Annals of Anatomy-Anatomischer Anzeiger最新文献_第4页

Histological methods to quantify changes of white and brown adipose tissue in response to a high content fat diet in mice 用组织学方法量化小鼠高脂肪饮食后白色和棕色脂肪组织的变化

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2025-09-20 DOI: 10.1016/j.aanat.2025.152738

Giulia Lazzarini , Lorenzo Flori , Andrea Pirone , Elisabetta Giannessi , Lara Testai , Vincenzo Calderone , Vincenzo Miragliotta

Background

Obesity is a major global health challenge associated with increased risk of metabolic, cardiovascular, and inflammatory diseases. White (WAT) and brown adipose tissue (BAT) are highly dynamic tissues, capable of morphological and functional adaptation in response to nutritional and metabolic changes.

Methods

This study investigated histological alterations in WAT and BAT of Balb/c mice subjected to either a standard diet (STD) or high-fat diet (HFD) for 10 weeks. Adipocyte density, lipid vacuole size, macrophage infiltration and their immunophenotype were measured in WAT and BAT, while UCP1 expression was measured in BAT only. Four-µm thick sections obtained from FFPE samples were H&E stained or immunostained with anti-UCP1, anti-Iba1 and anti-CD163.

Results

In WAT from HFD-fed mice, a significant increase in adipocyte size and a decrease in cell density were observed, indicating hypertrophy without evident hyperplasia. BAT exhibited larger and more dispersed lipid droplets, reduced cell density, and decreased UCP1 immunoreactivity, consistent with a whitening process and impaired thermogenic function. Additionally, immunohistochemical analysis revealed changes in macrophage distribution in WAT, with a reduction in anti-inflammatory CD163 + cells and clustering of Iba1 + macrophages, suggesting a shift in macrophage polarization.

Conclusions

These findings highlight the histological adaptability of adipose tissue under different dietary conditions and reinforce the importance of morphological analysis in understanding obesity-related tissue remodeling.

背景：肥胖是一项主要的全球健康挑战，与代谢性、心血管和炎症性疾病的风险增加有关。白色脂肪组织（WAT）和棕色脂肪组织（BAT）是高度动态的组织，能够根据营养和代谢变化进行形态和功能适应。方法观察Balb/c小鼠标准饮食（STD）和高脂饮食（HFD） 10周后WAT和BAT的组织学变化。在WAT和BAT中检测脂肪细胞密度、脂质液泡大小、巨噬细胞浸润及其免疫表型，而仅在BAT中检测UCP1的表达。从FFPE样品中获得4µm厚的切片，进行H&；E染色或抗ucp1、抗iba1和抗cd163免疫染色。结果hfd喂养小鼠WAT脂肪细胞大小明显增加，细胞密度明显降低，呈肥大，但未见明显增生。BAT表现出更大、更分散的脂滴，细胞密度降低，UCP1免疫反应性降低，与增白过程一致，产热功能受损。此外，免疫组织化学分析显示WAT中巨噬细胞分布发生变化，抗炎CD163 + 细胞减少，Iba1 + 巨噬细胞聚集，提示巨噬细胞极化发生改变。结论这些发现突出了脂肪组织在不同饮食条件下的组织学适应性，并加强了形态学分析在理解肥胖相关组织重塑中的重要性。

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引用次数: 0

Ethical use of the human body for teaching anatomy is not transgressive 在解剖学教学中道德地使用人体并没有越界。

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2025-09-19 DOI: 10.1016/j.aanat.2025.152736

Bernard Moxham , Diogo Pais , Odile Plaisant , Beverley Kramer

A transgressive act is one that breaks a moral code, going beyond what are acceptable boundaries of taste and decorum. In this regard, the history of anatomy, although illustrious, is also inglorious as body snatching by resurrectionists and the anatomisation of convicted and executed prisoners is nowadays universally condemned and recognised as being transgressive. The public display of anatomised bodies in contemporary times, whether or not the bodies are obtained legally, is controversial and is arguably transgressive, as is the dissection of unclaimed bodies for the education of healthcare professionals. It has also been claimed that, even when bodies are obtained from donors who have given informed consent, anatomical dissection for the education of healthcare workers involves transgressive behaviour that does not fit with modern concepts of a caring, life-enhancing practitioner. Consequently, there are medical schools that do not have anatomy dissection rooms, and the use of digitalised anatomical imagery is advocated as a more moral pedagogic tool. However, not all the digitised images emanate from consented individuals. In this article, we argue that the public display of anatomised bodies (including the display and publication of images without informed consent) and the use of unclaimed bodies for dissection are transgressive. We are of the opinion that the dissection of human bodies obtained through a donor programme need not be transgressive if due respect is accorded the donated bodies and if the students benefitting from the experience are properly controlled, well-informed about the ethical issues, and if the process considers issues relating to equality, diversity and inclusivity.

