Toomayan Glen A, Robertson Fabienne, Major Nancy M
Department of Radiology, Duke University Medical Center, P.O. Box 3808, Durham, NC 27710, USA.
Skeletal Radiol. 2005 Jun;34(6):307-13. doi: 10.1007/s00256-005-0910-2. Epub 2005 Apr 16.
A thorough understanding of compartmental anatomy is necessary for the radiologist participating in the care of a patient with a lower extremity musculoskeletal malignancy. Localization of tumor to compartment of origin and identification of extracompartmental spread preoperatively are needed to correctly stage a tumor and determine the appropriate surgical management. An understanding of the locations of fascial boundaries, extracompartmental tissues, and neurovascular structures of the thigh and lower leg facilitates this diagnostic process. For the radiologist planning to biopsy a suspicious musculoskeletal lesion, consultation with the referring orthopaedic surgeon is recommended in order to jointly select an appropriate percutaneous biopsy approach. Adequate preprocedural planning ensures selection of an approach which prevents iatrogenic tumor spread beyond the compartment of origin, protects neurovascular structures, and allows complete resection of the biopsy tract and scar at the time of surgical resection without jeopardizing a potential limb-sparing procedure. Cross-sectional anatomic review and case examples demonstrate the importance of a detailed understanding of compartmental anatomy when approaching the patient with a lower extremity musculoskeletal tumor.
对于参与下肢肌肉骨骼恶性肿瘤患者护理的放射科医生来说，全面了解肌间隔解剖结构是必要的。术前将肿瘤定位到起源的肌间隔并识别肌间隔外扩散情况，对于正确分期肿瘤和确定合适的手术治疗方案是必需的。了解大腿和小腿的筋膜边界、肌间隔外组织以及神经血管结构的位置有助于这一诊断过程。对于计划对可疑肌肉骨骼病变进行活检的放射科医生，建议与转诊的骨科医生进行会诊，以便共同选择合适的经皮活检方法。充分的术前规划可确保选择一种方法，防止医源性肿瘤扩散到起源肌间隔之外，保护神经血管结构，并在手术切除时能够完整切除活检通道和瘢痕，而不会危及可能的保肢手术。横断面解剖回顾和病例示例表明，在处理下肢肌肉骨骼肿瘤患者时，详细了解肌间隔解剖结构非常重要。
