通过血管铸型技术及CT三维重建来探讨子宫血管分布及血管网的意义

发布时间：2019-05-21 22:13

【摘要】：目的：通过对家兔的血管铸型技术、方法的进一步探讨及研究，从而获得家兔子宫动脉血管铸型标本，以及通过对人子宫血管行CT三维重建获得的影像资料，共同来观察子宫动脉、子宫动脉-卵巢支、子宫动脉-输卵管支的分布情况，以及对子宫动脉血管网的研究和分布情况，进一步对子宫动脉血管网吻合支的研究。方法：家兔正常麻醉处死后，于腹主动脉进行插管的同时行髂外动脉丝线结扎，来对家兔子宫及双侧输卵管、卵巢行血管铸型。铸型材料采用乙酸乙酯和过氯乙烯及邻苯二甲酸二丁酯、部分油画染料充分搅匀后做为填充剂，在插管后再行补灌注、腐蚀、冲洗、标本休整、标本保存等步骤，来完成家兔子宫血管铸型标本的制备。人体子宫动脉影像图像可通过行静脉血管打入血管造影剂，后经CT三维重建获得子宫动脉血管图像。结果：通过对家兔子宫铸型标本的观察，可以清晰的观察到子宫动脉血管的分布情况，以及子宫血管的二、三级分支及分布情况，对于细小的血管网借助扫描电镜可观察到子宫动脉卵巢支、输卵管支的血管分布及血管网吻合支情况。主要表现为： 1通过血管铸型获得的子宫血管情况： (1)子宫动脉血管网分布及吻合支分布情况： 1兔子宫动脉于宫体两侧迂曲向上，于宫体部发出子宫动脉螺旋支，虽较为细小，，但可通过放大镜或者扫描电镜观察到子宫体部存在明显的交通支，且分布十分密集，进一步证明了子宫动脉存在明显的相互供血倾向。2子宫动脉上行支为子宫体、卵巢和输卵管供血,下行支由于取标本原因未能显示。3子宫动脉上行支迂曲延输卵管走形发出子宫动脉卵巢支，可见子宫动脉卵巢支与卵巢动脉相互吻合情况。 2.通过对人静脉血管打入造影剂，经CT三维重建获得的子宫动脉血管图像情况： (1)子宫动脉血管分布情况： 1正常子宫动脉主干于宫颈内口水平依次分出膀胱支、输尿管支、上行支和下行支等动脉血管，可清晰看到子宫及其上行支，下行支、膀胱支及输尿管支由于由于血管较细造影剂流入较少故未能显示。2可观察到较粗大的子宫动脉上行支,沿子宫壁的侧缘迂曲向上,沿途可见子宫动脉上行支发出多条弓状动脉，弓状动脉再发出若干螺旋动脉,分布于子宫前、后面,在到达子宫底水平后，在子宫角处发出多条分支，分别为宫底支、卵巢支和输卵管支；子宫动脉上行支主要为子宫体、卵巢和输卵管供血。 (2)子宫动脉血管网分布形及吻合支分布情况： 1子宫动脉以中轴线为中心，可清晰看到两侧存在明显的交通支，尽管较为微细，但分布较为集中且密集，进一步证明了子宫动脉存在明显的相互供血倾向。2可见沿子宫壁迂曲向上的子宫动脉上行支于子宫角处直接发出较粗大的卵巢支,经过卵巢固有韧带向卵巢提供部分供血，由此可见，卵巢的血供不单有卵巢动脉供给，还有子宫动脉卵巢支。结论：通过应用血管铸型技术及CT三维重建图像处理后,都可清晰显示子宫动脉分支、分布及血管网吻合支情况,为妇产科疾病的临床诊断、手术治疗等方面提供血管形态学依据,为指导子宫动脉栓塞治疗及新式妇产科手术的开展提供解剖学平台。
[Abstract]:Purpose: Through the further exploration and study of the technique and method of the blood vessel casting of the rabbit, the uterine artery, the uterine artery and the ovary were observed together by the image data obtained by the three-dimensional reconstruction of the human uterine vessels. The distribution of the branch, the uterine artery and the branch of the fallopian tube, and the study and distribution of the uterine arterial network, and further study the anastomosis of the uterine artery. To study. Methods: After the normal anesthesia of the rabbit, the abdominal aorta was inserted and the external arterial wire was ligated to the uterus of the rabbit and the bilateral fallopian tube and the ovary. the blood vessel casting mold is prepared through the steps of ethyl acetate and perchloroethylene and dibutyl phthalate, partial oil painting dye is fully stirred, and the filling agent is used as a filling agent; after the intubation, filling, corrosion, washing, sample rest, sample preservation and the like are performed to complete the blood vessel casting of the rabbit The preparation of the specimen is that the image of the human uterine artery can be driven into the blood vessel contrast agent through the line vein blood vessel, and then the uterus can be obtained by the three-dimensional reconstruction of the CT. vein blood vessel The results showed that the distribution of the uterine artery was clearly observed by the observation of the specimen of the uterus of the rabbit, and the two, three-stage branches and the distribution of the uterine vessels were observed. The distribution of the blood vessels in the branch of the ovary of the uterine artery and the branch of the fallopian tube and vascular anastomosis branch condition. The main performance is:1 through blood vessel The condition of the uterine vessels obtained by the casting: (1) the uterine artery The distribution of the vascular network and the distribution of