大学学报

Objective:To explore of clinical value of three-dimensional computed tomography angiography(3D-CTA) in the etiological diagnosis and management of intracranial aneurysm.Methods:One hundred and fifteen patients with spontaneous SAH admitted from September 2007 to August 2008 were examined with 3D-CTA,and were examined with digital subtracted angiography(DSA),and eighty nine patients were found suffering from intracranial aneurysm which underwent DSA.Repeated 3D-CTA was performed 1 week after clipping in eighty one patients or embolization in eignt cases.The findings of 3D-CTA were compared with the results of DSA.Results:A total of ninty seven aneurysms in eighty nine cases were detected by 3D-CTA,but DSA revealed ninty three anurysms.DSA confirmed the findings of CTA except for five cases of small anterior communicating aneurysms and three cases posterior communicating aneurysms which were demonstrated by 3D-CTA and verified by surgery but missed by DSA and four cases which were found by DSA and verified by surgery but missed by 3D-CTA.The sensitivity of 3D-CTA to diagnose the intracranial aneurysms is 95.6% and the specificity is 100% and the accuracy is 96%.The diagnose accordance rate among 3D-CTA and DSA and/or surgery is 88.1%.Conclusion:3D-CTA and 2D-DSA and/or surgery have high diagnose accordance rate,and we should combine the two diagnostic techniques to examine intracranial aneurysms accurately.