一种简易的人体解剖学内脏塑化标本制作法

生物塑化技术(Plastination)是德国汉堡大学的Hagens教授发明的[1],其基本原理是选用多聚化合物作为生物塑化剂代替组织细胞内的水分和脂肪进行固化.所采用的塑化材料是硅胶,即先用丙酮将人体标本进行梯度脱水,脱水时间就需要数月之久.     

聚氨酯泡沫塑料在断层标本中的应用

随着ＣＴ和ＭＲＩ在临床上的广泛应用，国内许多医学院校相继开展了人体断层标本的制作，以供教学、临床和科研应用。但是，往往缺少尸体在锯切前的处理步骤，或处理不当，致使锯切后的断层标本出现左、右侧切面不在一条水平线上和厚薄不均现象，从而影响了标本的质量。聚氨酯泡沫塑料，在工业上是一种新型的管道保温材料。将它用于断层标本制作技术中，是由德国海德堡大学塑化（Ｐｌａｓｔｍａｔｉｏｎ）研究所Ｄｒ．ＧｕｎｔｈｅｒｖｏｎＨａｇｅｎｓ于８０年代首先使用。本文作者在海德堡大学塑化研究所学习期间．参加了该项技术工作。使…     

Hoffen P45生物塑化技术在断层标本制作中的应用

<正>断层塑化技术在断层解剖学研究中的应用主要包括:①塑化切片技术,将标本塑化后,再用钻石线锯切制成最薄可达20μm的断层标本;②薄片塑化技术,适     

冰冻薄层连续断层标本的制作方法

自 18 18年荷兰人Riemer率先用冰冻法制作人体断层标本以来 ,冰冻断层技术为断层解剖学的发展作出了巨大贡献[1] 。随着切割技术的进步 ,大体断层标本的厚度已由最初的厘米级进入了毫米级 ,为断层解剖学的发展提供了必要的技术手段。目前 ,冰冻断层标本的锯切工具多为细木工带锯机 ,其连续锯切的断层厚度多在 8mm以上[2～ 5] 。特别是对硬度较大的骨质标本锯切时很难控制其连续切割的厚度和精度 ,如头部。临床影像医学的进步需相应厚度的薄层断层标本加以配合。生物塑化断层技术可制作约 1mm厚的断层[6] ,但其制作费用高、周期长 ,且目前国…     

火棉胶切片标本盒装的保存方法

随着显微外科和影像医学的进展，对断层解剖学的研究要求也越来越深入和细致，传统的断层标本制作有如下几种方法：①锯切法：包括分部、划线、冰冻、锯切几步，层厚4-5mm，待点锯耗大、欠精确，难以显示细微结构。②生物塑化包埋法：用生物塑化技术制备断层切片层厚1.2mm，锯耗0.3mm。但塑化技术设备要求高、费用贵，现在国内尚未普及。     

生物塑化技术的应用前景

生物塑化技术是将高分子化合物和真空物理学与生物学相结合 ,用于处理、保存和研究生物标本的一种技术。经生物塑化技术处理后的标本呈干燥透明状态 ,无毒无味 ,具有一定韧性和弹性 ,不破坏标本原形和组织器官和位置关系 ,是目前形态学研究中具有较好性能和广泛用途的新方法 ,受到了国际上较为普遍的承认 ,并得到了推广。该技术是由德国汉德堡大学解剖学研究所哈根斯于 1978年发明的 ,并在国外获得广泛应用。如Ｔａｇｕｃｈｉ[1] 等专家论述了生物塑化技术是将硅胶或环氧树酯浸入有机体的一种保存解剖物质的新技术。我国在 1996年 ,大连医科…     

一种改良包埋模具和改良载玻片的设计与应用

在常规病理技术中[1,2],石蜡切片是诸多操作环节中非常重要的关键技术,能够为常规HE染色、特殊染色、免疫组化染色[3]及分子筛查等检测技术提供不同规格要求的组织切片。若宫腔刮出物、小脑占位组织、椎管内取出物等组织中的小灶组织疑有恶变或性质不能确定,可通过对原组织蜡块深切、连切、薄切等方式再进行常规HE染色,也可对重新切片的组织进行特殊染色、免疫组化染色等检测方法,以明确小灶组织的性质。     

生物塑化技术及其应用

生物塑化技术是七十年代末期诞生的一项生物标本保存技术，其基本步骤包括固定、脱水扣脱暗、真空内强制浸渗和聚合等，使生物标本中的水分和脂类被高分子多聚物所替代，从而制备出干燥无味可长期保存的标本。本文对这一技术的应用范围，基本步骤及部分操作过程进行了综述     

