Adolescent ; Blood Vessels ; pathology ; Female ; Femur Head ; blood supply ; pathology ; Femur Head Necrosis ; pathology ; Humans ; Male

OBJECTIVETo study the anatomy of the anterolateral thigh perforators flap and explore its clinical application in the reconstruction of head and neck defects.

METHODSFive adult fresh cadavers were prepared, and morphosis and blood supply of anterolateral thigh flap perforators were examined by microsurgery anatomy. During dissections, the following parameters were recorded: number and type of perforators vessels, diameter of perforators, pedicle length, diameter of the original vessels, route (infra fascia and supra fascia); its position were located by anatomical landmark.

RESULTSThere were an average of (4.4 +/- 1.8) anterolateral thigh perforators flaps (ALTP flap) in each specimen with 68.2% musculocutaneous perforator and 31.8% septocutaneous perforator. The mean pedicle length of the largest perforator was (10.86 +/- 1.18) cm (8.29-14.44) cm, and its location was constantly concentrated in the superolateral region of the midpoint of the line linking the anterosuperior iliac spine and superolateral border of the patella. The distance between surface location of the largest perforator and the midpoint was (3.25 +/- 0.69) cm. Original vessel was mostly descend branch of lateral circumflex femoral artery/vein with average diameter of (3.16 +/- 0.59) / (3.08 +/- 0.02) mm.

CONCLUSIONALTP flap has constant position, large caliber, and long pedicle and therefore is useful for operation and option in reconstruction of head neck defects.

Aged ; Autopsy ; Head ; surgery ; Humans ; Middle Aged ; Neck ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps ; blood supply ; Thigh ; blood supply ; surgery

The present paper aims to investigate whether or not vasculogenic mimicry (VM) exists in laryngeal squamous cell carcinoma (LSCC), and to elucidate its relationship to microvessel density (MVD), galectin-3 (Gal-3) expression, and clinicopathological factors of patients with LSCC. VM, score of MVD and expression of Gal-3 protein were detected by immunohistochemistry and histochemistry in 83 specimens of LSCC tissue and 20 specimens of normal laryngeal tissue. The positive rate of VM in normal laryngeal tissues was 0%, and was 33.7% in LSCC tissues. There was a significant difference between the two groups (P<0. 01). VM or MVD was significantly related to differentiation, pTNM stages and lymph node metastasis of LSCC (P<0.05), but not to age, gender and tumor site (P>0. 05). And there was a positive correlation between every two of VM, score of MVD, and Gal-3 protein (P< 0. 05). The results suggest that expression of Gal-3 protein may be related to the initiation, angiogenesis and VM formation in LSCC; And VM, angiogenesis and Gal-3 protein may be involved in the development, invasion and metastasis of LSCC.
Carcinoma, Squamous Cell ; blood supply ; Galectin 3 ; metabolism ; Head and Neck Neoplasms ; blood supply ; Humans ; Immunohistochemistry ; Laryngeal Neoplasms ; blood supply ; Lymphatic Metastasis ; Neovascularization, Pathologic ; Prognosis

OBJECTIVETo detect the blood perfusion of the necrotic area and the femoral head and neck junction in the patients diagnosed as osteonecrosis of femoral head (ONFH) with laser doppler flowmetry (LDF).

METHODSFrom 2007 to 2008, 50 patients with ONFH 82 hips were performed core decompression and autologous stem cells transplantation. Group A was for ARCO stage II 46 hips (IIA 6 hips, IIB 22 hips, IIC 18 hips), and Group B was for stage III 36 hips (IIIA 20 hips, IIIB 10 hips, IIIC 6 hips). Blood perfusion of necrotic area and femoral head and neck junction with LDP were detected during the operation. Statistical analysis was made.

RESULTSIn Group A, the perfusion volume of necrotic area was (30.2 +/- 3.0) PU, and the perfusion volume of femoral head and neck junction was (103.4 +/- 4.4) PU. In Group B, the perfusion volume of necrotic area was (30.6 +/- 2.8) PU, and the perfusion volume of femoral head and neck junction was (103.4 +/- 3.9) PU. In Group A and Group B, the perfusion volume of necrotic area was lower than that of femoral head and neck junction, and the difference was significant (P < 0.01).

