臂丛神经显微结构的计算机三维重建

Three-dimensional reconstruction of the microstructure of brachial plexus from serial tissue sections

目的重建臂丛神经的外轮廓及其内部神经束的精细三维行径,同时探索一种臂丛神经显微结构计算机三维重建的实用方法。方法取健康成年尸体的臂丛神经标本2例(从神经根管出口至正中神经交叉处,平均长20cm),作好标记,以女性头发作为定位线,采用连续组织切片后胆碱脂酶组织化学染色,高分辨率数码摄像系统获取二维数码信息后对臂丛神经显微结构进行三维重建。结果三维重建真实地再现臂丛神经的三维立体结构及其内部各神经束的三维立体行径,并可显示臂丛神经中神经束的任意断面及其全长的解剖结构与相互关系,形象地展示臂丛神经内部神经束的复杂重组过程。重建结构均能单独或搭配显示,还能任意角度显示。在臂丛的五个根中,C6～C8内部神经束数目较C5、T1多。在C6～C8中,又以C7神经根内部神经束数目最多。结论臂丛神经内部神经束结构相当复杂,相互间不断交叉重组,形成独特的神经束网络结构。臂丛神经显微结构三维重建由于采用了较为精确的定位材料和方法,三维图像显示效果较好,是一种较为实用的方法。

Objective To reconstruct the three-dimensional structure of human brachial plexus including its outer contour and delicate pathways of nerve fascicles inside, and to explore an useful and practical method for three-dimensional reconstruction of brachial plexus. Methods Taking woman hair as the localizing marks, two left-side brachial plexus from healthy adult cadaver were serially horizontally sliced with each section 0.2 mm in thickness(from the outlet of nerve root canal to the origin of median nerve, about 20 cm in length on an average), each slice was stained by AchE histochemical method. Each section of the two-dimensional image was taken by high-resolution digital camera, and the three-dimensional microstructure of brachial plexus was reconstructed and computer-assisted. Results The three-dimensional structure of brachial plexus reappeared successfully, including its outer contour and its delicate pathways of nerve bundles inside, the topographic anatomy of every nerve fascicle and its relationship in arbitrary sections as well as the patterns of branching, intersection and recombination of nerve bundles in the whole length. It could also display the outer contour of brachial plexus and the delicate pathways of nerve bundles inside either separately or totally. The reconstructed microstructure of the brachial plexus was smooth, natural and realistic, it could be rotated, zoomed and divided in any direction. The fascicular number of C7 root was more than C6 or C8, while C5 and T1 were the least. Conclusion The three-dimensional structure of brachial plexus inside is very complicated. The nerve bundles crisscross and recombine with each another. It combines a fine and delicate nerve network. Using the advanced localizing method, a good result is obtained. This is a practical method for three-dimensional reconstruction of the microstructure of brachial plexus.