National Center for Children's Health, Beijing, China.
Department of Urology, Beijing Children's Hospital affiliated to Capital Medical University, No.56 Nanlishilu Rd, West District, Beijing, China.
BMC Urol. 2019 Nov 8;19(1):111. doi: 10.1186/s12894-019-0547-4.
Micro-computerized tomography (micro-CT) is considered as an innovative non-invasive and high-resolution imaging technology. The current research aims to reconstruct the distribution of preputial vessels in different severity of rat congenital hypospadias model by micro-CT, and to provide an anatomic basis for the selection of preputial vessel pedicle flaps in surgery.
Pregnant rats were exposed to finasteride from gestational day 12 to 17. Depending on the position of the urethral meatus, the pups were divided into normal, mild hypospadias and severe hypospadias groups. Six months after birth, the preputial blood vessels were observed in vascular perfusion with Microfil (a silicone-based polymer) and scanned by micro-CT. CTvox and NRecon were utilized to reconstruct 3-dimentional (3D) images. A pathological analysis of the specimen was taken in order to determine the position of Microfil.
The normal group and the mild hypospadias group had similar preputial image characteristics. At the junction of the inner and outer prepuce, the deep layer vessels of the superficial fascia were transversely distributed and formed a vascular ring-like structure. Among the severe hypospadias group, five had sufficient blood circulation while six had insufficient blood circulation. In sufficient blood circulation type, the ring-like vessels were found at the junction of the inner and outer prepuce similar to that of the normal and mild hypospadias group. However, only a small amount of capillary supply to this area in the insufficient type.
The junction of the inner and outer prepuce with abundant blood circulation was suitable to be a vascular pedicle flap. The tubularized preputial island flaps were consistent with the ring-like vessels area, and the original blood supply was retained to the greatest extent.
微计算机断层扫描（micro-CT）被认为是一种创新的非侵入性和高分辨率成像技术。本研究旨在通过 micro-CT 重建不同严重程度大鼠先天性尿道下裂模型的包皮血管分布，为手术中选择包皮血管蒂瓣提供解剖学基础。
妊娠大鼠从妊娠第 12 天到第 17 天暴露于非那雄胺。根据尿道外口的位置，将幼仔分为正常、轻度尿道下裂和重度尿道下裂组。出生后 6 个月，用 Microfil（一种硅基聚合物）进行血管灌注，观察包皮血管，并用 micro-CT 扫描。使用 CTvox 和 NRecon 重建三维（3D）图像。对标本进行病理分析，以确定 Microfil 的位置。
正常组和轻度尿道下裂组的包皮图像特征相似。在内、外包皮交界处，浅筋膜深层血管横向分布，形成血管环样结构。在重度尿道下裂组中，有 5 例血供充足，6 例血供不足。在血供充足的类型中，在内、外包皮交界处发现与正常和轻度尿道下裂组相似的环状血管。然而，在不足类型中，只有少量毛细血管供应该区域。
内、外包皮交界处血供丰富，适合作为血管蒂瓣。管状包皮岛瓣与环状血管区域一致，最大限度地保留了原始血供。
