大脑中央前回计算神经影像解剖学及三维可视化
发布时间：2018-08-24 15:08
【摘要】：研究背景:随着显微神经外科的提高和神经影像技术的发展,当代神经外科由传统开颅方式向以病灶为中心的个体化微创手术入路发展,而微创手术的基础是术前对病灶的精确定位。近年来,由于立体定向技术的功能神经外科、微创神经外科以及放射神经外科的快速发展,计算机辅助的脑、神经影像学引导下立体定向和介入放射技术为大脑皮层病变的微侵袭治疗提供了现实途径。中央前回是分裂于大脑半球两侧,从半球间裂处,即后内上方走向前外下方的额叶脑回,止于外侧窝池上方,位于中央前沟与中央沟之间。中央前回是属于额叶的脑回,研究发现它在横断面上与额上回、额中回、额下回广泛相连,而与中央后回在靠近外侧窝池处相连。中央前回的一部分向后反折,突入中央沟内,形成一个明显的结区。中央沟、中央后回在此部位也向后稍有移位。而在大脑半球其他部位,虽然脑回存在弯曲和反折,但都不如在这个区域反折的幅度大,形成独特的半个花结形状。中央沟的一个小侧枝进入反折的脑回中,使结中间有一个小裂隙,呈ω形,也可不很明显。在矢状面上呈“典型的构型”,表现出一个清晰的岛形区,称之为“构型征”,或者呈“刺刀形”、“阶梯状”或“弯弯曲曲形”。中央前回这个特定区域涉及一部分特定脑部功能,又可作为中央前回的定位标志,具有非常重要的临床价值。本研究对中央前回手运动区分型进行补充,将之更细分为七种形态。在基于连合间径的笛卡尔三维坐标系中测量中央前回的立体定位数据集,求得其在坐标系中的平面回归方程;构建基于断层影像的中央前回在整脑中的三维可视化模型,为研究中前回区域的临床影像学、立体定向外科、介入放射及微创神经外科等提供量化影像解剖学资料。第一部分大脑中央前回手运动区的MRI形态学研究目的:通过研究以AC-PC线为扫描基线的活体薄层MR图像,定位及分析手运动区域的形态学规律。方法:选取48名右手利健康成人志愿者头颅进行薄层MRI扫描,获得48名志愿者96个大脑半球的mri横断位、矢状位及冠状位图像,对手运动区进行识别、定位,并观察分析其形态学规律。结果:手运动区域分7种类型:倒Ω,ω,ω内不对称,ω外不对称,曲线,三叶草,波浪型。对男女、男性和女性左右侧大脑半球各型进行秩和检验发现差异均无有统计学意义(p0.05)。对男女倒Ω型的高和宽进行统计学分析,男女性倒Ω型的高度无统计学差异(p0.05),而男女性基底宽有统计学差异,即男性基底宽大于女性(p0.05)。结论:完善中央前回手运动区在横断面的形态学分类,为临床及实验研究识别中央前回提供便利条件。第二部分大脑中央前回立体定位数据集的构建及回归分析1.中央前回前壁和后壁最内、外侧缘的立体定位数据集的构建目的:求得中央前回前壁和后壁最内、外侧缘在笛卡尔三维坐标系中的立体定位数据集方法:男女各20例健康成人志愿者颅脑,以大脑间径(ac-pc线)为扫描基线(冠状面为垂直于ac-pc线),行横断层2mm、矢状面2mm和冠状面2mmt1mr扫描。在微型计算机上将扫描数据以dicom3.0格式导入efilm3.4工作站。将颅脑横断层面mri数据经格式转化导入photoshop软件,以连合间经中点为原点,使连合间径与y轴重叠建立笛卡尔三维坐标系,测量每个层面上中央前回前壁和后壁最内、外侧点,读取、记录各取样点的x、y坐标值,z值为所在层面距离零层面的数目与层距的乘积。结果:得到正常成年男女中央前回前壁和后壁最内、外侧点在大脑中的三维空间立体定位数据集。结论:男女中央前回前壁和后壁最内、外侧点立体定位数据集的构建为立体定向神经外科、介入放射治疗及微创神经外科等有较大的临床应用价值;同时为神经生理功能、人类学等方面的研究提供形态学基础。2.中央前回前壁和后壁最内、外侧点的投影图及拟合曲线方程分析目的:计算中央前回前壁和后壁最内、外侧点在冠状面上的投影图及在冠状面、横断面上的拟合曲线方程。方法:将上述大脑中央前回前壁和后壁最内、外侧点的大脑空间坐标系的坐标值(X,Y,Z),利用excel求其在冠状面上的投影图,并利用SPSS17.0软件求解其在冠状面、横断面上的拟合曲线方程。结果:中央前回前壁和后壁最内、外侧点在冠状面上的投影图能够反映中央前回的形态特征,求出了中央前回前壁和后壁最内、外侧点在冠状面及横断面投影方向上的拟合曲线方程。结论:中央前回前壁和后壁,最内侧点相关系数较高,最外侧点相关系数较低,中央前回后壁较前壁相关系数较高,即中央前回中下内侧部分分布有显著汇聚趋势,即在大脑内侧面近大脑中部稳定性较高,外侧面大脑结构变异较高,这在脑的人类学、发育学、体质测量学等方面具有一定的科学意义。第三部分大脑中央前回的三维重建及可视化目的:重建中央前回的三维可视化模型,为微创神经外科手术、介入放射治疗及影像解剖学教学提供可视化模型。方法:在微型计算机上,将1例正常成人(无神经、精神病史及家族史)颅脑横断面2mm薄层MRI扫描数据以Dicom3.0格式导入3D-Doctor软件,人工分割中央前回、中央后回、侧脑室及大脑表面,分别以不同颜色标识,以复杂面重建方法对上诉三者同时进行三维重建。结果:成功重建了中央前回在整脑中的三维可视化模型,从不角度展现了中央前回在活体脑中的形态、位置及毗邻关系。结论:应用活体MRI数据建立中央前回的三维模型,可以从不角度观察中央前回三维形态、空间位置及其与重要结构的毗邻关系,并可以在模型上进行三维解剖学的测量,这在立体定向神经外科、介入放射治疗、影像解剖学教学等方面有应用价值
[Abstract]:BACKGROUND: With the development of microneurosurgery and neuroimaging technology, contemporary neurosurgery has evolved from traditional craniotomy to individual minimally invasive approach centered on lesions. The basis of minimally invasive surgery is preoperative precise localization of lesions. In recent years, due to stereotactic functional neurosurgery, minimally invasive spirit has emerged. With the rapid development of surgery and radioneurosurgery, computer-assisted brain, neuroimaging-guided stereotactic and interventional radiology have provided a practical approach for minimally invasive treatment of cerebral cortical lesions. The anterior central gyrus belongs to the frontal gyrus. It is extensively connected with the superior frontal gyrus, the middle frontal gyrus and the inferior frontal gyrus, but with the posterior central gyrus near the lateral fossa cistern. In other parts of the cerebral hemisphere, although the gyrus is curved and reflexed, the extent of reflexion is not as large as in this area, forming a unique half-nodule shape. A small lateral branch of the central sulcus enters the reflexed gyrus, causing a small fissure in the middle of the nodule. The shape of the anterior central gyrus, which involves a specific part of the brain function and serves as a marker for the location of the anterior central gyrus, shows a distinct "typical configuration" on the sagittal plane, which is called "configuration" or "bayonet-shaped", "ladder-shaped" or "curved". This study supplements the central anterior return motion classification and further subdivides it into seven shapes. In Cartesian three-dimensional coordinate