枕下海绵窦可视化成像与MRI对照研究

目的研究枕下海绵窦及毗邻结构的横断面形态及相互关系,为临床开展颅颈交界区手术及影像学诊断提供外科解剖学依据.方法从中国正常男性数字化可视人体数据集中选取从枢椎齿状突上缘到下缘的连续断面图像,将其与相对应的MRI 断面图像对照,观察枕下海绵窦及毗邻结构的细微解剖结构.结果枕下海绵窦部分共计50层,每层断面结构图像清晰,数据集大小为2.7 GB.数据集显示枕下海绵窦、枕下静脉丛、椎动脉旁静脉结构、椎内、外静脉丛、髁前、髁后静脉和颈内静脉之间相互交通.结论在横断薄层断面上可较好显示枕下海绵窦正常解剖结构及其毗邻关系,为枕下海绵窦的三维重建提供了准确的实验数据,为临床影像诊断学(超声、CT、MRI)提供了完整、连续的薄层断面解剖学资料,对枕下海绵窦区颅底病变的诊治具有重要参考价值.     

可视化肝脏横断面解剖与MR影像对照研究

目的应用数字化可视人体肝脏薄层横断面结构形态学信息,为人体肝脏断层影像学的识别与诊断提供解剖学依据.方法选取可视化人体数据集的肝脏连续横断面图像进行解剖形态学观察,与其相对应的MR图像对照研究,并完成计算机三维重建.结果在可视化肝脏横断面与其相对应的MR图像上,清晰显示肝内管道系统主支的走行分布特点,三维重建图像能清晰显示肝内管道空间结构特征,并明确肝内管道主支在肝脏横断面的最佳显示平面.结论通过对肝脏横断面解剖结构的探讨,可视化肝脏能够完整而精确地反映出该区域复杂的解剖学结构特点,为肝脏疾病的影像定性诊断及影像辅助定位治疗提供形态学依据.     

尸体肝脏横断面解剖与CT增强影像对比研究对活体肝移植的术前评估

目的 用国人尸体肝脏薄层横断面结构形态学信息,为人体肝脏断层影像学的识别和活体肝移植提供解剖学依据。方法选取人体尸体肝脏连续横断面图像进行解剖形态学观察,与其相对应的CT增强图像对照研究,并完成计算机三维重建。结果在尸体肝脏连续横断面图像与其相对应的CT增强图像,清晰显示肝内管道系统主支的走行分布特点,三维重建图像能清晰显示肝内血管空间结构特征以及所支配区域的空间体积。结论通过对肝脏横断面解剖结构的探讨,CT增强图像能够完整而精确地反映出该区域复杂的解剖学结构特点,为活体肝移植的术前评估提供坚实的形态学基础。     

大脑横断面解剖与MRI对照研究

目的探讨大脑主要结构在薄层横断面上的形态及其变化规律,为此区域的影像识别与分析提供依据.方法从首例中国可视人数据集中选出大脑有关的横断面图像与相对应的MRI图像对照.结果在人体大脑横断面标本与相应的MRI轴位图像上,清楚显示出大脑主要结构的形态与影像特征.结论首例中国数字化可视人体数据集的大脑断面标本图与MRI图像有良好的对应关系,通过对照观察,可在MRI上精确识别脑沟、回及脑内结构,为临床影像诊断提供详实准确的断层形态资料,对脑内微小结构占位性病变的早期诊断提供参考依据.     

数字化单心室胎儿人体结构数据集采集与心脏三维重建

目的 建立数字化单心室胎儿人体结构数据集,以及单心室合并主动脉缩窄的数字化三维心脏模型。 方法 选择经产前超声确诊后于妊娠35周引产、引产后经MR和64排CT扫描证实患有心脏复杂畸形的女性胎儿尸体标本1具,体质量2650 g,在-25℃低温实验室中从头至足逐层连续性铣切,同时用高清晰度数码相机摄影,得到胎儿人体结构数据集。采用半自动分割软件和Photoshop软件对心脏及心底部大血管进行图像分割与三维重建。 结果 CT扫描层厚0.625 mm。MR扫描层厚3.0 mm。连续解剖横断面层厚0.2 mm,全身共1495个断面。数字化摄影分辨力为10 989 056 pixels(4064×2704)像素,每个断面图像文件大小为31.4 MB,整个解剖切片数据集大小为46.943 GB。重建的心脏模型可以局部或整体多角度显示,与CT重建图像高度一致。 结论 所得数字化单心室胎儿人体结构数据集为整个标本的连续断面,无节段性数据缺损,且伴有复杂心脏畸形,对心脏外科及临床医学影像学教学均具有重要意义。     

