颞骨内部结构三维重建及临床应用

随着耳显微外科及侧颅底手术的广泛开展，颞骨的精确解剖结构空间关系日益显示出其重要性。颞骨内部结构复杂、体积小、毗邻关系复杂，常规解剖及单纯切片研究均不能很好地说明它们的空间细节及空间测量的精确性。近年来，应用计算机三维重建研究颞骨，已使颞骨研究从定性向定量发展，极大地促进了耳科及相关学科的发展。     

豚鼠颞骨三维重建的冰冻连续切片技术

目的　通过改进豚鼠颞骨冰冻连续切片技术 ,以获得更好的计算机三维图象。方法　将用甲酸脱钙后的颞骨标本 ,在低温下用明胶包埋。结果　此技术具有切片较薄、制片周期短和定位准确的优点。结论　该技术既具备切片的细节性 ,又能反映其空间特性 ,对颞骨解剖研究很有意义     

人心连续组织切片的计算机三维重建

用表面重建法对人心连续组织切片进行了三维重建，重建中应用了火棉胶断面切片技术及图像拟合与插值处理，与以往的解剖断面重建比较，图像更加清晰、逼真，可从不同观察心脏的外部轮廓与内部结构。作为三维重建的基础性研究，可为心血管影像诊断提供解剖形态学依据和可靠的三维软件。     

人体动脉连续组织切片的计算机三维重建

在Ｉｎｔｅｌ ４０４８６主机下，采用３Ｄ ＶＩＥＷＮＩＸ软件对正常股动不粥样硬化冠状动脉的连续组织切片进行计算机三维重建，重建的动脉图像色泽鲜艳，外形逼真，立体感强，可单独或同时显示粥样硬化斑块，中膜和外膜的外形轮廓有其相互关系，并可进行任意角度旋转和不同方位的断面剖割，较好地实现了对动脉形态结构的三维立体显示，为影像诊断学提供了有价值的形态学资料。     

耳蜗三维重建的研究及意义

长期以来,对于耳蜗的研究都是基于传统的二维组织切片,虽然取得了丰硕的成果,但未能提供 耳蜗的三维直观显示和三维参数。基于颞骨连续切片和SCT、MRI等医学影像扫描技术的三维重建则从三维 的角度显示耳蜗的结构与功能,提供三维参数,不仅帮助人们进一步认识耳蜗这一特殊的结构,而且可以辅助 医生进行临床诊疗,在临床和教学工作中有着深远的意义和广阔的应用前景。     

火棉胶切片技术在软硬组织联合切片中的应用

火棉胶组织切片制作技术在病理学科发展中起着重要的作用.特别是口腔的颌骨、胎儿头颅,既有软组织也有硬组织,组织之间软硬度差别较大,组织块体积较大,采用石蜡切片还达不到目的.而火棉胶包埋切片技术,能够保持组织的完整性.笔者介绍火棉胶切片制作技术在牙齿、颌骨及周围软组织等软硬组织联合切片中的应用及体会.     

喉组织切片与喉CT图像的对照研究及三维重建

目的对喉部MSCT和组织切片图像及其三维重建的比较研究。方法 30例(21男,9女)结构完整的喉标本,全喉连续大切片,HE染色,专业微距照相系统拍照,专业图像分析;30名(12男,18女)健康志愿者经64排高分辨率薄层MSCT扫描,得到喉部CT图像。在用3D-Doctor软件进行MSCT三维重建。测量组织切片和MSCT三维重建喉甲状软骨、环状软骨和6个切面会厌前间隙和声门旁间隙的面积,进行两组独立样本的t检验。结果 MSCT图像中甲状软骨、会厌软骨和环状软骨能清晰显示,但杓状软骨显示不全。会厌前间隙和声门旁间隙内容结构无法显示,而组织切片清晰显示间隙内容。组织切片和MSCT甲状软骨、环状软骨的测量结果无显著性差异(P0.05)。除了甲状软骨声带附着处至上、下切迹距离等四项数据无性别差异(P0.05)以外,其他数据均有性别差异(P0.05)。MSCT切割平面与组织切片会厌前间隙和声门旁间隙面积的测量结果无显著性差异(P0.05)。结论 MSCT对超过其分辨率的细微结构显示欠佳,其三维重建的细节效果不如组织切片完整清晰。组织切片能对MSCT起到良好的补充作用,使得MSCT及其三维重建作为临床医疗诊断和影像学检查的辅助工具,更适合于临床应用。     

