臂丛神经三维重建及相关解剖学研究

目的 通过对正常女性臂从及其周围组织进行三维重建,探索神经受压的解剖学基础.方法 利用虚拟中国人女性1号数据集C_2～T_3层面共计750幅图像对臂丛神经及其毗邻组织(主要为骨、肌肉及腱性组织)进行计算机三维重建,观察神经占位情况,然后在此基础上对三维模型的臂从神经各段(根、干、股、束)做模切面,分别计算神经/间隙比值.结果 三维重建后,可透过体表在任意角度观测模型的内部结构.其中臂丛神经根、干、股、束各段结构的空间位置及行径方向均可清晰显示.根、干、股、束段神经与神经间隙横断面比值分别为0.5547±0.1684、0.2909±0.0644、0.4552±0.1236及0.2950±0.0572.臂从神经根、股段所处空间通道占位情况明显大于干、束段.结论 臂丛神经周围的骨、肌肉及腱性绀织是造成神经卡压的主要因素,臂丛根、股段所处神经通道相对较为狭窄,为臂丛卡压的临床诊断及治疗提供了参考.

An anatomical research into brachial plexus based on 3D reconstruction

Objective To explore the anatomic basis for nerve entrapment by establishing a 3D model of brachial plexus and its surrounding tissues.Methods A 3D model was created by segmentation of the data of Chinese Virtual Human(CVH),using altogether 750 images from C2 to T3.Brachial plexus and its related structures were reconstructed to observe nerve occupation.At each segment,the nerve was cut vertically.In cross section images,the ratio of the nerve to its gap was calculated.Finally the results were analyzed statistically by one way ANOVA.Results The inner structures could be observed through body surface at any angle after the model was established.The spatial relationships of various structures involved in the nerve entrapment could also be well analyzed.It is found that brachial plexus went through a narrow tunnel surrounded by bone,muscle and tendon-like tissue.The occupation rates of the nerve at the segments of root,trunk,strand and cord were 0.5547±0.1684,0.2909±0.0644,0.4552±0.1236,and 0.2950±0.0572respectively.The brachial plexus occupied much more tunnel space at the segments of root and strand than at the segments of trunk and cord.Conclusions At the root and strand segments of brachial plexus,the nerve is greatly compromised.This finding may help diagnosis and treatment of the entrapment syndrome of the peripheral nerve.