越轨行为是违反道德准则的行为，超出了品味和礼仪的可接受范围。在这方面，解剖学的历史虽然辉煌，但也不光彩，因为复活者的身体掠夺和对被定罪和被处决的囚犯的解剖现在普遍受到谴责，并被认为是违法的。在当代，公开展示解剖过的尸体，无论尸体是否合法获得，都是有争议的，可以说是违法的，就像解剖无人认领的尸体来教育医疗专业人员一样。还有人声称，即使从已给予知情同意的捐赠者处获得尸体，为保健工作者的教育进行解剖也涉及违法行为，不符合关怀、改善生活的行医者的现代概念。因此，有些医学院没有解剖解剖室，而数字化解剖图像的使用被提倡为一种更道德的教学工具。然而，并非所有的数字化图像都来自个人同意。在这篇文章中，我们认为公开展示解剖过的尸体（包括未经知情同意的图像展示和出版）和使用无人认领的尸体进行解剖是违法的。我们认为，透过捐赠计划为教学目的而进行的人体解剖，只要对捐赠的遗体给予应有的尊重，而从中受益的学生受到适当的控制，对伦理问题有充分的了解，并考虑到平等、多元和包容的问题，就不必触犯法律。

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引用次数: 0

Beyond four heads: Should the quadriceps femoris be reclassified as multiceps muscle? 超越四个头：股四头肌应该被重新分类为多头肌吗？

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2025-09-19 DOI: 10.1016/j.aanat.2025.152737

Łukasz Olewnik , Ingrid C. Landfald , Kacper Ruzik , Judney Cley Cavalcante , Maria Piagkou , George Triantafyllou , Teresa Vázquez , Paloma Aragones , Fabrice Duparc

Background

The quadriceps femoris (QF) is classically described as a four-headed muscle. However, anatomical and radiological studies increasingly reveal supernumerary heads and tendon stratifications, challenging this concept.

Objective

This review synthesizes current cadaveric, imaging, and surgical evidence to propose a reclassification of QF as a multiceps femoris (MF). A five-type tendon-based classification system is introduced, reflecting distinct morphological variants and layering complexities.

Methods

An extensive review of anatomical dissection studies, radiological investigations (MRI and ultrasound), and clinical reports were conducted to evaluate morphological variability and its implications for tendon harvesting and surgical access.

Results

Accessory heads such as the tensor vastus intermedius and caput tertium were present in over 60 % of cases, often contributing to distinct layers within the quadriceps femoris tendon (QFT). These configurations influence graft length, harvesting safety, and radiological interpretation. Misidentification of these structures may result in surgical complications or diagnostic errors. Functional and evolutionary analogies with other multiceps systems support the anatomical independence of these heads.

Conclusion

The MF model aligns with modular systems seen in the triceps surae and biceps femoris. Recognizing QF as MF offers a more anatomically accurate and clinically relevant framework. Adoption of updated terminology and imaging protocols may improve diagnosis, reduce surgical risk, and support personalized interventions.

背景：股四头肌（QF）被经典地描述为一个四头肌。然而，解剖学和放射学研究越来越多地揭示了多余的头部和肌腱分层，挑战了这一概念。目的：本文综合目前的尸体、影像学和外科证据，提出将QF重新分类为股多头肌（MF）。介绍了一种基于肌腱的五类分类系统，反映了不同的形态变异和分层复杂性。方法：广泛回顾解剖解剖研究、放射学调查（MRI和超声）和临床报告，以评估形态变异及其对肌腱收获和手术通路的影响。结果：超过60%的病例中存在股中间张肌和三角肌头等副头，通常导致股四头肌肌腱（QFT）内的不同层。这些结构影响接枝长度、收获安全性和放射学解释。这些结构的错误识别可能导致手术并发症或诊断错误。与其他多头肌系统的功能和进化相似性支持这些头部在解剖学上的独立性。结论：MF模型与三头肌表面和股二头肌的模块化系统一致。将QF识别为MF提供了一个解剖学上更准确和临床相关的框架。采用更新的术语和成像协议可以提高诊断，降低手术风险，并支持个性化干预。