壁虎颈髓连续组织切片计算机三维重建研究

目的:利用壁虎颈髓连续切片,探索一种用计算机三维重建技术,获得"壁虎虚拟脊髓"形态的方法。方法:通过数码显微摄像系统对连续的Nissl染色的冰冻切片进行拍照,获得壁虎颈髓连续切片的图像,再利用三维重建方法,把二维的切片图像重建成三维图像。结果:在MATLAB开发平台上,采用基于有序数据结构的Shear-Warp算法,重建得到虚拟脊髓,重建后的脊髓可以进行任意的切割、旋转等操作。结论:利用计算机辅助三维重建方法对壁虎颈髓重建,是一种较为实用的方法。     

中药组织连续切片计算机三维重建与动态显示

实现了产药材附子连续切片三维重建与动态显示，为计算机辅助生药学教学和鉴定提供了具有生动性和立体感的三维图像技术和资料。     

Plastination and computerized 3D reconstruction of the temporal bone

The purpose of this study was to generate a computerized 3D reconstruction of the temporal bone and intratemporal structures. A plastination technique was used to obtain equidistant serial thin sections of 1.2 mm thickness and, on an SGI workstation, a Contour-Marching Cubes algorithm was selected to reconstruct the temporal bone and intratemporal structures in three dimensions. All reconstructed structures can be represented individually or jointly and rotated in any plane. Any diameter and angle of a structure can be conveniently measured. The capability of reconstructing individual and combined images of intratemporal structures, viewing them from all surgical angles, and accurately measuring their spatial relationships gives skull base and otologic surgeons important guidance. The reconstructed model can also be used for resident education, rehearsal of an unfamiliar surgery, and for developing a new surgical approach.     

An original technique for histological study of the human temporal bone

Summary An original technique for histological study of the human temporal bone is presented. It allows faster and better results than previous methods. It becomes obvious that the systematic study of the temporal bone may give important data in the field of pathology, foeto-pathology and forensic medicine.

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Une technique originale d'étude de l'os temporal humain

Résumé Les auteurs présentent une nouvelle technique histologique pour l'étude de l'os temporal permettant une mise en uvre rapide et une grande finesse des coupes. Cette technique revêt un grand intérêt pour des pathologies variées et incite à pratiquer des examens systématiques de cet os en anatomie pathologique, fto-pathologie et médecine légale.

     

颞骨岩部结构的定位解剖及临床意义

目的:为颅底手术中耳蜗的定位、岩尖的磨除范围提供解剖学方法。方法:在12个成人头颅标本上利用颅中窝入路暴露岩内面神经、耳蜗、颈内动脉等结构。观测岩内膝状神经节、颈内动脉(internalcarotidartery,ICA)的膝部、内耳道内侧缘、棘孔与耳蜗之间的解剖关系。结果:耳蜗位于面神经膝状神经节的前下方和岩内ICA膝部的后上方,耳蜗覆盖到ICA膝部的上方。ICA水平段与ICA膝部和内耳道内侧缘连线的夹角为67.1°±4.3°。结论:以棘孔和膝状神经节连线的中点、膝状神经节、内耳道内侧缘形成的三角定位耳蜗。在耳前—颞下窝斜坡手术入路中,在中颅底,过ICA膝部做与ICA水平段成67.1°±4.3°的夹角,在这个夹角内磨除岩尖骨质,不会损伤耳蜗、内耳道及其内容物。耳蜗基底圈至ICA膝部的距离为(0.302±0.016)cm。从前向后磨除岩尖骨质时,ICA膝部后方的骨质磨除不要超过(0.302±0.016)cm,否则会损伤耳蜗。     

颞浅动脉额支的定位观测及其对眉再造的意义

目的：为颞浅动脉额支岛状头皮瓣再造眉提供解剖学基础。方法：解剖６３侧成人头面部标本,建立坐标定点测量颞浅血管额支的位置。结果：①颞浅动脉额支Ｅ点的ｘ值与Ｃ点的ｘ值呈直线相关,＾ｙ＝－２．８２＋０．８８ｘ。②颞浅动脉额支在ＡＢ、ＤＥ、ＥＦ段的倾斜角分别为４７．１°±１８．９°、８４．４°±３３．７°、７６．９°±１２．８°。③颞浅动脉额支在Ａ、Ｄ、Ｅ、Ｈ点与同名静脉间的距离分别为６．１±３．６ｍｍ、８．６±５．２ｍｍ、１０．４±７．３ｍｍ、１９．８±８．９ｍｍ。结论：①颞浅动脉额支Ｅ点可作为血管蒂旋转轴点;②选择扇形血管蒂有利于血运。     

Immunological and histological studies of temporal arteries from patients with temporal arteritis and/or polymyalgia rheumatica.

