数字化原位子宫动脉血管3D可视化模型的构建及意义

目的探讨构建女性原位子宫动脉血管3D可视化模型和研究子宫动脉血管的结构特征。方法采用聚乙烯醇-氧化铈血管造影术进行2例女尸盆腔动脉血管灌注,X线平位摄影、64排螺旋CT扫描后采集数据,导入计算机Mimics10.01重建软件进行子宫动脉血管3D可视化模型构建,观察子宫动脉血管的形态及血供分布情况。结果①构建的子宫动脉血管三维模型图像清晰,管道饱满,立体空间感强,均能清晰地显示子宫动脉的4级以上血管,各级分支血管的形态、走行、分布及各血管间的吻合显影清晰,效果满意。2例子宫及附件无实质性病变,为正常子宫。②清晰显示子宫动脉血管网的构建特点:子宫动脉自主干依次发出膀胱支、输尿管支、上行支、下行支等分支动脉;上行支较粗呈弓状沿子宫体侧缘迂曲上行,至宫角处分为宫底支、输卵管支和卵巢支,主要向子宫体和子宫附件供血;下行支较细分布于宫颈及阴道上段,但分布于阴道的血管较少;子宫动脉通过其卵巢支与卵巢动脉相交通;同时子宫动脉的供血还存有着明显的同侧倾向,双侧子宫动脉在子宫的中轴线处有少量细小的交通支。结论采用聚乙烯醇-氧化铈血管造影术盆腔动脉血管灌注可构建理想的子宫动脉血管网3D可视化模型,为系统研究人子宫动脉血管网的形态结构和血供分布提供了血管解剖学基础。

Establishment and significance of 3D digitalization visualization model of uterine artery in situ

Objective To discuss the establishment of 3D digitalization visualization model of vessels net in uterine artery in situ and research structure character of uterine artery.Methods The angiography with polyvinyl alcohol-ceria was used to make perfusion into pelvic cavity artery of two female bodys.The data was collected by prospositin scanning with X-ray scanner and CT scanning.3D digitalization visualization model was established by Mimics10.01 based on imported data.The morphology of the uterine artery and distribution of the blood-supply were observed.Results ① The model imaging was clear,with full vessels and strong spacial sense.It precisely displayed more than 4 levels of uterine artery blood vessels,The morphology,distribution,and vascular anastomosis to other vessels were clear and satisfactory.All cases had normal uterine without tumor.②It precisely displayed the construction characters of vessel net in uterine artery:it was separated into bladder branch,ureter branch,ascending branch,descending branch and other branches from the stem;The thicker upward one was distributed upwards along lateral margin of uterine wall,and at cornua uteri,it was separated again into uterine fundus branch,tubal branch and ovarian branch;While the thinner downward one was distributed in cervix uteri and superior segment of vagina,with less in vagina vessel;Uterine artery was intersected with ovarian artery via its ovarian branch;The blood-supply of uterine artery had obvious homolateral preference.But a few communicating branchs of bilateral uterine artery still could be found in the media axis of uterine.Conclusions Perfusion of pelvic cavity artery by angiography with polyvinyl is satisfactory method for alcohol-ceria establishment of 3D digitalization visualization model.It provides vessel anatomy evidence for systematic study on vessel net morphology and distribution of uterine artery.