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引用次数: 0

Early-career anatomical networks: Lviv professor of anatomy Henryk Kadyi as a Habsburg case study 早期职业解剖学网络：利沃夫解剖学教授Henryk Kadyi作为哈布斯堡案例研究。

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2025-09-13 DOI: 10.1016/j.aanat.2025.152734

Leo Schaukal , Sophia Bauer , Uliana Pidvalna , Ryszard Gryglewski , Lesya Mateshuk-Vatseba , Wolfgang J. Weninger

Background

This article addresses the formation of academic networks among anatomists in the Austro-Hungarian Empire in the late 19th century during the earliest part of their careers, their student years, at the capital’s university (University of Vienna), based on the example of the Galician anatomist Henryk Kadyi.

Material and methods

This comparative inquiry is based on archive material from the Lviv Regional State Archive, the Central State Historical Archives of Ukraine in Lviv (both Ukraine), the Archive of the University of Vienna, the Austrian State Archive (both Austria) and the Archives of the Jagiellonian University (Poland).

Results

Archival sources show the variety of contacts a medical student could form within the anatomical community (both with teachers and student colleagues), which constituted the foundation for connections that lasted for an academic lifetime. The study demonstrates which knowledge, techniques, and methods were circulated within these newly formed anatomical networks. Kadyi was not a unique case but rather just one example of a broader dynamic among Galician students who came to Vienna.

Conclusion

Research on early-career networks is a promising approach for studying academic networks, especially their starting point, as the example of Henryk Kadyi proves. The importance of long-lasting contacts formed during an early academic career and their continued impact over the following years and decades cannot be overstated.

背景：本文以加利西亚解剖学家亨利克·卡迪（Henryk Kadyi）为例，探讨了19世纪末奥匈帝国解剖学家在其职业生涯的早期阶段，即他们在首都大学（维也纳大学）的学生时代，学术网络的形成。材料和方法：这项比较调查是基于来自利沃夫地区国家档案馆、乌克兰利沃夫中央国家历史档案馆（都是乌克兰）、维也纳大学档案馆、奥地利国家档案馆（都是奥地利）和雅盖隆大学档案馆（波兰）的档案材料。结果：档案资料显示医学生在解剖学群体中（包括与老师和学生同事）可以形成各种各样的联系，这构成了持续学术生涯的联系的基础。研究表明，哪些知识、技术和方法在这些新形成的解剖学网络中流传。卡迪并不是一个独特的案例，而只是来维也纳的加利西亚学生中更广泛的动态的一个例子。结论：正如Henryk Kadyi的例子所证明的那样，早期职业网络的研究是研究学术网络，特别是其起点的一种很有前途的方法。在早期学术生涯中形成的长期交往的重要性及其在接下来的几年和几十年里的持续影响怎么强调都不为过。

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引用次数: 0

Retrograde lymphatic pressure experiments on the human thoracic duct in Thiel embalmed specimens: Using short alternating pressure sequences, combined with microscopic video recordings Thiel防腐标本人体胸导管逆行淋巴压力实验：使用短时间交替压力序列，结合显微录像。

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2025-09-11 DOI: 10.1016/j.aanat.2025.152735

Michael E.J. Stouthandel , Charlotte Debbaut , Anna Boogaerts , Laura Boone , Silke Dumoulein , Jurgen Deviche , Bernard Depypere , Dominique Adriaens , Tom Van Hoof

Background

More accurate data of the anatomical location of the lymphatic system in relation to the surrounding anatomy is required to optimize radiotherapy treatment planning. To accurately visualize/map these anatomical relationships in 3D, contrast agent needs to be injected into the lymphatic vessels, so they are visible on medical imaging data (CT/micro-CT). Retrograde lymphatic injections (injections against the lymphatic flow/valve direction) have theoretical advantages for lymphatic mapping studies, but more data on lymphatic vessel wall and valve behavior is needed to optimize retrograde lymphatic injection methodologies.

Methods

Quickly alternating (30 sec) infusion pressures were tested on thoracic duct specimens and experiments were recorded using a surgical microscope. Manual injection was added after each pressure sequence.

