精道远端区域应用解剖及MRI影像特征研究

发布时间：2018-02-23 20:25

本文关键词： 精囊射精管前列腺小囊解剖 MRI影像　出处：《第三军医大学学报》2015年23期 　论文类型：期刊论文

【摘要】：目的通过对成年男性精道远端区域精细解剖结构的深入观察和相关生理数据的准确测量,为临床更加精确地开展精道内镜技术提供依据。方法收集35例行根治性前列腺切除(laparoscopic radical prostatectomy,LRP)及11例行全膀胱切除(laparoscopic radical cystectomy,LRC)术后完整的组织标本,对其精道远端解剖结构进行精细观察和测量,并结合患者术前MRI,对精道远端结构的MRI影像特征与实际测量结果进行对比分析;对109例前列腺增生(benign prostatic hyperplasia,BPH)患者行经尿道内镜手术前双侧精囊按摩,直视下观察射精管开口与前列腺小囊开口的解剖特征。结果 46例术后标本的精细解剖结果:精囊长度:左侧(39.7±7.4)mm,右侧(41.4±8.6)mm;宽度:左侧(16.5±3.3)mm,右侧(16.4±3.0)mm;厚度:左侧(7.8±2.4)mm,右侧(7.8±2.3)mm;射精管长度:左侧(15.0±2.5)mm,右侧(14.9±2.4)mm;内径:左侧(1.2±0.2)mm,右侧(1.1±0.2)mm。47.8%(22/46)标本可见前列腺小囊,深度(6.7±1.7)mm。MRI图像下所测精囊长度:左侧(39.4±6.6)mm,右侧(41.3±7.6)mm;宽度:左侧(17.1±3.4)mm,右侧(16.4±2.9)mm,显示与实体标本测量数据高度吻合。内镜下观察显示:78.9%(86/109)显示前列腺小囊开口于精阜隆起部,21.1%(23/109)未发现明确前列腺小囊开口,射精管通常开口于前列腺小囊开口两侧旁约2 mm处,与其构成三角形或直线排列关系。结论本研究获得的精道远端区域的解剖数据对临床开展相关内镜技术具有重要指导意义,MRI对该区域具有良好分辨价值。
[Abstract]:Objective to observe the fine anatomical structure of the distal region of spermatogonium in adult males and to measure the relevant physiological data accurately. Methods 35 cases of radical radical prostatectomy and 11 cases of total cystectomy radical were collected. The anatomical structure of the distal spermatozoa was carefully observed and measured, and the MRI imaging features of the distal spermatozoa structure were compared with the actual measured results combined with the preoperative MRI. Bilateral seminal vesicle massage was performed before transurethral endoscopic surgery in 109 patients with benign prostatic hyperplasia (BPH). Results the fine anatomical results of 46 postoperative specimens were as follows: the length of seminal vesicle was 39.7 卤7.4 mm on the left side, 41.4 卤8.6 mm on the right side, 16.5 卤3.3 mm on the left side and 16.4 卤3.0 mm on the right side, and the thickness was 7.8 卤2.4 mm on the left side and 7.8 卤2.3 mm on the right side. The length of the ejaculatory duct was 15.0 卤2.5mm on the left side, 14.9 卤2.4m on the right side, and 1.2 卤0.2mm on the left side, and 1.1 卤0.2mm. 47.8mm on the right side. Length of seminal vesicle measured on MRI images: left side 39.4 卤6.6 mm, right side 41.3 卤7.6 mm; width: left side 17.1 卤3.4 mm, right side 16.4 卤2.9 mm, showing high agreement with measured data of solid specimen. Endoscopic observation showed that the prostatic vesicle opened in the protuberance of caruncle. The opening of the small prostate sac is now clear. The ejaculatory duct is usually located about 2 mm on either side of the orifice of the small prostatic sac. Conclusion the anatomical data of the distal region of spermatozoa obtained in this study have important guiding significance for the clinical development of relevant endoscopic techniques. MRI has a good value in distinguishing the region.
【作者单位】：第三军医大学大坪医院野战外科研究所泌尿外科;
【基金】：大坪医院全军计划生育优生优育中心人精子蛋白与男性不育关系研究课题资助(505-1539)~~
【分类号】：R322.6

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