人体冠状断层标本制作技术

<正>随着断层解剖学实验教学要求的逐步提高和数字化可视人体科研不断的发展,以及人体断层塑化标本制作的需求[1-3],利用电动带锯机制作了去除上肢的人体连续冠状断层标本,达到了预期的效果,现把这一制作技术报道如下。     

提高人体断层解剖学教学水平的实践

医学影像学的发展 ,要求尽快培养出符合时代要求的专业人才。然而 ,与影像设备的普及程度与速度和影像技术的发展相比 ,医学影像专业的主干课程———人体断层解剖学的发展相对滞后和很不完善。 1993年我校设立了医学影像专业 ,承担为其开设人体断层解剖学。为培养宽专业、厚基础和临床应用能力强的影像专业实用人才 ,必须重视本门课程教学过程中的各个环节 ,经过几年的教学实践 ,取得了一些成绩[1] ,同时 ,我们也感到有必要改革断层解剖学教学内容和教学模式 ,提出应吸纳局部应用解剖学和影像解剖学知识 ,采用以局部应用解剖学为基础、断层…     

Radiologic anatomy of the inferior lung margins as demonstrated on computed radiography with enhancement of low frequencies

The aim of this work was to describe the radiologic anatomy of the inferior lung margins (ILMs). The method was to enhance the low frequencies of 50 normal chest computed radiographs. On each side, the anterior and posterior ILMs were divided into two halves. The frequency of visibility of each half of each ILM was calculated as their shape, lateral and medial continuities, depth, and vertebral level. The differences were compared by a paired Student t-test. The right posterior ILM was always visible and usually concave upward (94%). Its height was 8.7 ± 1.6 cm. Its most inferior part faced L1 or L2 in 92% of cases. It was continuous medially inside with the azygo-esophageal recess in 96% of cases. The left posterior ILM was not visible laterally in 34% of cases and medially in 60% of cases. It was most often concave upward (82% of cases). Its height was 6.9 ± 1.5 cm. Its most inferior part was at the level of L1 or L2. It was continuous medially with either the left paraspinal line or the paraaortic line. The right anterior ILM was visible in 76% of cases. It was most often oblique upward and medially (46%) or concave upward (33%) and often notched (38%). The left anterior ILM was visible in 64% of cases and more often oblique inward and upward (58%). It was continuous medially with the left inferior precardiac recess. The anterior ILMs were more variable than the posterior. The posterior ILMs were very similar in shape and inferior level and differed in depth only by the difference of height of the diaphragmatic cupolas.     

Main accessory sulcus of the liver

It has been proposed that the superficial part of the portal fissures weakens the surface hepatic parenchyma, allowing the development of accessory sulci caused by diaphragmatic pressure. To evaluate the relationship of the sulci in the antero-superior surface of the right liver with the right portal fissure, macroscopic post mortem examination of 85 livers was carried out and radio-opaque resins were injected into the portal and hepatic venous systems to obtain vascular casts. After formalin fixation, the 85 livers also underwent CT and MR scans and 3D image elaboration. Diaphragmatic sulci were found in 32 cases. We studied the sulci located in the right liver, i.e., those that lay to the right of the line of Cantlie. They were found in 28 instances and in 16 cases they were multiple. In the livers with a single sulcus, it extended between the anterior and right surfaces of the right liver and showed a curved course downward and forward, toward the inferior margin. In the cases with multiple sulci, one sulcus always showed a course similar to that of the single sulci. The 28 sulci, with similar position and course, showed variable characteristics (mean length=7.6 +/- 2.7 cm, mean width=0.8 +/- 0.7 cm, mean depth=1.4 +/- 0.8 cm). Both radiological images and corrosion casts showed a correspondence between these sulci and the right hepatic vein and the right portal fissure in 71% of cases. These sulci may represent the variable expression (cranial, intermediate, or caudal portions) of a potential sulcus, the main accessory sulcus (MAS), that develops along a theoretically predictable course corresponding to the superficial part of the right portal fissure. The high prevalence of location of the MAS at the level of the upper part of the right portal fissure can be ascribed to the presence at this level of the watershed between the roots of the tributaries of the hepatic veins coming from segments VIII and VII, draining respectively into the middle and right hepatic veins. Thus, the coexistence of the two portal and hepatic venous boundaries may represent a further predisposition to the effects of diaphragmatic pressure. The MAS may represent a marking for the right portal fissure, and hence a superficial reference for the deep course of the right hepatic vein.     