system based on the connecting diameters, the data sets of the central anterior return are measured to obtain the plane regression equation in the coordinate system, and the pre-central return is integrated based on the sectional images. The three-dimensional visualization model in the brain provides quantitative image anatomical data for the study of clinical imaging, stereotactic surgery, interventional radiology and minimally invasive neurosurgery in the anterior gyrus. Part I: MRI morphological study of the anterior central gyrus motor area. Methods: 48 right-handed healthy adult volunteers were scanned with thin-slice MRI, and 96 cerebral hemispheres of 48 volunteers were obtained in transverse, sagittal and coronal MRI images. The hand motion areas were identified, located and observed. Types: inverted_, _, _internal asymmetry, _external asymmetry, curves, clover, wave type. No significant difference was found in the left and right hemispheres of men and women, men and women by rank sum test (p0.05). Statistical analysis of the height and width of inverted_between men and women showed no significant difference in the height of inverted_between men and women (p0.05). Conclusion: Perfecting the morphological classification of the anterior central gyrus provides convenient conditions for clinical and experimental studies to identify the anterior central gyrus. Part II Construction and regression analysis of stereotaxic data sets of the anterior central gyrus. Objective: To construct a stereotaxic data set of the innermost and lateral margins of the posterior wall and anterior wall of the anterior and posterior gyrus of the central anterior gyrus. Methods: Twenty healthy adult volunteers, male and female, were scanned with the AC-PC line as the baseline (the coronal plane was perpendicular to the AC-PC line), and transverse sectional section 2 was performed. Mm, sagittal 2mm and coronal 2mmt 1MR scans. Scanning data are imported into efilm 3.4 workstation in DICOM 3.0 format on microcomputer. Transverse cranial tomographic MRI data are transformed into Photoshop software. The origin is the midpoint of the junction, and the diameter of the junction overlaps with the Y Y Y Y Y Y Y Y Y Y Y Y Y axis to establish a Cartesian 3-D coordinate system for measuring the middle of each plane. Results: Three-dimensional spatial data sets of the anterior and posterior walls of the central gyrus were obtained in normal adult men and women. The data set of stereotactic location of the anterior and posterior wall and the lateral points is of great clinical value for stereotactic neurosurgery, interventional radiotherapy and minimally invasive neurosurgery. It also provides morphological basis for the study of neurophysiological function and anthropology. 2. Projection and fitting of anterior and posterior wall of the central anterior gyrus Objective: To calculate the projection of the anterior and posterior walls of the central anterior gyrus and the fitting curve equation of the lateral points on the coronal plane and the coronal plane and cross section. Results: The projection maps of the anterior and posterior walls of the central anterior gyrus and the lateral points on the coronal plane can reflect the morphological characteristics of the anterior and posterior walls of the central anterior gyrus, and the projection directions of the anterior and posterior walls of the central anterior gyrus are obtained. CONCLUSION: The correlation coefficients of the anterior and posterior walls of the anterior and posterior gyrus are higher, the correlation coefficients of the laterolateral points are lower, and the correlation coefficients of the anterior and posterior walls of the central gyrus are higher than those of the anterior wall. The third part is the three-dimensional reconstruction and visualization of the anterior central gyrus. The purpose is to reconstruct the three-dimensional visualization model of the anterior