女性盆腔的可视化研究及其意义

目的建立中国女性盆腔三维可视化数字模型.方法应用首例中国女性数字化可视人体数据集,在VRM计算机平台上进行女性盆腔的可视化研究.结果成功建立了三维可视化女性盆腔模型,该模型能进行任意方位的旋转,可进行连续的任意角度的切割,并能清晰地显示出各个方位切割面的断面解剖结构.结论可视化女性盆腔能够提供各个方位、完整而准确的薄层断面数据,为妇产科及外科手术治疗提供了准确的形态学依据,为虚拟手术奠定了基础.     

虚拟中国人Ⅰ号女性坐骨神经的断层解剖学研究

目的为直观分析骨盆骨折合并坐骨神经损伤的可能机制与好发部位,观测"虚拟中国人"VCH Ⅰ号女性坐骨神经连续横断面的走行.方法应用中国虚拟人女Ⅰ号(VCH-FⅠ)数据集,在薄层断面图像上观察坐骨神经的构成及其与髋关节的关系.结果在VCH-F Ⅰ的骨盆薄层断面图像上可以清楚地显示了坐骨神经及其他的结构,同时观察结果显示坐骨神经离髋臼后壁最近.结论VCH-FⅠ数据集能够提供完整精确的坐骨神经断面解剖,为下一步坐骨神经与骨盆关系的三维重建提供了良好的基础,同时说明髋臼后壁的骨折最易损伤坐骨神经.     

比较不同影像学方法对耻骨直肠肌综合征患者功能障碍的评估价值

目的:比较排粪造影、CT及MRI三种影像学检查方法对耻骨直肠肌综合征的诊断价值及限度,为临床检查方法的选择、外科手术治疗及术后康复评估提供理论依据。方法:1988-03/2004-04解放军第三军医大学大坪医院野战外科研究所普通外科经诊断证实且均进行了排粪造影、CT和MRI三种影像学检查的62例耻骨直肠肌综合征患者,分别测量出肛直角及耻骨直肠肌压迹长度、深度和厚度并与56例健康自愿者的排粪造影、CT和MRI检查结果进行对照分析。结果:正常人肛直角力排相较静息相明显增大。耻骨直肠肌综合征患者中49例肛直角力排相较静息相明显减小,且均伴有耻骨直肠肌压迹,耻骨直肠肌压迹长度(3.52±0.65)cm,深度(1.68±0.49)cm,另外13例静息、力排时肛直角均无变化,钡剂不排或少排且均出现“搁架征”。CT,MRI断面图像上,耻骨直肠肌综合征患者耻骨直肠肌厚度明显较正常人厚,差异有非常显著性意义(P<0.01)。且还能清晰显示出盆底肌群、筋膜及其周围间隙。结论:排粪造影能显示耻骨直肠肌功能性异常,是诊断耻骨直肠肌综合征较可靠的方法。CT,MRI能直接清楚地显示耻骨直肠肌位置、形态大小、与邻近结构的关系及各部分的发育情况等,并更进一步了解耻骨直肠肌综合征患者的解剖结构改变、邻近结构异常及盆底其他功能性疾病。故将     

比较不同影像学方法对耻骨直肠肌综合征患者功能障碍的评估价值

目的:比较排粪造影、CT及MRI三种影像学检查方法对耻骨直肠肌综合征的诊断价值及限度,为临床检查方法的选择、外科手术治疗及术后康复评估提供理论依据.方法:1988-03/2004-04解放军第三军医大学大坪医院野战外科研究所普通外科经诊断证实且均进行了排粪造影、CT和MRI三种影像学检查的62例耻骨直肠肌综合征患者,分别测量出肛直角及耻骨直肠肌压迹长度、深度和厚度并与56例健康自愿者的排粪造影、CT和MRI检查结果进行对照分析.结果:正常人肛直角力排相较静息相明显增大.耻骨直肠肌综合征患者中49例肛直角力排相较静息相明显减小,且均伴有耻骨直肠肌压迹,耻骨直肠肌压迹长度(3.52&;#177;0.65)cm,深度(1.68&;#177;0.49)cm,另外13例静息、力排时肛直角均无变化,钡剂不排或少排且均出现“搁架征”.CT,MRI断面图像上,耻骨直肠肌综合征患者耻骨直肠肌厚度明显较正常人厚,差异有非常显著性意义(P＜0.01).且还能清晰显示出盆底肌群、筋膜及其周围间隙.结论:排粪造影能显示耻骨直肠肌功能性异常,是诊断耻骨直肠肌综合征较可靠的方法.CT,MRI能直接清楚地显示耻骨直肠肌位置、形态大小、与邻近结构的关系及各部分的发育情况等,并更进一步了解耻骨直肠肌综合征患者的解剖结构改变、邻近结构异常及盆底其他功能性疾病.故将它们三者有机结合对早期而全面诊断该疾病并指导外科手术治疗及术后康复评估具有重要意义.     