肾上腺静脉MSCT影像解剖研究

目的　利用MSCT准确显示肾上腺静脉正常解剖结构及变异,为临床提供影像解剖数据。 方法　回顾分析上腹部CTA患者108例。薄层MIP/MPR评估测量肾上腺静脉管径、长度及走行路径。 结果　①右侧：显示率64.81%（70/108）,变异5.71%(4/70);汇入下腔静脉7点至8点间占优势42.42%;其管径Rr (2.19±0.56) mm,腺外段长度RD1 (5.02±1.82) mm,汇入下腔静脉距右肾静脉汇入距离RD2 (40.69±12.96) mm,汇入口开口向下角度RA (60.25±17.85)°。②左侧：显示率97.22%（105/108）;变异14.29%（15/105）;肾上腺静脉管径Lr (2.39±0.56) mm,腺外段长度LD1 (7.28±4.01) mm,膈-肾上腺静脉干管径LR (3.65±0.93) mm,膈-肾上腺静脉的共干段长度LD2 (14.07±6.77) mm,膈-肾上腺静脉汇入左肾静脉点至下腔静脉左侧缘距离LD3 (32.89±4.85) mm,膈-肾上腺静脉汇入左肾静脉开口向内的角度LA1 (118.06±18.49)°,肾上腺静脉与膈静脉共干段开口向下的角度LA2 (156.15±13.81)°。 结论　MSCT可显示大部分右侧肾上腺静脉及绝大部分左侧肾上腺静脉正常走行及变异,测量相关影像解剖数据,为AVS等手术方案提供影像数据。     

经导管植入钳夹装置治疗三尖瓣膜关闭不全的应用解剖

目的　为经导管植入钳夹装置治疗三尖瓣膜关闭不全提供三尖瓣区相关的应用解剖。 方法　解剖28例(男18,女10)外形大小正常的成年人心脏标本,观察三尖瓣膜的形态及与周围组织的解剖关系,测量与三尖瓣膜相关的数据。 结果　三尖瓣环周长为(109.4±14.2) mm,长径为（43.5±6.5）mm,短径为（29.3±5.4）mm。前瓣游离缘到附着缘最大距离为（22.3±4.1）mm,后瓣游离缘到附着缘最大距离为（20.5±3.8）mm。 结论　钳夹装置的大小和形状的设计应根据三尖瓣区解剖特点及与周边结构的关系来决定,钳夹三尖瓣的前后瓣叶可行。     

内侧楔骨与第2跖骨底间韧带重建的解剖学研究

目的　通过对内侧楔骨与第2跖骨底间韧带进行形态学相关参数测量,为其重建提供解剖学依据。 方法　8只新鲜成年尸体足部标本,测量跗跖背侧及跖侧韧带、Lisfranc韧带的长、宽、面积,Lisfranc韧带附着点距关节面距离及其走行角度。根据测量数据,建立内侧楔骨-第2跖骨底间骨隧道。 结果　Lisfranc在3条韧带中形态学数据最大,长、宽、面积分别为(9.11~12.03 mm)、(7.36~10.16 mm)、（92.01~120.01 mm²)。骨隧道进针点在第2跖骨底,距第2跖骨-中间楔骨关节面距离为（8.25~11.22 mm）,角度与Lisfranc韧带走行一致,与矢状面呈(39.2°~47.6°）,水平面呈（12.5°~19.8°）,出针点为Lisfranc韧带在内侧楔骨上的附着点。 结论　Lisfranc韧带在3条韧带中最为粗壮,重建通道应按照其附着点和走行角度重建背侧韧带和Lisfranc韧带,而跖侧韧带由于位置较深,受技术所限,此为类解剖重建。     

腰椎间孔镜的应用解剖

目的　为不同节段腰椎间孔镜手术提供解剖学依据。 方法　10具成人脊柱腰骶段（L1～S1）标本,观测L1/2～L5/S1椎间孔高、椎间孔安全三角、椎管内安全三角的形态。 结果　①L1/2～L5/S1椎间隙水平中线与椎间孔安全三角高的交点到出行神经根的距离为（4.75±0.80）、（6.42±0.44）、（7.30±0.82）、（7.74±0.52）、（4.68±1.27）mm;②L1/2～L5/S1椎间盘后缘水平中线与椎弓根中内1/3纵垂线交点到出行神经根的距离为（4.02±0.78）、（4.67±0.65）、（5.17±0.91）、（6.16±0.74）、（5.48±0.61）mm;③L1/2～L5/S1椎间盘后缘水平中线与椎弓根中内1/3纵垂线交点到硬膜囊/走行神经根的距离为（3.89±0.61）、（4.39±0.71）、（5.17±0.97）、（6.58±0.70）、（6.22±1.20）mm。 结论　掌握腰椎不同节段的解剖特点,有利于椎间孔镜手术时合适尺寸工作套管的选取。     

