肝胰壶腹组织及其周围细小结构的三维重建  

Three-dimensional reconstruction of micro blood vessels,nerves and lymphatic system in the hepatopancreatic ampulla

作　　者：刘健男 张伟娜 王三贵 刘燕 石玉莲 刘家瑄 李祥天 肖钊明 叶锡银 黄文华 戴景兴 李严兵 Liu Jiannan;Zhang Weina;Wang Sangui;Liu Yan;Shi Yulian;Liu Jiaxuan;Li Xiangtian;Xiao Zhaoming;Feng Xiaohui;Huang Wenhua;Dai Jingxing;Li Yanbing(Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics&Guangdong Engineering Research Center for Translation of Medical 3D Printing Application&National Virtual&Reality Experimental Education Center for Medical Morphology(Southern Medical University)&National Key Discipline of Human Anatomy,School of Basic Medical Sciences,Southern Medical University,Guangzhou 510515,China;Dongguan Institute of Hepatobiliary Diseases,Dongguan Nancheng Hospital,Dongguan 523000,China;Department of Anatomy,Gannan Healthcare Vocational College,Ganzhou 341000,China;The Second Clinical Medical College,Southern Medical University,Guangzhou 510280,China)

机构地区：[1]南方医科大学基础医学院人体解剖学教研室/广东省数字医学与生物力学重点实验室/广东省医学3D打印应用转化工程研究中心/南方医科大学国家级医学形态学虚拟仿真实验教学中心,广东广州510515 [2]东莞市南城医院/东莞市肝胆疾病研究所,广东东莞523000 [3]赣南卫生职业学院解剖教研室,江西赣州341000 [4]南方医科大学第二临床医学院,广东广州510280

出　　处：《中国临床解剖学杂志》2025年第2期157-163,167,共8页Chinese Journal of Clinical Anatomy

基　　金：国家重点研发计划项目(2022YFF1202603)。

摘　　要：目的明确肝胰壶腹附近的细小动脉、静脉、交感神经、淋巴管道的配布及数量关系。方法将人肝胰壶腹的375张连续石蜡组织切片分成3组,分别进行苏木精与伊红染色、抗Tyrosine Hydroxylase组化染色、抗LYVE1抗体组化染色后扫描,用Photoshop进行图像配准。使用Mimics21.0分别将扫描切片进行叠加、分割、三维重建。在三维模型中,分析肝胰壶腹动脉、静脉、交感神经和淋巴管道及其分支在肝胰壶腹周围的分布和吻合情况,以及以上结构间的位置关系。结果肝胰壶腹区域的动脉、静脉相互伴行,弯曲走行,围绕在肝胰壶腹周围,紧密贴合肝胰壶腹管道分布;交感神经神经束分布清晰,围绕肝胰壶腹周围,伴随血管束走行;淋巴管道与血管伴行,围绕在肝胰壶腹管道表面与淋巴结周围。肝胰壶腹两层肌层结构区分清晰。结论本研究为肝外胆道、胆囊疾病的诊断和手术提供了准确的解剖学依据。Objectives To clarify the branches,distribution,arrangement and quantitative relationship of micro arteries,veins,sympathetic nerves and lymphatic vessels around the hepatopancreatic ampulla.Methods 375 continuous paraffin tissue sections were divided into three groups:those in the first group were stained with hematoxylin and eosin(HE),those in the second group with anti-tyrosine hydroxylase antibody,and those in the third group with anti-lymphatic vessel endothelial receptor-1(LYVE1)antibody staining.The scanning data of the slides were registered by Photoshop and the scanned data slices were superimposed,divided and 3D reconstructed by using Mimics 21.0.The distribution and anastomosis of arteries,veins,sympathetic nerves,lymphatic vessels,as well as their branches around the hepatopancreatic ampulla were analyzed in the three-dimensional models.The relationships among these four structures were also analyzed.Results The micro arteries and veins in the region of hepatopancreatic ampulla accompanied each other,bending walked around the ampulla and closely adhering to it.Sympathetic nerve tracts were clearly distributed around the hepatopancreatic ampulla and were accompanied by the vascular bundles.Lymphatic vessels and blood vessels were concomitant,surrounding the surface of the hepatopancreatic ampulla and lymph nodes.The structure of the two muscle layers of the hepatopancreatic ampulla was clearly distinguished.Conclusions This study provides accurate anatomical basis for the diagnosis and surgery of extrahepatic biliary tract and gallbladder diseases.

关 键 词：三维重建 肝胰壶腹 肝外胆道 精细解剖 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]