the anastomosis:1 rabbit's uterine artery is tortuous and upward on both sides of the uterine body, and the uterine body part In that form of a spiral branch of the uterine artery, it is very small, but it can be observe by the magnifying glass or the scanning electron microscope that there is a clear traffic branch in the body of the uterus, and the distribution is very dense, which further proves that the uterine artery has obvious mutual blood supply tendency. The branch of the uterus, the ovary and the fallopian tube, and the descending branch failed to show the cause of the sample. The relationship between the branch of the vein and the ovary of the ovary.2. The contrast agent is injected into the human vein blood vessel, and the contrast agent is computed by the CT. Three-dimensional reconstruction of uterine artery image: (1) distribution of uterine artery:1 normal uterine artery The main branch of the cervix is divided into the branch of the bladder, the branch of the ureter, the ascending branch and the descending branch, so that the uterus and the ascending branch, the descending branch, the branch of the urinary bladder and the ureter branch can be clearly seen because of the small inflow of the small contrast agent of the blood vessel, and can not be shown. The upper ascending branch of the uterine artery, along the side edge of the uterine wall, is tortuous and upward, and the ascending branch of the uterine artery is seen to send a plurality of arcuate arteries along the way, a plurality of spiral arteries are arranged in the arch-shaped artery and distributed in the front of the uterus, and after reaching the level of the fundus of the uterus, the ascending branch of the uterine artery a plurality of branches, namely, a uterine fundus branch, an ovary branch and a fallopian tube branch, The ascending branch of the uterine artery is mainly the blood supply of the uterus, the ovary and the fallopian tube. (2) Distribution of the uterine artery and the distribution of the anastomosis:1. The uterine artery is centered on the central axis, and the two sides can be clearly seen. In the obvious traffic branch, although the distribution is relatively small, the distribution is more concentrated and dense, and further proves that the uterine artery has obvious mutual blood supply tendency. It can be seen that the upper uterine artery in the tortuous direction of the uterine wall can directly send the coarse eggs at the corner of the uterus. The nest is provided with a partial supply of blood to the ovary through the native ligament of the ovary. , ovary The blood supply of the uterine artery is not only the supply of the ovarian artery, but also the ovarian branch of the uterine artery. Conclusion: The branch, distribution of the uterine artery and the anastomosis of the vascular network can be clearly shown by the application of the vascular casting technique and the image processing of the three-dimensional reconstruction of the CT. and provides a blood vessel morphological basis for clinical diagnosis, operation treatment and the like of the obstetrics and gynecology diseases,
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R816.2;R711.74

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