Results

Infusion pressures up to and including 25 mmHg frequently showed retrograde filling. Above pressures of 25 mmHg, retrograde filling was rare and lymphatic valves frequently withstood infusion pressures of up to 75 mmHg. Microscopic video recordings proved very useful for data analysis.

Conclusions

Quickly alternating infusion pressures did not stimulate valve breakage, but seemed to protect lymphatic walls from ruptures at higher pressures. A distinction between inherently weak valves, and strong valves that can withstand infusion pressures of up to 75 mmHg was uncovered. Retrograde filling sometimes coincides with antegrade filling, depending on lymphatic network organization, but this can be beneficial for lymphatic mapping. Flow through lymph nodes should be studied in more detail in future retrograde injection studies, since different types of lymph nodes were encountered that showed distinct filling patterns.

背景：需要更准确的淋巴系统相对于周围解剖结构的解剖位置数据来优化放疗计划。为了在3D中准确地可视化/绘制这些解剖关系，需要将造影剂注射到淋巴管中，以便在医学成像数据（CT/micro-CT）上可见。逆行淋巴注射（逆淋巴管流动/瓣膜方向注射）在淋巴管测绘研究中具有理论上的优势，但需要更多关于淋巴管壁和瓣膜行为的数据来优化逆行淋巴注射方法。方法：对胸导管标本进行快速交替（30sec）输注压力测试，并在手术显微镜下记录实验结果。每个压力序列后加入手动注射。结果：25mmHg及以下输注压力常出现逆行充盈。在25mmHg以上的压力下，逆行填充是罕见的，淋巴阀经常承受高达75mmHg的输注压力。显微录像证明对数据分析非常有用。结论：快速交替输注压力不会刺激瓣膜破裂，但似乎可以保护淋巴壁在更高压力下免于破裂。发现了固有的弱阀和可以承受高达75mmHg输液压力的强阀之间的区别。逆行填充有时与顺行填充重合，这取决于淋巴网络组织，但这可能有利于淋巴制图。由于不同类型的淋巴结表现出不同的填充模式，因此在未来的逆行注射研究中应更详细地研究通过淋巴结的血流。

{"title":"Retrograde lymphatic pressure experiments on the human thoracic duct in Thiel embalmed specimens: Using short alternating pressure sequences, combined with microscopic video recordings","authors":"Michael E.J. Stouthandel , Charlotte Debbaut , Anna Boogaerts , Laura Boone , Silke Dumoulein , Jurgen Deviche , Bernard Depypere , Dominique Adriaens , Tom Van Hoof","doi":"10.1016/j.aanat.2025.152735","DOIUrl":"10.1016/j.aanat.2025.152735","url":null,"abstract":"<div><h3>Background</h3><div>More accurate data of the anatomical location of the lymphatic system in relation to the surrounding anatomy is required to optimize radiotherapy treatment planning. To accurately visualize/map these anatomical relationships in 3D, contrast agent needs to be injected into the lymphatic vessels, so they are visible on medical imaging data (CT/micro-CT). Retrograde lymphatic injections (injections against the lymphatic flow/valve direction) have theoretical advantages for lymphatic mapping studies, but more data on lymphatic vessel wall and valve behavior is needed to optimize retrograde lymphatic injection methodologies.</div></div><div><h3>Methods</h3><div>Quickly alternating (30 sec) infusion pressures were tested on thoracic duct specimens and experiments were recorded using a surgical microscope. Manual injection was added after each pressure sequence.</div></div><div><h3>Results</h3><div>Infusion pressures up to and including 25 mmHg frequently showed retrograde filling. Above pressures of 25 mmHg, retrograde filling was rare and lymphatic valves frequently withstood infusion pressures of up to 75 mmHg. Microscopic video recordings proved very useful for data analysis.</div></div><div><h3>Conclusions</h3><div>Quickly alternating infusion pressures did not stimulate valve breakage, but seemed to protect lymphatic walls from ruptures at higher pressures. A distinction between inherently weak valves, and strong valves that can withstand infusion pressures of up to 75 mmHg was uncovered. Retrograde filling sometimes coincides with antegrade filling, depending on lymphatic network organization, but this can be beneficial for lymphatic mapping. Flow through lymph nodes should be studied in more detail in future retrograde injection studies, since different types of lymph nodes were encountered that showed distinct filling patterns.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152735"},"PeriodicalIF":1.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anatomic mapping of osteochondral lesions of the distal tibial plafond reveals regional lesion characteristics – A retrospective MRI study 胫骨远端平台骨软骨病变的解剖定位揭示了区域病变特征-回顾性MRI研究。

