C7神经前后股末端神经束结构特点和三维重建初步研究

目的研究C7神经前、后股末端神经束的特点。方法取自愿捐献新鲜成人尸体臂丛神经标本,确定C7神经,切取股束结合部由神经外膜包绕的前、后股末端,以4根头发作为定位线,连续横断面冰冻切片,片厚10μm,行乙酰胆碱酯酶染色,采集图像后进行神经功能束的鉴别和计数,并用Amira 4.1医学三维重建软件进行三维重建。结果前、后股染色深浅对比不明显,神经功能束由近向远逐渐分开。C7神经前股末端感觉束多于运动束,感觉束主要位于内侧,运动束主要位于外侧;后股末端运动束多于感觉束,运动束及感觉束内、外侧均有分布。C7神经前股末端运动束(2.85±0.36)束,感觉束(5.13±1.01)束;后股末端分别为(6.00±0.69)束及(3.78±0.94)束;前、后股末端间运动束和感觉束差异均有统计学意义(P<0.05)。三维重建后可从不同角度观察C7神经前、后股末端神经功能束的特点,可见神经功能束在走行过程中不断交叉、融合。结论 C7神经前股末端以感觉束为主,主要位于内侧;后股末端以运动束为主,内、外侧均有分布。应用Amira 4.1软件可实现C7神经前、后股末功能束的三维重建。

Elementary research of constructive feature and three-dimensional reconstruction of nerve bundles of C7 anterior and posterior division end

Objective To observe the distribution feature of nerve bundles in C7 nerve anterior and posterior division end.Methods The brachial plexus specimen was harvested from 1 fresh adult cadaver.After C7 nerve was confirmed,the distal end of anterior and posterior division was dissected and embedded by OCT.Then the samples were serially horizontally sliced with each 10 μm deep.After acetylcholinesterase(AChE) histochemical staining,the stain characteristics of different nerve fiber bundles were observed and amount of the nerve fiber bundles were counted under optic-microscope.At last,the imaging which were collected were three-dimensional(3-D) reconstructed by using Amira 4.1 software.Results There was no obvious difference in the stain between the anterior and posterior divisions.The running of the nerve fiber bundles were dispersive from proximal end of nerve to distal end of nerve.Nerve fiber bundles of anterior division were mainly sensor nerve fiber bundles,which located in medial side.Nerve fiber bundles of posterior division were mainly moter nerve fiber bundles,having no regularity in the distribution of nerve fiber bundles.The total number of nerve fiber bundles in distal end of anterior division was 7.85 ± 1.04,the number of motor nerve fiber bundles was 2.85 ± 0.36,and the number of sensor nerve fiber bundles was 5.13 ± 1.01.The total number of nerve fiber bundles in distal end of posterior division was 9.79 ± 1.53,the number of motor nerve fiber bundles was 6.00 ± 0.69,and the number of sensor nerve fiber bundles was 3.78 ± 0.94.There were significant differences in the numbers of motor and sensor nerve fiber bundles between anterior and posterior divisions(P < 0.05).The microstructure 3-D model was reconstructed based on serial slice through Amira 4.1.The intercross and recombination process of nerves bundles could be observed obviously.The nerve bundle distribution showed cross and combination.Conclusion Nerve fiber bundles of anterior division are mainly sensor nerve fiber bundles and locate in medial side.Nerve fiber bundles of posterior division are mainly motor nerve fiber bundles,which has no regularity in the distribution of nerve fiber bundles.The 3-D reconstruction can display the internal structure feature of the C7 division end.