虚拟中国人I号女性坐骨神经的断层解剖学研究

目的:为直观分析骨盆骨折合并坐骨神经损伤的可能机制与好发部位,观测“虚拟中国人”VCHⅠ号女性坐骨神经连续横断面的走行。方法:应用中国虚拟人女Ⅰ号(VCH-FⅠ)数据集,在薄层断面图像上观察坐骨神经的构成及其与髋关节的关系。结果:在VCH-FI的骨盆薄层断面图像上可以清楚地显示了坐骨神经及其他的结构,同时观察结果显示坐骨神经离髋臼后壁最近。结论:VCH-FⅠ数据集能够提供完整精确的坐骨神经断面解剖,为下一步坐骨神经与骨盆关系的三维重建提供了良好的基础,同时说明髋臼后壁的骨折最易损伤坐骨神经。     

Pelvic floor function in elite nulliparous athletes.

OBJECTIVE: There is preliminary evidence linking long-term participation in high-impact exercise with poor performance in labor and increased incidence of stress urinary incontinence, which may be due to altered pelvic floor function. Recent work has shown that HIFIT (high-impact, frequent intense training) athletes have an increased cross-sectional area of the levator ani muscle group as visualized using magnetic resonance imaging (MRI). The aim of this study was to further characterize pelvic floor muscle function and pelvic organ descent in a nulliparous athletic population and compare it with non-athletic controls matched for age and body mass index, using three-dimensional/four-dimensional (3D/4D) pelvic floor ultrasound imaging. METHODS: In this prospective comparative study translabial ultrasound imaging was used to assess pelvic floor anatomy and function in 46 nulliparous female volunteers (aged 19-39 years), 24 HIFIT and 22 controls. Two-dimensional (2D) and 3D translabial ultrasonography was performed on all subjects, after voiding and in the supine position. Descent of the pelvic organs was assessed on maximum Valsalva maneuver, whilst volume datasets were acquired at rest, during pelvic floor muscle contraction and during a Valsalva maneuver. Participants performed each maneuver at least three times and the most effective was used for evaluation. RESULTS: HIFIT athletes showed a higher mean diameter of the pubovisceral muscle (0.96 cm vs. 0.70 cm, P < 0.01), greater bladder neck descent (22.7 mm vs. 15.1 mm, P = 0.03) and a larger hiatal area on Valsalva maneuver (21.53 vs. 14.91 cm(2), P = 0.013) compared with the control group. There were no significant differences in hiatal area at rest or on maximal voluntary contraction between the two groups. CONCLUSION: HIFIT athletes show significant differences in several of the measured parameters for both function and anatomy of the pelvic floor. Further research into the impact of this altered function on childbirth and continence mechanisms is needed.     

基于数字化可视人的医学图像融合研究

目的为数字化可视人体数据应用于临床影像设备提供完整的技术方案和程序代码。方法通过数字化可视人体分割数据与标准DICOM3.0数据格式的转换,对中国可视化人的彩色分割图像与CT图像进行融合。结果建立了一套符合临床放射治疗系统数据要求的标准DICOM3.0中国可视化人体数据源女性盆腔数据。结论为妇科肿瘤放射治疗过程中靶区勾画、治疗方案优化和剂量评估提供了具有重要器官分割特性的数字模拟计算模型,有助于数字化可视人体数据的临床推广应用。     

未产妇阴道不同水平横断面的三维盆底超声观察

目的 探讨未产妇不同水平阴道横断面及周围结构的三维盆底超声表现,为女性盆底支持结构的形态学观察提供有效的影像学方法 .方法 对50例无生育史年轻女性进行三维盆底超声检查,获得盆底横断面声像图,连续观察宫颈外口至阴道外口间阴道横断面及周围结构的声像图表现.结果 三维盆底超声清晰显示阴道全程的横断面声像图.不同水平的阴道横断面形态不同:近段阴道呈"唇形",中段阴道呈"蝶形",远段阴道呈"月牙形".不同水平的阴道周围结构不同:远段阴道水平可见会阴体,中段阴道水平可见尿道阴道隔、直肠阴道隔及阴道旁支持结构,近段阴道水平可见阴道周围结缔组织,阴道周围结构回声均匀致密完整.结论 未产妇阴道及周围结构在不同水平有不同的三维盆底横断面超声表现,这对盆底支持结构及盆底功能障碍性疾病的三维超声研究有重要意义.     

