颌面部血管的应用解剖及三维可视化研究

发布时间：2018-05-09 15:21

本文选题：颌面部血管 + 明胶-氧化铅　；参考：《南华大学》2008年硕士论文

【摘要】： 目的: 1.对人体颌面部进行巨微解剖及血管铸型,为临床整形美容术提供应用解剖参考依据。 2.探讨人体颌面部血管数字化的方法,对颌面部血管及其周围结构的毗邻关系进行三维可视化研究。材料和方法: 1.巨微解剖:6例正常成人头颈部标本,经颈总动脉灌注红色乳胶或汞溴红溶液,在肉眼和手术显微镜下从下颌骨下缘、耳屏前缘至鼻背部由浅入深逐层解剖,观测并记录颌面部血管的起始处外径、走行、分支、分布、吻合及伴行情况。 2.血管铸型:3例正常成人头颈部标本(新鲜),经颈总动脉加压注入红色过氯乙烯填充剂,经腐蚀后观察颌面部血管的来源、走行、分支、分布、吻合及伴行情况。 3.血管造影及三维重建:3例新鲜成人头面部标本,灌注前行CT扫描,扫描后经颈总动脉灌注明胶-氧化铅造影剂,分别进行放射显影和CT连续扫描,扫描数据以.dicom格式保存,导入Mimics软件,采用表面遮盖显示法(shaded surface display,SSD)对颅骨、颌面部血管和面部轮廓进行三维重建与可视化显示,观察它们的三维毗邻关系。结果: 1.颌面部血管的解剖学特点颌面部的动脉血管主要来源于面动脉、眼动脉、上颌动脉和颞浅动脉的分支。⑴面动脉主要供养面颊部、唇部和颏部,起始部位恒定,但其走行、分布、终止部位易变,面动脉起始处外径2.3±0.4mm,出现率为100%。⑵颏下动脉是面动脉的恒定分支,起始外径1.8±0.6mm,出现率为100%。⑶下唇动脉的起始外径1.2±0.4mm,出现率为75%。⑷上唇动脉起始部位较恒定,起始外径1.3±0.3mm,出现率为96.8%。⑸鼻翼下缘动脉起始外径1.0±0.3mm,出现率为83.3%。⑹鼻翼动脉起始外径0.6±0.2mm,出现率为91.67%。⑺鼻外侧动脉起始外径0.9±0.2mm,出现率为91.67%。⑻内眦动脉起始外径0.6±0.2mm,出现率为66.67%。⑼面动脉咬肌支起始处外径1.2±0.2mm,出现率为50%。⑽鼻背动脉起始外径0.8±0.3mm,出现率为58.33%。⑾眶下动脉出眶下孔起始外径1.0±0.2mm,出现率为100%。⑿面横动脉起始外径1.8±0.5mm,出现率为100%。⒀颧眶动脉起始外径1.0±0.3mm,出现率为100%。⒁眶上动脉出眶上孔起始处外径1.0±0.2mm,出现率为100%。⒂滑车上动脉起始处外径1.3±0.3mm,出现率为100%。 2.不同研究方法显示血管的特点 ⑴.巨微解剖:常规灌注后血管饱满,血管走行清楚,容易分离,便于追踪观测血管的分支、分布、外径大小。 ⑵.血管铸型:颌面部血管细密,管道饱满、粗细、疏密合理,动脉显示完整,标本美观、色泽鲜艳、立体感强。 ⑶.三维可视化:重建颌面部主要动脉的三维可视化解剖模型,生动形象的显示了颌面部血管的空间位置及与周围组织的毗邻关系,可以任意方向旋转、观察,可以按照设计需要进行切割、局部显示,操作简单、灵活方便。结论: 1.通过乳胶灌注、血管铸型、明胶-氧化铅血管造影及三维重建等多种方法对颌面部动脉血管进行了系统的研究,为临床颌面部整形美容术提供了应用解剖参考依据。 2.乳胶灌注、血管铸型、明胶-氧化铅血管造影及三维重建等方法均能清晰地显示颌面部的动脉血管,各有其特点。其中明胶-氧化铅血管造影及三维重建建立的颌面部血管的三维可视化模型,可以为临床颌面部整形术的手术设计、制定术前方案及应用解剖基础研究等提供新的方法,具有较好的发展与应用前景。
[Abstract]:Objective:
1. microanatomy and vascular casting for human maxillofacial region will provide anatomical basis for clinical plastic surgery.
2. to explore the method of digitalization of human maxillofacial vessels, and to visualize the relationship between maxillofacial vessels and their surrounding structures.
Materials and methods:
1. giant microanatomy: 6 cases of normal adult head and neck specimens, red latex or Merbromin Solution were perfused through the common carotid artery. Under the naked eye and operation microscope, the lower edge of the mandible, the anterior edge of the screen to the back of the nose were dissected from the shallow to the deep, and the external diameter, branch, distribution, anastomosis and accompanying condition of the maxillofacial vessels were observed and recorded.
2. vascular cast: 3 cases of normal adult head and neck specimens (fresh), the red perchloroethylene filling agent was injected through the common carotid artery, and the origins, branches, distribution, anastomosis and accompanying conditions of the maxillofacial vessels were observed after corrosion.
3. angiography and three-dimensional reconstruction: 3 cases of fresh adult head and face specimens, before perfusion CT scan, after scanning the common carotid artery perfusion of gelatin and lead oxide contrast agent, the radiography and CT continuous scanning, the scanning data were stored in.Dicom format, imported Mimics software, using the surface cover display method (shaded surface display, SSD) to the skull, Three dimensional reconstruction and visualization of maxillofacial vessels and facial contours were carried out to observe their 3-dimensional adjacency relationship.
Result:
Anatomic characteristics of the 1. maxillofacial vessels