CONCLUSIONSLDF can effectively detect that the perfusion volume of ONFH decreased, which provides a theoretical basis in order to further study the pathogenesis of ONFH. Meanwhile, there is application value of LDF on the study of ONFH.

Adult ; Female ; Femur Head ; blood supply ; Femur Head Necrosis ; pathology ; Hemodynamics ; Humans ; Laser-Doppler Flowmetry ; Male ; Microcirculation ; Middle Aged

Balanced steady-state free precession (bSSFP) is a highly efficient pulse sequence that is known to provide the highest signal-to-noise ratio per unit time. Recently, bSSFP is getting increasingly popular in both the research and clinical communities. This review will be focusing on the application of the bSSFP technique in the context of probing the physiological and functional information. In the first part of this review, the basic principles of bSSFP are briefly covered. Afterwards, recent developments related to the application of bSSFP, in terms of physiological and functional imaging, are introduced and reviewed. Despite its long development history, bSSFP is still a promising technique that has many potential benefits for obtaining high-resolution physiological and functional images.
Cervical Vertebrae/*blood supply/radiography ; Head/*blood supply/radiography ; Humans ; Image Processing, Computer-Assisted/*methods ; Magnetic Resonance Imaging/*methods ; Signal-To-Noise Ratio

OBJECTIVE: This study was designed to evaluate the usefulness of three-phase CT to characterize the hemodynamics of vascular lesions in the head and neck area. MATERIALS AND METHODS:We analyzed vascular malformations of head and neck regions in 21 patients with the use of three-phase CT, including pre-contrast phase, vascular phase (scan delay: 20-35 seconds after intravenous contrast material injection) and equilibrium phase (scan delay: 3-5 minutes) imaging. The flow characteristic of each lesion was determined and categorized as either a high- or a low-flow lesion according to findings on selective arteriography and/or direct puncture venography. The CT number was acquired from two areas in a vascular lesion, sorted by the enhancement pattern: area 1, a highly enhanced area seen on the vascular phase; area 2, a delayedly enhanced area seen on the equilibrium phase. The CT numbers of each phase were compared between high- and low-flow lesions with use of the unpaired t-test. The flow patterns of high- and low-flow lesions were analyzed by assessment of time-density curves of three phase CT. RESULTS: High-flow lesions were detected in nine patients and low-flow lesions were detected in 12 patients. On the vascular phase, the CT number of areas 1 and 2 of high-flow lesions was significantly higher than for low-flow lesions (p < 0.05). Contrary to early peaks seen in time-density curves of high-flow lesions, low-flow lesions showed a delayed peak. CONCLUSION: Three-phase CT seems to be a valuable non-invasive method to differentiate a high-flow lesion from a low flow lesion of head and neck vascular lesions.
Adolescent ; Adult ; Angiography/methods ; Arteriovenous Malformations/*radiography ; Child ; Female ; Head/*blood supply ; Humans ; Male ; Middle Aged ; Neck/*blood supply ; Tomography, X-Ray Computed/*methods

Superficial veins of the head and neck are utilised for central venous cannulation, oral reconstruction and parenteral nutrition in debilitated patients. Clinical and sonological examinations of these veins may provide clues toward underlying cardiac pathology. Hence, although variations in these vessels are common, a sound knowledge of such variations becomes clinically important to surgeons, radiologists and interventional anaesthetists. We report a rare case of a left-sided double external jugular vein where the common facial vein continued as the second external jugular vein, and where there was a communicating channel between the internal jugular vein on the same side and the anterior jugular vein.
Brachiocephalic Veins ; abnormalities ; Cadaver ; Head ; blood supply ; Humans ; Jugular Veins ; abnormalities ; Male ; Middle Aged ; Neck ; blood supply ; Subclavian Vein ; abnormalities ; Vascular Malformations ; diagnosis

OBJECTIVETo explore the application of MS-CT and 3D reconstruction in diagnosis and treatment of vascular malformations in head and neck.