central gyrus and provide a visualization model for minimally invasive neurosurgery, interventional radiotherapy and imaging anatomy teaching. On a microcomputer, the 2mm thin-slice MRI data of a normal adult (without neurological, psychiatric and family history) were imported into the 3D-Doctor software in Dicom 3.0 format. The anterior central gyrus, posterior central gyrus, lateral ventricle and brain surface were artificially segmented and marked with different colors, and the appellate was reconstructed simultaneously by complex surface reconstruction method. Results: Three-dimensional visualization model of anterior central gyrus was successfully reconstructed, and the morphology, location and adjacent relationship of anterior central gyrus in vivo were displayed from different angles. The adjacent relationship of the structure and the measurement of three-dimensional anatomy on the model can be used in stereotactic neurosurgery, interventional radiotherapy, image anatomy teaching and so on.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R445.2
本文编号：2201204
[Abstract]:BACKGROUND: With the development of microneurosurgery and neuroimaging technology, contemporary neurosurgery has evolved from traditional craniotomy to individual minimally invasive approach centered on lesions. The basis of minimally invasive surgery is preoperative precise localization of lesions. In recent years, due to stereotactic functional neurosurgery, minimally invasive spirit has emerged. With the rapid development of surgery and radioneurosurgery, computer-assisted brain, neuroimaging-guided stereotactic and interventional radiology have provided a practical approach for minimally invasive treatment of cerebral cortical lesions. The anterior central gyrus belongs to the frontal gyrus. It is extensively connected with the superior frontal gyrus, the middle frontal gyrus and the inferior frontal gyrus, but with the posterior central gyrus near the lateral fossa cistern. In other parts of the cerebral hemisphere, although the gyrus is curved and reflexed, the extent of reflexion is not as large as in this area, forming a unique half-nodule shape. A small lateral branch of the central sulcus enters the reflexed gyrus, causing a small fissure in the middle of the nodule. The shape of the anterior central gyrus, which involves a specific part of the brain function and serves as a marker for the location of the anterior central gyrus, shows a distinct "typical configuration" on the sagittal plane, which is called "configuration" or "bayonet-shaped", "ladder-shaped" or "curved". This study supplements the central anterior return motion classification and further subdivides it into seven shapes. In Cartesian three-dimensional coordinate system based on the connecting diameters, the data sets of the central anterior return are measured to obtain the plane regression equation in the coordinate system, and the pre-central return is integrated based on the sectional images. The three-dimensional visualization model in the brain provides quantitative image anatomical data for the study of clinical imaging, stereotactic surgery, interventional radiology and minimally invasive neurosurgery in the anterior gyrus. Part I: MRI morphological study of the anterior central gyrus motor area. Methods: 48 right-handed healthy adult volunteers were scanned with thin-slice MRI, and 96 cerebral hemispheres of 48 volunteers were obtained in transverse, sagittal and coronal MRI images. The hand motion areas were identified, located and observed. Types: inverted_, _, _internal asymmetry, _external asymmetry, curves, clover, wave type. No significant difference was found in the left and right hemispheres of men and women, men and women by rank sum test (p0.05). Statistical analysis of the height and width of inverted_between men and women showed no significant difference in the height of inverted_between men and women (p0.05). Conclusion: Perfecting the