正中神经显微结构三维可视化研究

目的 将正中神经干全长作连续冰冻组织切片,采集系列切片的神经二维信息,开发3D Nerve可视化系统,实现正中神经内部显微结构的三维可视化.方法 取新鲜成人尸体正中神经标本,作好定位并标记、OCT包埋、采用连续冰冻组织切片、染色、用扫描仪获取切片染色前后的连续的正中神经断面二维信息数据库,开发并应用3D Nerve可视化系统.结果 通过3D Nerve可视化系统观察发现,在不同断面正中神经神经束的数量、位置以及神经束内神经纤维的性质变化较大.在该系统中可在任意断面放大的视野下观察正中神经的显微结构,追踪各神经束在正中神经内的立体行径;重建的正中神经能在空间位置上绕任意轴作任意角度旋转,便于从不同的角度对各神经束的形态、空间位置及相互毗邻关系进行观察,从而动态地展示正中神经内部的复杂结构.结论 正中神经3D Nerve可视化系统真实地再现正中神经干全长及其内部各神经束和束组的三维立体结构,可为临床修复正中神经损伤提供精确的断层解剖图像.

Three-dimensional visualization of microstructure of the median nerve

Objective To develop three-dimensional (3D) nerve visualization system by obtaining the two-dimensional (2D) image information from serial freezing tissue sections of the median nerve and to realize 3D visualization of its microstructure. Methods One fresh cadaver median nerve was taken. After its orientation was labelled, the nerve was embedded in OCT and serial freezing tissue sections were made. The sections were stained. 2D image information databases of stained and unstained sections were obtained through high resolution scanner. 3D visualization of the median nerve was finally realized with 3D nerve visualization system. Results With 3D nerve visualization system, it can be revealed that different cross sections of the median nerve correspond to quite different number and positions of fascicles. In addition, characters internal nerve fiber are also quite different. The reconstructed structures can be rotated at any angle along any axis. This allows observation of the shape, position and relationship of fascicles from different positions. 3D nerve visualization system makes it possible to cut the median nerve at any angle at any cross section and to observe microstructure of the nerve at magnified vision. Conclusion 3D visualization of the median nerve trunk can show microstructures of the entire course of the median nerve and the three dimensional stereo-structure of fasciculus and fasciculus groups. It could provide exact topography atlas and facilitate precise repair of median nerve injury clinically.