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2025-09-11 DOI: 10.1016/j.aanat.2025.152733

Zheheng Li , Lin Huang , Wei Wei , Jie Zhao , Jinshan Xing , Lei Zhang

Background

Current systematic imaging analyses of osteochondral lesions of the distal tibial plafond (OLTP) remain insufficient. This study aimed to define the anatomical characteristics of OLTP using MRI to provide detailed morphological data that can guide diagnosis and inform surgical decision-making.

Methods

We retrospectively analyzed MRI data from 105 OLTP patients (mean age 47.88 ± 16.46 years; 51 males, 54 females). Anatomical parameters were measured, and statistical analyses were performed to compare results across different lesion zones, sexes, and laterality (left and right).

Results

The anterolateral zone (Zone 3) and anterocentral zone (Zone 2) of the distal tibial plafond were the most frequently injured areas, accounting for 25.71 % and 24.76 % of cases, respectively. The central-medial zone (Zone 4) demonstrated the most severe lesions, with the lesion area in the sagittal view measuring 162.86 ± 91.95 mm² and the lesion area in the axial view reaching 213.07 ± 135.31 mm². Pairwise comparisons of anatomical parameters across specific injury zones showed statistically significant differences (P < 0.05) in the maximum width of the lesion in the sagittal view, the lesion area in the sagittal view, and the depth of osteochondral lesion with subchondral bone involvement. Furthermore, males had significantly greater cartilage thickness and deeper lesions than females (P < 0.05), with no significant laterality differences.

Conclusion

This study provides the first systematic anatomical map of OLTP, revealing significant regional variations in lesion distribution and sex-specific differences. These findings offer objective criteria to enhance diagnostic precision and guide personalized treatment.

背景：目前对胫骨远端平台（OLTP）骨软骨病变的系统影像学分析仍然不足。本研究旨在通过MRI确定OLTP的解剖学特征，为指导诊断和手术决策提供详细的形态学数据。方法：回顾性分析105例OLTP患者的MRI资料（平均年龄：47.88±16.46岁，男51例，女54例）。测量解剖参数，并进行统计分析，比较不同病变区域、性别和侧边（左和右）的结果。结果：胫骨远端平台前外侧区（3区）和前中央区（2区）是最常见的损伤区域，分别占25.71%和24.76%。中内侧区（4区）病变最严重，矢状面病变面积为162.96±91.95mm²，轴向面病变面积为213.07±135.31mm²。各损伤区解剖参数两两比较，矢状面最大病变宽度、矢状面病变面积、软骨下受累骨软骨病变深度差异均有统计学意义（P < 0.05）。此外，男性的软骨厚度和病变深度均显著高于女性（P < 0.05），但侧边性差异不显著。结论：本研究首次提供了OLTP的系统解剖图谱，揭示了病变分布的明显区域偏好和性别差异。这些发现为提高诊断精度和指导个性化治疗提供了客观标准。

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引用次数: 0

Innervation pattern of the anterolateral ligament (ALL) of the knee: Indication of an active role in proprioception and autonomic modulation 膝关节前外侧韧带（ALL）的神经支配模式：在本体感觉和自主神经调节中起积极作用的指示。

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2025-09-11 DOI: 10.1016/j.aanat.2025.152732

P. Arviza-Lorenzo , P. Aragonés , F.J. Valderrama-Canales , M. Schicht , F. Paulsen , T. Tschernig , M. Brockmeyer , K. Ruzik , M.T. Vázquez Osorio

Background

The anterolateral ligament (ALL) of the knee is increasingly recognized as a key structure in rotational stability, yet its anatomical and functional properties remain incompletely understood. This study investigates the innervation of the ALL using immunohistochemistry and electron microscopy to characterize its neurochemical profile and structural organization.

Methods

Seventeen ALL samples from adult human body donors were analyzed. Thirteen were examined using immunohistochemical staining for PGP9.5 (ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1)), VAChT (Vesicular acetylcholine transporter), TH (tyrosine hydroxylase), CGRP (calcitonin gene-related peptide), and NOS (nitric oxide synthase). Four additional samples underwent transmission electron microscopy to assess ultrastructural features. Six Fibular collateral ligaments (FCL) were used as controls.

