人类和犬类背阔肌肌内血管连接的差异。

Differences in intramuscular vascular connections of human and dog latissimus dorsi muscles.

作者信息

Yang D, Morris S F

机构信息

Department of Anatomy, Dalhousie University, Halifax, Nova Scotia, Canada.

出版信息

Ann Thorac Surg. 1999 Feb;67(2):489-93. doi: 10.1016/s0003-4975(98)01263-6.

DOI:10.1016/s0003-4975(98)01263-6

PMID:10197676

Abstract

BACKGROUND

Distal ischemia and necrosis of the dog latissimus dorsi muscle flap used in experimental cardiomyoplasty have been reported. However, little information on the intramuscular vascular anatomy of the dog latissimus dorsi is available. It is unclear whether there are any anatomic factors relating to the muscle flap ischemia and necrosis, and whether the dog latissimus dorsi is a suitable experimental model.

METHODS

To study the intramuscular vascular territories in the dog latissimus dorsi muscle, and to compare the intramuscular vasculature of the dog with that of the human, 5 fresh dog cadavers and 7 fresh human cadavers were injected with a mixture of lead oxide, gelatin, and water (200 mL/kg) through the carotid artery. Both the dog and the human latissimus dorsi muscles and neurovascular pedicles were dissected and radiographed. The intramuscular vascular anatomy of the latissimus dorsi muscles was compared.

RESULTS

Radiographs demonstrate clearly that the pattern of latissimus dorsi intramuscular anastomoses between branches of the thoracodorsal artery and the perforators of posterior intercostal arteries in the proximal half of the muscle are different between the dog and the human. In the dog muscle, vascular connections between the thoracodorsal artery and the posterior intercostal arteries are formed by reduced-caliber choke arteries, whereas four to six true anastomoses without a change in caliber between them are found in the human muscle. The portion of the latissimus dorsi muscle supplied by the dominant thoracodorsal vascular territory was 25.9% +/- 0.3% in the dog and 23.9% +/- 0.5% in the human. For further comparison, an extended vascular territory in the latissimus dorsi muscle was demonstrated, including both the thoracodorsal territory and the posterior intercostal territories. The area of the extended vascular territory was 52% +/- 0.5% of the total muscle.

CONCLUSIONS

The dog latissimus dorsi model may not be a perfect predictor of the behavior of the human latissimus dorsi muscle flap in cardiomyoplasty.

摘要

背景

已有报道称，用于实验性心肌成形术的犬背阔肌肌瓣会出现远端缺血和坏死。然而，关于犬背阔肌肌内血管解剖结构的信息却很少。目前尚不清楚是否存在与肌瓣缺血和坏死相关的解剖学因素，以及犬背阔肌是否是一个合适的实验模型。

方法

为了研究犬背阔肌的肌内血管分布区域，并比较犬与人的肌内血管系统，通过颈动脉向5具新鲜犬尸体和7具新鲜人尸体注射氧化铅、明胶和水的混合物（200 mL/kg）。对犬和人的背阔肌及神经血管蒂进行解剖并进行X线摄影。比较背阔肌的肌内血管解剖结构。

结果

X线片清楚地显示，犬和人在肌肉近端半部分，胸背动脉分支与肋间后动脉穿支之间的背阔肌肌内吻合模式不同。在犬的肌肉中，胸背动脉与肋间后动脉之间的血管连接是由管径变细的阻塞动脉形成的，而在人的肌肉中则发现有四到六个管径无变化的真正吻合。在犬中，由优势胸背血管区域供血的背阔肌部分为25.9%±0.3%，在人中为23.9%±0.5%。为了进一步比较，还展示了背阔肌中一个扩展的血管区域，包括胸背区域和肋间后区域。扩展血管区域的面积占肌肉总面积的52%±0.5%。