Ultrasound imaging in three and four dimensions

Three-dimensional (3D) reconstruction of ultrasound images was first demonstrated nearly 15 years ago, but only now is becoming a clinical reality. In the meantime, methods for 3D reconstruction of CT and MRI images have achieved an advanced state of development, and 3D imaging with these modalities has been applied widely in clinical practice. 3D applications in ultrasound have lagged behind CT and MRI, because ultrasound data is much more difficult to render in 3D, for a variety of technical reasons, than either CT or MRI data. Only in the past few years has the computing power of ultrasound equipment reached a level adequate enough for the complex signal processing tasks needed to render ultrasound data in three dimensions. At this point in time, the clinical application of 3D ultrasound is likely to advance rapidly, as improved 3D rendering technology becomes more widely available. This article is a review of the present status of 3D ultrasound imaging. It begins by comparing the characteristics of CT, MRI, and ultrasound image data that either make these data amenable or not amenable to 3D reconstruction. The article then considers the technical features involved with acquiring an ultrasound 3D data set and the mechanisms for reconstructing the images. Finally, the article reviews the literature that is available regarding clinical application of 3D ultrasound in obstetrics, ultrasound, the abdomen, and blood vessels.     

Bilateral avulsion of the puborectal muscle: magnetic resonance imaging-based three-dimensional reconstruction and comparison with a model of a healthy nulliparous woman.

OBJECTIVES: Obstetric trauma to the puborectal muscle seems to be an important cause of pelvic floor dysfunction in women. Due to the complicated three-dimensional (3D) arrangement of the pelvic structures, two-dimensional images are not sufficient to demonstrate its relationships in a complex fashion. Thus, we aimed to create a 3D computer model to visualize the normal female pelvic floor anatomy and to compare this with the anatomy after bilateral avulsion of the puborectal muscle following delivery. METHODS: We created two 3D computer models of the female pelvic floor, one of a healthy nulliparous woman and the other of a woman with bilateral puborectal muscle avulsion after vaginal delivery. The data for the models were obtained from magnetic resonance imaging examinations and the following structures were depicted: pelvic bones, puborectal muscle, internal obturator muscle, urethra, urinary bladder, vagina and rectum. The models were compared. RESULTS: The models allowed us to demonstrate in three dimensions changes in the puborectal muscle after avulsion. Its relations to the bone, internal obturator muscle, perineal membrane and the deep part of the external anal sphincter were modeled and differences from the normal non-injured anatomy were demonstrated. Avulsion altered the support to the whole endopelvic fascia and destabilized both the anterior and the posterior vaginal walls. CONCLUSIONS: The use of 3D technology including modeling allows for the acquisition of new knowledge and aids in the understanding of both normal and pathological pelvic anatomy.     

髋关节表面置换三维可视化设计

背景：髋关节表面置换过程中二维图谱只能观察到三维解剖结构的某一个侧面,不能全面地把握撼体的三维结构。目的：利用个人计算机结合图像处理软件Amira4．1对髋关节表面臀换进行三维重建,建立髋关节表面置换的可视化数字模型。方法：对1例髋关竹表面置换后患者骨盆进行多排螺旋CT扫描,观测内置物的位黄形态,将原始数据以．dicom格式输入个人PC,利用Amira软件,经剪切、分割、表面重建及体绘制等步骤,根据解剖结构特点,对骨盒及髋关节进行三维重建,获得立体形态的髋关节及内置物位置结构。结果与结论：重建了骨盆、髋关节及内置物的形态构成,熏建的三维结构可以多彩色、透明或任意组合显示,经不同角度观察,整体显示清晰、实体感强。存三维表面熏建的图像中可清楚观察表面假体的位置形念,特别足吲‘以立体直观显示全髋关节表面置换假体的大小、倾角、稳定性以及磋磨股骨头形态,井可精确测带。提示髋关¨表面置换三维重建对基础研究、临床试验及手术规划具有重要价值,应用Amira软件可为三维建模提供基础。