Dayan Joseph H, Dayan Erez, Kagen Alexander, Cheng Ming-Huei, Sultan Mark, Samson William, Smith Mark L
Division of Plastic Surgery, Beth Israel Medical Center, New York, New York.
Department of Radiology, Beth Israel Medical Center, New York, New York.
J Reconstr Microsurg. 2014 Jan;30(1):41-5. doi: 10.1055/s-0033-1351668. Epub 2013 Sep 9.
Vascularized groin lymph node transfer (VGLNT) has been successfully used to treat lymphedema. However, lack of familiarity with the inguinal node anatomy and concerns regarding donor site morbidity have limited its widespread use. The purpose of this study was to use magnetic resonance angiography (MRA) to clarify the inguinal anatomy and provide a reliable method for identifying the location of the superficial transverse inguinal lymph nodes. In this study MRA was used to evaluate the superficial inguinal lymph nodes in 117 patients. Coordinates of lymph nodes were plotted relative to an axis from the anterior superior iliac spine (ASIS) to the pubic tubercle (PT). The nodes were also plotted relative to the superficial circumflex iliac vein (SCIV) and superficial inferior epigastric vein (SIEV). A total of 1,938 lymph nodes were identified. These lymph nodes were concentrated on one-third the distance from the PT toward the ASIS and 3 cm perpendicularly below this line. About 67% of the superficial inguinal nodes were located within the bifurcation of the SIEV and SCIV. The results from this study provide useful guidelines for locating lymph nodes targeted for VGLNT.
带血管蒂腹股沟淋巴结转移术（VGLNT）已成功用于治疗淋巴水肿。然而，对腹股沟淋巴结解剖结构的不熟悉以及对供区并发症的担忧限制了其广泛应用。本研究的目的是利用磁共振血管造影（MRA）来阐明腹股沟区的解剖结构，并提供一种可靠的方法来确定腹股沟浅淋巴结的位置。在本研究中，MRA用于评估117例患者的腹股沟浅淋巴结。将淋巴结的坐标相对于从髂前上棘（ASIS）到耻骨结节（PT）的轴线进行绘制。这些淋巴结也相对于旋髂浅静脉（SCIV）和腹壁浅静脉（SIEV）进行绘制。共识别出1938个淋巴结。这些淋巴结集中在从耻骨结节向髂前上棘方向距离的三分之一处，并在该线垂直下方3厘米处。约67%的腹股沟浅淋巴结位于腹壁浅静脉和旋髂浅静脉的分叉处。本研究结果为定位VGLNT靶向的淋巴结提供了有用的指导原则。
