网膜囊与毗邻结构空间关系的三维可视化研究  

Three-dimensional visualization of the spatial relationships of omental bursatoits adjacent structures

作　　者：何明静 徐浩铜 李颖 雷秀兵[1] 史恺 田伏洲 HE Ming-jing;XU Hao-tong;LI Ying;LEI Xiu-bing;SHI Kai;TIAN Fu-zhou(Department of Human Anatomy,School of Basic Medicine,Panzhihua University,Panzhihua Sichuan 617000,China;General Surgery Center,General Hospital of Western Theater Command,Chengdu Sichuan 610083,China;Department of Digital Medicine,Biomedical Engineering and Medical Imaging,Army Medical University,Chongqing 400038,China)

机构地区：[1]攀枝花学院基础医学院人体解剖学教研室,四川攀枝花617000 [2]西部战区总医院全军普外中心,四川成都610083 [3]陆军军医大学生物医学工程与影像医学系数字医学教研室,重庆400038

出　　处：《局解手术学杂志》2023年第8期657-661,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：国家重点研发计划项目子课题(2018YFC0116901);攀枝花学院博士启动基金项目(035200147);攀枝花学院2020年校级项目(035001416)。

摘　　要：目的运用三维可视化技术深入了解网膜囊的解剖特征,以弥补厚层断面解剖与CT图像无法清晰显示网膜囊及其毗邻结构的空间关系的不足。方法从2号中国可视人数据库(CVH2)获取上腹部图像数据,对网膜囊各隐窝及其毗邻结构进行数据分割,三维可视化重建和多平面重建后进行两种重建图像的整合,并在断层与三维多角度观察网膜囊各隐窝与毗邻结构的空间关系。在53例肝硬化伴大量腹水患者的CT多平面重建图像上观察上述空间关系,并判断上、下隐窝通连情况。结果网膜囊由上隐窝、前庭部、下隐窝和脾隐窝组成。网膜囊大孔是上、下隐窝的分界标志,也是上、下隐窝通连的唯一路径,CT图像显示其通连方式分为通连和不通连两型,36例(67.9%)患者的CT图像上可见上、下隐窝直接通连,17例(32.1%)患者不通连。网膜孔右侧正对门腔间隙,该间隙最小前后径为4.5 mm。三维图像显示胃裸区位于上隐窝、下隐窝和脾隐窝之间。脾隐窝被左侧的脾裸区包饶。结论本研究运用CVH2图像可视化技术呈现了网膜囊及其与毗邻结构的空间关系,这将有助于提高网膜囊区域病变的鉴别诊断和解剖定位的准确性,从而降低网膜囊区病变的误诊率。Objective In order to overcome the obstacle that detailed spatial relationships of the omental bursa to its adjacent structures cannot be displayed clearly by the thick-slice sectional anatomical imaging and CT imaging,the three-dimensional visualization was used to explore the anatomic features of the omental bursa.Methods The upper abdomen data was retrieved from Second Chinese Visible Human dataset(CVH2),three-dimensional visualization reconstruction and multiplane reconstruction of each recess of omental bursa and its related structures were conducted after data segmentation,and then the integration of these two reconstructed images was performed.Moreover,the spatial relationships of each recess of omental bursa to its related structures were observed on sectional and three-dimensional models.The above spatial relationships were observed on the CT multiplane reconstruction images of 53 patients with cirrhosis and massive ascites,and the connection between the superior and inferior recesses was judged.Results The omental bursa was composed of the superior recess,vestibulum bursae omentalis,inferior recess and splenic recess.The foramen bursae omenti major was the anatomic landmark between the superior and inferior recesses,and was also the only pathway communicating between the superior and inferior recesses of the omental bursa.The connection pathway could be divided into the connection and non-connection types on CT images.The superior and inferior recesses of 36(67.9%)patients were of direct communication on CT images,and those of 17(32.1%)patients were of non-connection.The right layer of the foramen of Winslow faced to the portacaval sapce,whose minimum anteroposterior diameter was 4.5 mm.The gastric bare area was located among the superior,inferior and splenic recesses on 3D image.The splenic recess was surrounded by the splenic bare area on the left.Conclusion In this study,the spatial relationships of the omental bursa to its adjacent structures can be presented by the visualization technique using CVH

关 键 词：可视化 网膜囊 左膈下腹外膜间隙 胃裸区 脾隐窝 上隐窝 下隐窝 

分 类 号：R323.7[医药卫生—人体解剖和组织胚胎学]