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

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。

Study of the three-dimensional reconstruction model of the nerve and vascular in uterosacral ligament from tissue serial sections.

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.