Biopsies from the temporal arteries of 62 out of 80 patients presenting the clinical picture of temporal arteritis and/or polymyalgia rheumatica showed morphologically active or healed arteritis. Fifty-five of these biopsies revealed anti-IgG activity as measured by the mixed agglutination test. In 21 of the 27 cases which could be completely studied, the anti-IgG activity was connected with the presence of IgA, either alone, or together with IgG or IgM, or both, and complement. All of these 21 biopsies showed morphologically active granulomatous arteritis with signs of tissue destruction. In 6 biopsies, the active component appeared to be some type of Fc receptor in the tissue. Morphologically these biopsies showed either non-granulomatous mononuclear arteritis without definite necrosis or they represented various stages of healing arteritis with no or minor signs of tissue destruction. Weak anti-IgG activity was often found in a morphological type characterized by minimal inflammatory activity. These lesions are easily overlooked and the mixed agglutination test proved to be a good diagnostic tool in such cases. Arteries without anti-IgG activity showed no signs of active arteritis.     

Three-dimensional reconstruction of the ankle by means of ultrathin slice plastination

Computerized reconstruction of anatomical structures is becoming very useful for developing anatomical teaching modules and animations. Although databases exist consisting of serial sections derived from frozen cadaver material, plastination represents an alternate method for developing anatomical data useful for computerized reconstruction. Plastination is used as an excellent tool for studying different anatomical and clinical questions. The sheet plastination technique is unique because it offers the possibility to produce transparent slices series, which can easily be processed morphometrically. The purpose of this study was to describe a method for developing a computerized model of the human ankle using plastinated slices. This method could be applied to reconstruct any desired region of the human body.A human ankle was obtained, plastinated, sectioned, and subjected to 3D computerized reconstruction using WinSURF modeling system (SURFdriver Software). Qualitative observations revealed that the morphological features of the model were consistent with those displayed by typical cadaveric specimens. Morphometric analysis indicated that the model did not significantly differ from a sample of cadaveric specimens. These data support the use of plastinates for generating tissues sections useful for 3D computerized modeling.     

Postirradiation osteosarcoma of pelvic bone with unusual histological pattern

This paper reports an osteosarcoma of the pelvic bone appearing 8 years after postoperative radiation therapy for carcinoma of the uterus and ovary. Unusual was the existence of well differentiated parts and possibly early sarcomatous changes which were found only in the primary tumour and not in the metastases.     

Prognostic significance of the histological features of malignant melanoma

A review of 694 patients with localized cutaneous malignant melanoma (clinical stage I) revealed that three histological features of the primary lesion had no effect of their own on survival rate but derived their prognostic significance only because of their close correlation with tumour thickness. Primary lesions of superficial spreading histogenetic type, or of low mitotic activity or showing evidence of partial regression appeared to have a more favourable prognosis than lesions of nodular histogenetic type or of high mitotic activity or showing no regression. However, the former three histological features were predominant in thin lesions which had a better prognosis than thicker lesions. It was concluded that these features exerted only an indirect effect upon survival, tumour thickness being the most important prognostic determinant.     

The structure and innervation of the male urethra: histological and immunohistochemical studies with three-dimensional reconstruction

The structure of the striated urethral sphincter, the so-called rhabdosphincter, remains the subject of controversy. There are two main concepts regarding its structure: either it is a part of the urogenital diaphragm, or it extends from the base of the bladder up to the urogenital diaphragm and is an integral part of the urethra. It is also uncertain whether it possesses a somatic innervation or a mixed innervation (i.e. autonomic and somatic). The purpose of this study was to show the precise location of the nerves running to the urethra, and to try to determine their exact nature. Histology and immunohistochemistry were performed in the external urethral sphincter of ten male fetuses (114-342 mm crown-rump length, or between 14 and 40 weeks of gestation). A three-dimensional (3D) reconstruction of the urethral structure and its innervation was made from serial sections. The 3D reconstruction of the same section levels with different strains allowed us to identify the precise structure of the muscle layers (smooth and striated muscle fibres) and the nature of the nerve elements (myelinated and unmyelinated), their distributions and their relationship to the urethral wall, the prostate and the seminal vesicles. Histological and immunohistochemical 3D reconstruction of the anatomical elements of the urethral sphincter helps us to understand the 3D arrangement of the sphincter muscle layers. It also provides a better understanding of the origin and nature of the nerve elements that play a role in urinary continence.