OBJECTIVE: To investigate the repairing method of inguinal scar contracture deformity in children with transpositional fasciocutaneous flap of anterior-medial side of thigh. METHODS: From August 1989 to August 1999, 33 cases with inguinal scar contracture deformity were adopted in this study. Among them, there were 26 males and 7 females, aged from 3 to 11 years old. The transpositional fasciocutaneous flap consisted of a huge tongue-shape flap with a pedicled triangular flap between the edge of skin defect and the above tongue-shape flap. The maximal size of the transpositional fasciocutaneous flap was 18 cm x 10 cm and the minimal size was 13 cm x 8 cm, the transpositional angle was 60 degrees to 80 degrees. During operation, the tongue-shape flap was used to repair the inguinal region and the triangular flap was used to repair the donor site in one stage. RESULTS: All the flaps survived. The function and appearance of perineum were satisfactory. CONCLUSION: The transpositional fasciocutaneous flap is suitable for repairing the inguinal scar contracture deformity in children, and skin graft is unnecessary.
【摘要】 目的 评价多排螺旋CT（MDCT）在腹股沟区疝诊断中的价值。 方法 回顾性分析2009年6-12月96例经临床证实为腹股沟区疝患者的CT图像资料。通过多平面重建技术获得冠状位及矢状位图像，评价不同平面图像在腹股沟区疝诊断及分类中的应用价值。 结果 63例斜疝患者（66疝）疝囊于腹壁下动脉外侧经腹股沟深环进入腹股沟管，疝囊位于精索或圆韧带前侧（43/66，65.2%）或前内侧（15/66，22.7%）；30例直疝患者（37疝）疝囊位于腹壁下动脉内侧，位于精索内侧（27/37，73.0%）；斜疝及直疝疝囊均走行于腹股沟韧带前上方；3例股疝患者（3疝）疝囊位于腹股沟韧带后下方，冠状位“影像学股三角”内。 结论 MDCT对腹股沟区疝的诊断与鉴别诊断具有重要价值，可为手术前评估及手术中操作提供重要参考信息。【Abstract】 Objective To assess the value of multi-detector row CT (MDCT) in diagnosis of the inguinal region hernia. Methods The CT images of 96 patients with inguinal region hernia from June to December 2009 were retrospectively analyzed. The diagnosis and application of coronal and sagittal views in inguinal region hernia were assessed by multi-planer reconstruction. Results Hernia sac in 63 indirect hernia patients (66 hernias) originated lateral to the inferior epigastric artery enter the inguinal canal through the deep ring, anterior (43/63,68.3%) or anteromedial (15/63,23.8%) to the spermatic cord or round ligament;sac in 30 direct hernia patients (37 hernias) originated medial to the inferior epigastric artery, medial to the spermatic cord;both indirect and direct hernia sac located anterosuperior to the inguinal ligament;sac in three femoral hernia patients (three hernias) located posterior to the inguinal ligament and inside the “radiological femoral triangle” of coronal views. Conclusion MDCT plays on important role in diagnosing the inguinal region hernia, and provides critical information for preoperative and intraoperative.
Objective To investigate the application of multi-detector row spiral CT （MDCT） and multi-planer reconstruction （MPR） in identify the anatomy detail of normal adult groin region. Methods We retrospectively collected the CT images of 50 adult subjects with normal groin anatomic structure underwent groin region thin-slice MDCT scans between July and December 2009, 30 males and 20 females, obtained the coronal and sagittal views by MPR, investigated the value of different plans in identifying anatomic detail. Results Bilateral inferior epigastric artery (100/100, 100%), spermatic cord (60/60, 100%), and round ligament of uterus (40/40, 100%) were well identified on all plans in all subjects. The bilateral “radiological femoral triangle” could be demonstrated on coronal views in all subjects (100/100, 100%). The bilateral inguinal ligament were visible on coronal view in all subjects (100/100, 100%) and on sagittal views in 34 subjects (68/100, 68%), but on axial views was identified in 3 male subjects (6/100, 6%). The bilateral inguinal canal and deep inguinal ring were reliably visible on coronal views in all subjects (100/100, 100%), and on sagittal views in 46 subjects (92/100, 92%). On coronal views, the widths of inguinal canal was (0.97±0.35) cm in left, (0.89±0.23) cm in right for males, and (0.62±0.11) cm in left, (0.71±0.11) cm in right for females. No significant difference was found between two sides (P=0.059 in males， P=0.067 in females), but there were significant differences between males and females (P=0.007 in left， P=0.009 in right). Transverse diameter of deep inguinal ring was (1.32±0.31) cm in left, (1.31±0.36) cm in right for males, and (1.07±0.35) cm in left, (1.07±0.30) cm in right for females. No significant difference was found between two sides (P=0.344 in males， P=0.638 in females), but there were significant differences between males and females (P=0.001 in left， P=0.002 in right). Conclusion MDCT with different plans plays an important role in identify the anatomic details of groin region, the coronal views especially.