基于组织连续切片子宫骶骨韧带内神经脉管数字化三维模型构建研究
陈春林1a，王俊1a，刘萍1a，王莉伶1a，段慧1a，李维丽1a，张彦1b，王黎2，黄志霞1a，唐雷3，李鉴轶3，钟世镇3
中国实用妇科与产科杂志 ›› 2015, Vol. 31 ›› Issue (6) : 530-534.
基于组织连续切片子宫骶骨韧带内神经脉管数字化三维模型构建研究
Study of the three-dimensional reconstruction model of the nerve and vascular in uterosacral ligament from tissue serial sections.
目的 研究基于新鲜组织连续切片数据集构建子宫骶骨韧带内神经脉管的数字化三维模型。方法 选择2014年8月于南方医科大学南方医院因宫颈鳞状细胞癌ⅠB1期行经腹广泛性子宫切除术的新鲜右侧子宫骶骨韧带标本1例，标本外侧缘取切片经病理学检查证实无癌细胞浸润。用印度墨水标记韧带宫颈侧与上缘，标本常规固定、脱水后，利用穿刺针穿取4条略长于标本的猪肝组织（直径约0.5mm）作为定位杆标记，与标本一起进行石蜡包埋，从宫颈侧开始连续切片，切片厚度5μm，连续5张为一组分别进行HE染色、动脉弹力纤维特殊染色及免疫组织化学特殊染色。对所有连续切片进行图像采集、融合，并对其进行配准。利用计算机三维重建软件构建出子宫骶骨韧带内神经与脉管数字化三维模型。结果 成功利用组织连续切片数据集构建出子宫骶骨韧带及其内神经与脉管的数字化三维模型。结论 通过观察重建的数字化三维模型，可清楚地显示出交感神经、副交感神经、血管及淋巴管在子宫骶骨韧带内的走行分布及立体关系，为系统保留盆腔自主神经的广泛性子宫切除术步骤的规范化提供依据。
Abstract： Objective To study the three-dimensional reconstruction model of nerve vascular tissue for uterosacral ligament.Methods A fresh uterosacral ligament specimen was obtained from a stage ⅠB1 cervical cancer patient who underwent abdominal radical hysterectomy.The direction of the uterosacral ligament was fixed with India ink.The processed uterosacral ligament was then cut coronally at a 5 um thickness，every 5 serial layers as a group.Each slice was stained with HE，TH，VIP，D2-40 and artery fibers.All serial sections were given image acquisition，integration，and its registration.Input images into Mimics software，select the appropriate threshold after positioning and interpolation processing，and then reconstruct the three-dimensional digital model of nerve vascular tissue in uterosacral ligament.Results We successfully reconstructed three-dimensional digital model of the nerve and vessel in the uterosacral ligament.
子宫骶骨韧带 / 系统保留盆腔自主神经的广泛性子宫切除术 / 组织连续切片 / 三维重建
uterosacral ligament / SNSRH / tissue serial sections / three-dimensional reconstruction
［1］ 刘萍，黄蕾，陈春林，等.骶子宫韧带精细显微组织结构定性研究［J］.中国实用妇科与产科杂志，2012，28（9）:691-694.
［2］ 陈春林，王黎，刘萍，等.基于连续切片子宫主韧带内神经脉管数字化三维重建定位材料的探讨［J］.中国数字医学杂志，2014，9（3）: 56-59.
［3］ Butler-Manuel SA，Buttery LD，Polak JM，et al.Autonomic nerve trauma at radical hysterectomy: the nerve content and subtypes within the superficial and deep uterosacral ligaments［J］.Reprod Sci，2008，15 （1）:91-94.
［4］ Hounnou GM，Uhl JF，Plaisant O，et al.Morphometry by computerized three-dimensional reconstruction of the hypogastric plexus of a human fetus［J］.Surg Radiol Anat，2003，25（1）: 21-31.
［5］ Bertrand MM，Alsaid B，Droupy S，et al.Prudhomme. Optimal plane for nerve sparing total mesorectal excision，immunohistological study and 3D reconstruction: an embryological study［J］.Original Article，2013,10(16):1522-1528.
［6］ Fujii S，Takakura K，Matsumura N，et al.Anatomic identification and functional outcomes of the nerve sparing Okabayashi radical hysterectomy［J］.Gynecol Oncol，2007，107（1）: 14-13.
［7］ Katahira A，Niikura H， Ito K，et al.Vesicouterine ligament contains abundant autonomic nerve ganglion cells: the distribution in histology concerning nerve-sparing radical hysterectomy［J］.Int J Gynecol Cancer，2008，18（1）: 193-198.
［8］ Chen CL，Guo HX，Yu YH，et al.The measurement of vesical detrusor electromyographic activity during nerve-sparing radical hysterectomy［J］.Reprod Sci，2010，17（12）: 1144-1152.
（2015-02-01收稿 2015-03-21修回）
国家自然科学基金（81272585、30970762）；国家十二五科技支撑项目（2014BAI05B03）
/
| 〈 |
|
〉 |