Results

All ALL specimens displayed positive immunoreactivity for the markers evaluated, confirming the presence of neurochemically diverse peripheral nerve fibers. Both myelinated and unmyelinated fibers were identified, though no encapsulated mechanoreceptors were observed. The innervation pattern was comparable to that of the (FCL), used as a control.

Conclusion

The ALL is a richly innervated structure with sensory, autonomic, and potential for neuromodulation, suggesting an active role in proprioception and homeostasis. These findings challenge previous views of the ALL as a passive capsular thickening and underscore its functional relevance in knee joint physiology.

背景：膝关节前外侧韧带（ALL）越来越被认为是维持旋转稳定性的关键结构，但其解剖学和功能特性仍不完全清楚。本研究利用免疫组织化学和电子显微镜研究ALL的神经支配，以表征其神经化学特征和结构组织。方法：对17例成人供体ALL样本进行分析。13例采用免疫组化染色检测PGP9.5（泛素羧基末端水解酶L1 (UCH-L1)）、VAChT（囊泡乙酰胆碱转运蛋白）、TH（酪氨酸羟化酶）、CGRP（降钙素基因相关肽）和NOS（一氧化氮合酶）。另外四个样品通过透射电子显微镜观察其超微结构特征。6条腓骨副韧带（FCL）作为对照。结果：所有All标本对评估的标记物显示阳性免疫反应，证实存在神经化学多样性的周围神经纤维。髓鞘纤维和无髓鞘纤维均被鉴定，但未观察到包封的机械感受器。神经支配模式与作为对照的（FCL）相当。结论：ALL是一个神经支配丰富的结构，具有感觉、自主神经和神经调节的潜力，在本体感觉和体内平衡中起着积极的作用。这些发现挑战了以前认为ALL是一种被动囊增厚的观点，并强调了其在膝关节生理学中的功能相关性。

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引用次数: 0

Further findings on anterolateral thigh flap (ALT) perforasome anatomy: Contribution of epoxy resin injection technique followed by virtual microdissection 大腿前外侧皮瓣（ALT）穿体解剖的进一步发现：环氧树脂注射技术和虚拟显微解剖的贡献。

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2025-09-10 DOI: 10.1016/j.aanat.2025.152726

Jérémy Hardy , Fabien Fredon , Cynthia Abane , Sylvaine Durand Fontanier

Introduction

The aim of this study was to specify the morphology and relative importance of the types of arterial anastomoses between the different perforasomes constituting the anterolateral thigh (ALT) flap vascular tree.

Methods

15 ALT flaps were injected on a single perforator with epoxy resin and then analyzed via 3D CT microangiography. Data were processed using a broad binary threshold based on the Hounsfield density of the various contrast-enhanced arteries. A virtual dissection of the 3D images associated with a virtual segmentation of the flap's vascular tree was then performed, enabling direct visualization of the various means of connection between the different perforasomes.

Results

The average surface area of the flap's vascular territory was 190.5 cm2.

The various perforasomes were linked via

40 % of mixed anastomoses including both arteries from the subdermal plexus AND the suprafascial plexus, 35 % of exclusively suprafascial anastomoses, 25 % of exclusively subdermal anastomoses. Some connections via the dermal plexus could be identified, but their relative importance could not be established. No subcutaneous plexus connections were identified.

Discussion / conclusion

This study demonstrates that ALT constitutive perforasomes are mostly linked with each other via anastomosing arteries located in the suprafascial plexus.

The debulking of ALT flaps must take this data into account in order to preserve the supra fascial plexus linking arteries as much as possible to avoid loss of vascular territory and marginal necrosis of the flap in vivo.