morphological classification of the anterior central gyrus provides convenient conditions for clinical and experimental studies to identify the anterior central gyrus. Part II Construction and regression analysis of stereotaxic data sets of the anterior central gyrus. Objective: To construct a stereotaxic data set of the innermost and lateral margins of the posterior wall and anterior wall of the anterior and posterior gyrus of the central anterior gyrus. Methods: Twenty healthy adult volunteers, male and female, were scanned with the AC-PC line as the baseline (the coronal plane was perpendicular to the AC-PC line), and transverse sectional section 2 was performed. Mm, sagittal 2mm and coronal 2mmt 1MR scans. Scanning data are imported into efilm 3.4 workstation in DICOM 3.0 format on microcomputer. Transverse cranial tomographic MRI data are transformed into Photoshop software. The origin is the midpoint of the junction, and the diameter of the junction overlaps with the Y Y Y Y Y Y Y Y Y Y Y Y Y axis to establish a Cartesian 3-D coordinate system for measuring the middle of each plane. Results: Three-dimensional spatial data sets of the anterior and posterior walls of the central gyrus were obtained in normal adult men and women. The data set of stereotactic location of the anterior and posterior wall and the lateral points is of great clinical value for stereotactic neurosurgery, interventional radiotherapy and minimally invasive neurosurgery. It also provides morphological basis for the study of neurophysiological function and anthropology. 2. Projection and fitting of anterior and posterior wall of the central anterior gyrus Objective: To calculate the projection of the anterior and posterior walls of the central anterior gyrus and the fitting curve equation of the lateral points on the coronal plane and the coronal plane and cross section. Results: The projection maps of the anterior and posterior walls of the central anterior gyrus and the lateral points on the coronal plane can reflect the morphological characteristics of the anterior and posterior walls of the central anterior gyrus, and the projection directions of the anterior and posterior walls of the central anterior gyrus are obtained. CONCLUSION: The correlation coefficients of the anterior and posterior walls of the anterior and posterior gyrus are higher, the correlation coefficients of the laterolateral points are lower, and the correlation coefficients of the anterior and posterior walls of the central gyrus are higher than those of the anterior wall. The third part is the three-dimensional reconstruction and visualization of the anterior central gyrus. The purpose is to reconstruct the three-dimensional visualization model of the anterior central gyrus and provide a visualization model for minimally invasive neurosurgery, interventional radiotherapy and imaging anatomy teaching. On a microcomputer, the 2mm thin-slice MRI data of a normal adult (without neurological, psychiatric and family history) were imported into the 3D-Doctor software in Dicom 3.0 format. The anterior central gyrus, posterior central gyrus, lateral ventricle and brain surface were artificially segmented and marked with different colors, and the appellate was reconstructed simultaneously by complex surface reconstruction method. Results: Three-dimensional visualization model of anterior central gyrus was successfully reconstructed, and the morphology, location and adjacent relationship of anterior central gyrus in vivo were displayed from different angles. The adjacent relationship of the structure and the measurement of three-dimensional anatomy on the model can be used in stereotactic neurosurgery, interventional radiotherapy, image anatomy teaching and so on.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R445.2
【参考文献】
相关期刊论文 前1条
1 栾丽菊,刘丰春;中央前、后回在矢状断面上的定位[J];中国临床解剖学杂志;2004年02期
，本文编号：2201204
本文链接：https://www.wllwen.com/huliyixuelunwen/2201204.html
最近更新
教材专著