METHODS20 cases with vascular malformations in head and neck underwent MS-CT and 3-D reconstruction. Then the treatment was determined based on the results of MSCT scanning. The postoperative results were evaluated.

RESULTSThe images of MS-CT showed the edge of vascular malformations partially or completely in 16 cases of venous malformations. The lesion's anatomic site and 3-D position was obtained. The 3-D images also showed the overexpanded supply arteries in 4 case of arteriovenous malformations. 2 case of venous malformations in lip underwent resection and healed completely. 12 cases of venous malformations in buccal and floor of mouth were treated with compartmentalized sclerotherapy with partial lesion involution. 2 case of venous malformations in mouth floor were treated with operation followed by sclerotherpy with partial lesion involution. 4 cases of arteriovenous malformations were treated with Superselective Artery Embolization with partial lesion involution.

CONCLUSIONMS-CT and 3D reconstruction can play an important role in diagnosis and treatment of vascular malformations in head and neck.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Head ; blood supply ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Neck ; blood supply ; Tomography, Spiral Computed ; Vascular Malformations ; diagnostic imaging ; surgery ; Young Adult

OBJECTIVE: To investigate the usefulness of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion MRI for the evaluation of femoral head ischemia. MATERIALS AND METHODS: Unilateral femoral head ischemia was induced by selective embolization of the medial circumflex femoral artery in 10 piglets. All MRIs were performed immediately (1 hour) and after embolization (1, 2, and 4 weeks). Apparent diffusion coefficients (ADCs) were calculated for the femoral head. The estimated pharmacokinetic parameters (Kep and Ve from two-compartment model) and semi-quantitative parameters including peak enhancement, time-to-peak (TTP), and contrast washout were evaluated. RESULTS: The epiphyseal ADC values of the ischemic hip decreased immediately (1 hour) after embolization. However, they increased rapidly at 1 week after embolization and remained elevated until 4 weeks after embolization. Perfusion MRI of ischemic hips showed decreased epiphyseal perfusion with decreased Kep immediately after embolization. Signal intensity-time curves showed delayed TTP with limited contrast washout immediately post-embolization. At 1-2 weeks after embolization, spontaneous reperfusion was observed in ischemic epiphyses. The change of ADC (p = 0.043) and Kep (p = 0.043) were significantly different between immediate (1 hour) after embolization and 1 week post-embolization. CONCLUSION: Diffusion MRI and pharmacokinetic model obtained from the DCE-MRI are useful in depicting early changes of perfusion and tissue damage using the model of femoral head ischemia in skeletally immature piglets.
Animals ; Arteries/physiopathology ; Diffusion Magnetic Resonance Imaging/*methods ; Disease Models, Animal ; Embolism/complications ; Epiphyses/*blood supply/*pathology ; Femur Head/*blood supply/*pathology ; Male ; Osteonecrosis/pathology ; Pelvic Bones/blood supply/pathology ; Reperfusion Injury/complications/*diagnosis ; Swine

OBJECTIVETo observe the pathological changes in the blood vessels in rabbit femoral head with glucocorticoid-induced necrosis and investigate the pathogenesis of glucocorticoid-induced osteonecrosis.

METHODSTwenty New Zealand white rabbits were randomly divided into two groups, namely group A. which was injected with horse serum and prednisone and group B as the control group. Chinese ink was injected into the femoral cavity of the rabbits to observe the blood vessels in the femoral head under optical microscope and the femoral head was examined histopathologically.

RESULTSCompared with the normal control group, the rabbits in group A had significantly decreased number of perfused vessels, which was featured by defective perfusion, osteocytie pyknosis or necrosis, increase of empty ostoocyte lacunae and fat cells, decrease of hematopoietic tissue, and blood vessel occlusion.

CONCLUSIONVascular occlusion and vasculitis due to glucocorticoid treatment may cause avascular necrosis of the femoral head.

Animals ; Blood Vessels ; pathology ; Female ; Femur Head ; blood supply ; pathology ; Femur Head Necrosis ; chemically induced ; pathology ; Male ; Prednisolone ; Rabbits ; Random Allocation ; Vasculitis ; pathology