简介：本研究的目的是明确构成股前外侧皮瓣血管树的不同穿孔体之间的动脉吻合类型的形态学和相对重要性。方法：将15个ALT瓣注射于单支穿支上，通过三维CT微血管造影分析。数据使用基于各种增强动脉的霍斯菲尔德密度的宽二值阈值进行处理。然后进行与皮瓣血管树的虚拟分割相关的3D图像的虚拟解剖，从而可以直接可视化不同穿孔体之间的各种连接方式。结果：皮瓣血管区平均表面积为190.5 cm2。各种穿孔体通过：40%的混合吻合，包括来自皮下丛和筋膜上丛的两条动脉，35%的纯筋膜上吻合，25%的纯真皮下吻合。一些通过真皮神经丛的连接可以被识别，但它们的相对重要性不能确定。未发现皮下神经丛连接。讨论/结论：本研究表明ALT构成性穿体主要通过位于筋膜上丛的吻合动脉相互连接。ALT瓣的减体积必须考虑到这些数据，以便尽可能地保留连接动脉的筋膜上丛，以避免血管区域的丧失和皮瓣的边缘坏死。

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引用次数: 0

Modified free functional split gracilis flap design for periorbital and perioral smile reanimation in patients with total flaccid facial paralysis: A cadaveric study 改良的自由功能性薄股肌瓣设计用于全弛缓性面瘫患者的眶周和口周微笑恢复：一项尸体研究。

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2025-09-09 DOI: 10.1016/j.aanat.2025.152727

Murat Enes Saglam , Ayhan Comert , Mehmet Yilmaz , Mehmet Aydin , Necati Salman , R. Shane Tubbs , Murat Igde

Background

Facial reanimation after total flaccid facial paralysis requires natural smile animation with participation of both periorbital and perioral compartments.

Objective

To define detailed anatomy of gracilis muscle flap and investigate anatomical feasibility of split muscle flap transfer for periorbital and perioral smile reanimation.

Materials and methods

Flap transfer was evaluated on 20 gracilis muscles, was adapted between temporal area and oral and eyelid regions. Morphological measurements were obtained. Vascular pedicle of flap was examined. Distal vessel distribution was visualized on radiography.

Results

Width of gracilis was 55.94 ± 6.83 mm. Number of distal branches of major pedicle was minimum four and maximum six. There was no correlation between number of vessels and muscle width. Appropriate length of distal muscle was cut from hilum. Vessels within sagittal sections at the distal edge of the flap were examined under an operating microscope. Uppermost(1st) part had a weak vascular network (1.70 ± 0.45). All neurovascular morphological measurements indicated suitability for anastomosis sites.

Conclusion

Results showed that distal part of gracilis muscle flap in all cadavers could be split into four equal parts, each having vessels. Anatomically, modified free functional split gracilis flap design is suitable and transferable for periorbital and perioral smile reanimation.

背景：完全弛缓性面瘫后的面部恢复需要眶周和口周隔参与的自然微笑。目的：明确股薄肌瓣的详细解剖结构，探讨分离肌瓣移植用于眶周、口周微笑恢复的解剖学可行性。材料和方法：对20块薄股肌进行皮瓣转移，在颞区和口腔、眼睑区之间进行移植。形态学测量得到。检查皮瓣血管蒂。x线片显示远端血管分布。结果：股薄肌宽度为55.94±6.83mm。主蒂远端支数最少4支，最多6支。血管数量与肌肉宽度无相关性。从门部切取适当长度的远端肌肉。在手术显微镜下检查皮瓣远端矢状面血管。上(1)部血管网较弱（1.70±0.45）。所有神经血管形态学测量显示吻合部位的适宜性。结论：所有尸体的股薄肌远端皮瓣均可均匀地分成四等份，每一等份均有血管。解剖学上，改良的自由功能性薄股肌瓣设计适合于眶周和口周的微笑恢复。

{"title":"Modified free functional split gracilis flap design for periorbital and perioral smile reanimation in patients with total flaccid facial paralysis: A cadaveric study","authors":"Murat Enes Saglam , Ayhan Comert , Mehmet Yilmaz , Mehmet Aydin , Necati Salman , R. Shane Tubbs , Murat Igde","doi":"10.1016/j.aanat.2025.152727","DOIUrl":"10.1016/j.aanat.2025.152727","url":null,"abstract":"<div><h3>Background</h3><div>Facial reanimation after total flaccid facial paralysis requires natural smile animation with participation of both periorbital and perioral compartments.</div></div><div><h3>Objective</h3><div>To define detailed anatomy of gracilis muscle flap and investigate anatomical feasibility of split muscle flap transfer for periorbital and perioral smile reanimation.</div></div><div><h3>Materials and methods</h3><div>Flap transfer was evaluated on 20 gracilis muscles, was adapted between temporal area and oral and eyelid regions. Morphological measurements were obtained. Vascular pedicle of flap was examined. Distal vessel distribution was visualized on radiography.</div></div><div><h3>Results</h3><div>Width of gracilis was 55.94 ± 6.83 mm. Number of distal branches of major pedicle was minimum four and maximum six. There was no correlation between number of vessels and muscle width. Appropriate length of distal muscle was cut from hilum. Vessels within sagittal sections at the distal edge of the flap were examined under an operating microscope. Uppermost(1st) part had a weak vascular network (1.70 ± 0.45). All neurovascular morphological measurements indicated suitability for anastomosis sites.</div></div><div><h3>Conclusion</h3><div>Results showed that distal part of gracilis muscle flap in all cadavers could be split into four equal parts, each having vessels. Anatomically, modified free functional split gracilis flap design is suitable and transferable for periorbital and perioral smile reanimation.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152727"},"PeriodicalIF":1.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dural penetration patterns of the suboccipital vertebral arteries 枕下椎动脉的硬脑膜穿透模式。