The arterial blood vessels of the maxillofacial region are mainly derived from the branches of the facial artery, the ophthalmic artery, the maxillary artery and the superficial temporal artery. The main supply of the facial artery is the cheek, the lip and the chin, and the initial location is constant, but it moves, distributes, the terminated part is changeable, the external diameter of the beginning of the facial artery is 2.3 + 0.4mm, and the occurrence rate of the submental artery is a constant branch of the facial artery, 100%. (2). The initial external diameter was 1.8 + 0.6mm. The initial external diameter of the lower lip artery of 100%. 3 was 1.2 + 0.4mm, the occurrence rate was the constant initial location of the upper lip artery of 75%. 4, the initial outer diameter was 1.3 + 0.3mm, the occurrence rate was 1 + 0.3mm of the initial outer diameter of the inferior flange of the nasal alar artery, and the occurrence rate was 0.6 + 0.2mm, and the occurrence rate was 91.67%.. The initial external diameter of the lateral nasal artery was 0.9 + 0.2mm, and the occurrence rate was 0.6 + 0.2mm external diameter of the medial canthus artery of 91.67%.. The appearance rate was 1.2 + 0.2mm, the occurrence rate was 0.8 + 0.3mm, the occurrence rate was 1 + 0.2mm, the incidence rate was 100. The initial external diameter of the transverse lateral artery was 1.8 + 0.5mm, and the occurrence rate was 1 + 0.3mm, and the occurrence rate was 1 + 0.2mm of the outer diameter of the upper orbital foramen of 100%. (100%.). The occurrence rate was 1.3 + 0.3mm, and the occurrence rate was 100%..
2. different methods of study show the characteristics of blood vessels
Microanatomy: after routine perfusion, the vessels are full and the blood vessels are clear and easy to separate. It is easy to track and observe the branches, distribution and external diameter of blood vessels.
2. Vascular cast: the maxillofacial vessels are dense, the pipes are full, the thickness is thick, the density is reasonable, the arteries are displayed intact, the specimens are beautiful, the color is bright, and the three-dimensional sense is strong.
Three-dimensional visualization: reconstruction of the three-dimensional visual anatomical model of the main arteries of the maxillofacial region, vividly showing the spatial position of the blood vessels in the maxillofacial region and the adjacent relations with the surrounding tissue. It can be rotated in any direction, and can be cut in accordance with the needs of the design, local display, simple operation and flexible and convenient.
Conclusion:
1. the arterial vessels of the maxillofacial region were systematically studied through a variety of methods, such as latex perfusion, vascular cast, gelatin - lead oxide angiography and three-dimensional reconstruction, which provided an applied anatomical reference for the clinical maxillofacial plastic surgery.
2. latex perfusion, vascular cast, gelatin lead oxide angiography and three-dimensional reconstruction can clearly display the arterial vessels of the maxillofacial region, each of which has its own characteristics. The former program and applied anatomy basic research provide new methods and have good prospects for development and application.

【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R322

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