Rozen Warren M, Chubb Daniel, Stella Damien L, Taylor G Ian, Ashton Mark W
Reconstructive Plastic Surgery Research Unit, Room E533, Department of Anatomy and Cell Biology, The University of Melbourne, Grattan St, Parkville, Vic. 3050, Australia.
ANZ J Surg. 2009 Dec;79(12):913-7. doi: 10.1111/j.1445-2197.2009.05143.x.
Cadaveric research has widely influenced our understanding of clinical anatomy. However, while many soft-tissue structures remain quiescent after death, other tissues, such as viscera, undergo structural and functional changes that may influence their use in predicting living anatomy. In particular, our understanding of vascular anatomy has been based upon cadaveric studies, in which vascular tone and flow do not match the living situation.
An angiographic analysis of the abdominal wall vasculature was performed using plain film and computed tomography angiography in 60 cadaveric hemi-abdominal walls (from 31 cadavers) and 140 living hemi-abdominal walls (in 70 patients). The deep inferior epigastric artery (DIEA) and all of its perforating branches larger than 0.5 mm were analysed for number, calibre and location.
Both large, named vessels and small calibre vessels show marked differences between living anatomy and cadaveric specimens. The DIEA was of larger diameter (4.2 mm versus 3.1 mm, P < 0.01) and had more detectable branches in the cadaveric specimens. Perforators were of greater calibre (diameter 1.5 mm versus 0.8 mm, P < 0.01) and were more plentiful (16 versus 6, P < 0.01) in cadaveric specimens. However, the location of individual vessels was similar.
Cadaveric anatomy displays marked differences to in vivo anatomy, with the absence of living vascular dynamics affecting vessel diameters in cadaveric specimens. Blood vessels are of greater measurable calibre in cadaveric specimens than in the living. Consequently, cadaveric anatomy should be interpreted with consideration of post-mortem changes, while living anatomical studies, particularly with the use of imaging technologies, should be embraced in anatomical research.
尸体研究对我们理解临床解剖学产生了广泛影响。然而，虽然许多软组织在死后保持静止，但其他组织，如内脏，会发生结构和功能变化，这可能会影响它们在预测活体解剖中的应用。特别是，我们对血管解剖学的理解一直基于尸体研究，其中血管张力和血流与活体情况不匹配。
使用平片和计算机断层血管造影对60个尸体半腹壁（来自31具尸体）和140个活体半腹壁（70例患者）的腹壁血管系统进行血管造影分析。分析腹壁下深动脉（DIEA）及其所有直径大于0.5 mm的穿支的数量、管径和位置。
无论是大的、有命名的血管还是小口径血管，活体解剖和尸体标本之间都存在明显差异。尸体标本中腹壁下深动脉的直径更大（4.2 mm对3.1 mm，P < 0.01），且可检测到的分支更多。尸体标本中的穿支管径更大（直径1.5 mm对0.8 mm，P < 0.01）且数量更多（16个对6个，P < 0.01）。然而，单个血管的位置相似。
尸体解剖与活体解剖存在明显差异，尸体标本中缺乏活体血管动力学影响血管直径。尸体标本中的血管管径比活体中的更大。因此，在解释尸体解剖时应考虑死后变化，而在解剖学研究中应采用活体解剖研究，特别是使用成像技术的研究。