逆行经皮髋臼后柱螺钉的影像解剖学

目的 探讨逆行髋臼后柱螺钉的进钉位置、方向及固定范围。方法 收集100例正常成人骨盆CT数据（男、女各50例）,利用交互式医学图像控制系统（Mimics）17.0软件三维重建骨盆并导入Geomagic Studio 2015软件。从坐骨结节至髂窝方向进行透视,垂直后柱“三棱柱”通道横断面放置虚拟螺钉,测量螺钉的最大直径、进钉点、方向、出钉点及螺钉安全倾角。确定螺钉固定的范围,螺钉在后柱通道易穿出部位及术中判断螺钉是否穿出的透视体位。结果 髋臼后柱安全通道近似“三棱柱”形,进钉点位于坐骨结节内外侧缘中线上,距离坐骨结节最远端男性为(12.99±1.99) mm,女性为 (13.26±2.58) mm,男女差异无显著性 (P＞0.05);髂窝出钉点距离同侧前方骶髂关节线男性为(23.65±2.42)mm,女性为(24.94±2.39) mm;距离真骨盆缘男性为(19.33±2.60)mm,女性为(17.63±2.00) mm;最大螺钉直径男性为(17.21±1.41) mm,女性为(15.54±1.51) mm;髋臼后柱逆行置钉方向与矢状面夹角男性为(10.52±3.04)°,女性为(7.72±2.99)°;与冠状面夹角男性为(15.00±4.92) °,女性为 (12.94±4.72)°,以上数据男女间差异均有显著性（P＜0.05）。逆行经坐骨结节置钉可固定股骨头中心所在水平面近端 4 cm 以下所有的髋臼后柱骨折,易穿出部位分别为髋臼后壁与坐骨支移行处、髋臼中部、坐骨大切迹水平下1 cm。“三棱柱”的3个侧面的切线位分别是髂骨斜位10°,闭孔斜位60°,髂骨斜位60°。结论 逆行髋臼后柱螺钉进钉点位于坐骨结节内外侧缘中线,距离坐骨结节最远端1.3 cm,方向约外倾10°,前倾15°,可固定股骨头中心所在水平面近端4 cm以下的髋臼后柱骨折。     

Serial anatomy of the auditory tube: correlation to CT and MR imaging

Summary Serial anatomy of the auditory tube (AT), was studied in nine anatomical specimens, according to transverse, coronal and specific oblique planes and was correlated to computed tomography and magnetic resonance imaging. In order to assess the orientation of the oblique plane, parallel to the AT, 30 AT specimens were catheterized: the mean angle between the AT and the Virchow plane or the bony palate was 34°. The bony portion is better explored with CT, whereas the cartilaginous portion is better studied with MR. The cartilage, posterior and medial, is closed anteriorly and inferiorly by a fibrous membrane (lamina membranacea), which is not seen on CT or MR images. The AT is closely related to the tensor veli palatini muscle (TVPM) anterolaterally, and the levator veli palatini muscle inferiorly (LVPM); both are well imaged on the oblique plane. They are bounded by fascias: the submucosal fascia (tela submucosa) is medial, the pharyngobasilar fascia runs between the TVPM and the LVPM and the auditory tube; the fascia of Weber-Liel is lateral to the TVPM. Fascias are difficult to distinguish from the surrounding fatty tissue and the adjacent muscles. The auditory tube and its muscles, forming the lateral wall of the nasopharynx, are well studied by CT and MR imaging, using the transverse or, preferably oblique plane, together with coronal plane.