IF 1.7 3区医学 Q2 ANATOMY & MORPHOLOGY

Annals of Anatomy-Anatomischer Anzeiger

Pub Date : 2025-09-05 DOI: 10.1016/j.aanat.2025.152725

George Triantafyllou , Panagiotis Papadopoulos-Manolarakis , Nikolaos-Achilleas Arkoudis , Georgios Velonakis , Alexandros Samolis , Łukasz Olewnik , Maria Piagkou

Background

The vertebral artery (VA) undergoes a critical anatomical transition as it pierces the dura mater at the craniocervical junction. Precise knowledge of dural penetration patterns and angulation is essential for diagnostic imaging, neurosurgical planning, and minimizing iatrogenic risk in posterior fossa procedures.

Methods

This retrospective imaging study evaluated 100 adult patients who underwent 1.5 Tesla magnetic resonance angiography (MRA) with a time-of-flight protocol. The site of VA dural penetration was categorized on axial images as ventral, middle, or dorsal, and on coronal images as symmetrical (Type A) or asymmetrical (Types B or C). Angulations at the point of dural entry were quantified in axial and coronal planes. Documented vascular variants included extradural origins of the posterior inferior cerebellar artery (PICA) and aberrant VA trajectories.

Results

Middle axial penetration was the most frequent pattern (87 % of sides), while symmetrical coronal entry (Type A) predominated in 77 % of patients. Axial VA angulation differed significantly by sex (p = 0.034), with females exhibiting sharper angles. No side-related differences were observed for angulation or penetration type. Extradural PICA origin and aberrant VA course were identified in 16.5 % and 6 % of sides, respectively, but did not correlate with dural entry patterns.

Conclusions

The VA exhibits a highly consistent trajectory at the dura, most commonly entering at the middle axial zone with symmetrical coronal configuration. A sex-related difference in axial angulation may have biomechanical and hemodynamic implications. Although vascular variants are relatively common, they do not appear to influence penetration type yet remain relevant for surgical safety and diagnostic accuracy.

背景：椎动脉（VA）在颅颈交界处穿透硬脑膜时经历了一个关键的解剖转变。准确了解硬脑膜穿透模式和成角对诊断成像、神经外科计划和减少后窝手术的医源性风险至关重要。方法：本回顾性影像学研究评估了100例接受1.5特斯拉磁共振血管造影（MRA）和飞行时间协议的成年患者。硬脑膜穿透部位在轴位像上分为腹侧、正中或背侧，在冠状像上分为对称（A型）或不对称（B型或C型）。在轴位和冠状面上量化硬脑膜进入点的角度。记录的血管变异包括小脑后下动脉（PICA）的硬膜外起源和异常的VA轨迹。结果：中轴贯入是最常见的模式（87%），而对称冠状位进入（A型）占77%。轴向VA成角在性别上差异显著（p = 0.034），女性表现出更尖锐的角度。未观察到成角或穿透类型的侧面相关差异。硬脑膜外异位的起源和异常的静脉曲张路径分别在16.5%和6%的两侧被确定，但与硬脑膜进入模式无关。结论：VA在硬脑膜处表现出高度一致的轨迹，最常见的是在对称冠状位的中轴区进入。轴向成角的性别差异可能具有生物力学和血流动力学意义。虽然血管变异相对常见，但它们似乎并不影响穿透类型，但仍与手术安全性和诊断准确性相关。

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引用次数: 0