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Anatomie sérielle de la trompe auditive : correlation à l'imagerie tomodensitométrique et par résonance magnétique

Résumé L'anatomie sérielle de la trompe auditive (TA), étudiée chez neuf sujets anatomiques selon les plans de coupe transversal, coronal et selon un plan de coupe oblique spécifique, a été corrélée à l'imagerie tomodensitométrique et par résonance magnétique. Afin de déterminer l'orientation du plan oblique, parallèle à la TA, la TA de 30 sujets anatomiques a été cathétérisée : l'angle moyen de la TA avec le plan de Virchow ou le plan du palais osseux est de 34°. La partie osseuse de la TA est mieux étudiée par le scanner, tandis que la partie cartilagineuse est mieux étudiée par l'IRM. Le cartilage, postéro-médial, est fermé en avant et en bas par une membrane fibreuse (lame membranacée), qui n'est pas visible en scanner et en IRM. La TA est en rapport étroit avec le muscle tenseur du voile du palais (MTVP) en avant et latéralement, et avec le muscle élévateur du voile du palais (MEVP) en bas ; ces deux muscles sont bien étudiés par le plan oblique. La TA et ses muscles sont accompagnés par des fascias : le fascia sous-muqueux (tela submucosa) est médial ; le fascia pharyngobasilaire chemine entre le MTVP d'une part et le MEVP et la TA d'autre part ; le fascia de Weber-Liel reste en dehors du MTVP. Les fascias sont difficiles à distinguer du tissu graisseux, qui les entoure, et des muscles adjacents. La TA et ses muscles, qui forment la paroi latérale du nasopharynx, sont bien étudiés par le scanner et l'IRM, en utilisant le plan transversal, ou plutôt le plan oblique, associé au plan coronal.

     

Sulci of the liver found after death: Their nature and potential teaching value

Accessory sulci of the liver are more commonly found after death than in life, raising questions as to their causation and possible classification. We have analyzed a group of 180 livers sampled from un‐embalmed (96) and embalmed cadavers (84). In un‐embalmed cadavers, no accessory sulci were found on the diaphragmatic surface in 58 cases. Diaphragmatic sulci were found in the right lobe of 38 livers. When removed from the abdominal cavity and placed flat on the examination table (the “bench position”) all 58 livers without sulci appreciable in the abdominal cavity showed the appearance of two sulci. The first ran from the right side of the inferior vena cava (IVC), curving anteriorly to the inferior border of the liver, at a point midway between the right extremity of the inferior border and the gallbladder fossa, concave towards the left. The second sulcus ran from the left side of the IVC, curving anteriorly to reach the inferior border of the liver at the level of the gallbladder fossa, concave towards the right. With progressive side‐to‐side manual compression, the sulci on the diaphragmatic surface become more evident. Division of the hepatic parenchyma along the two sulci exposed the right and middle hepatic veins respectively in more than 90% of cases. In embalmed cadavers, 24 livers showed antero‐posterior sulci in the superior surface, visible and palpable on the liver examined in situ. When the livers with sulci had been removed from the abdomen for further examination, the appearance of the superior surface did not change. In a removed liver, accessory sulci can be divided into true, “diaphragmatic,” sulci and “false” sulci due to the position of the free liver on the examination table. The “false” sulci may be considered as further morphological evidence of the functional anatomical division of the liver. Their demonstration may also be useful in teaching its topographical and surgical anatomy. Clin. Anat. 26:592–597, 2013. © 2012 Wiley Periodicals, Inc.     

腰椎椎弓根螺钉双皮质固定的椎前大血管解剖学研究

目的观测腰椎椎体前面与椎前大血管的解剖关系,为腰椎椎弓根螺钉双皮质固定技术提供血管解剖学依据。方法62例成年人行腰椎CT三维重建及腹部血管成像检查（其中男32例,女30例）,观测腰椎椎弓根平面椎体前面与腹主动脉、下腔静脉或髂动静脉之间的距离,腹主动脉、下腔静脉或髂动静脉相对于椎体前面的相对位置关系。结果L1-L4椎体左侧平椎弓根平面腹主动脉距椎体前面距离为0．26-0．37cm、位于椎体前面-7°-34°区域;L1-L3椎体右侧平椎弓根平面下腔静脉距椎体前面距离分别为1．03cm、0．75cm、0．36cm,位于椎体前面17°-63°区域;L。椎体右侧、L5椎体双侧平椎弓根平面髂动静脉距椎体前面距离小于0．15cm,位于椎前73°区域内。结论L1-L4左侧双皮质椎弓根螺钉置钉过深容易损伤腹主动脉,L1-L3椎右侧椎弓根螺钉最容易操作完成,损伤下腔静脉的可能性较小,L4右侧、L5双侧的双皮质椎弓根螺钉最容易损伤椎前大血管。