人脑内囊的三维重建及临床应用

Three-dimensional reconstruction of internal capsule and its clinical application

目的:通过超薄冰冻切面构建人脑内囊各部分三维形态,并通过软件测得内囊各部分的长度、宽度、体积和形心坐标等参数,为临床打靶治疗内囊部位的多种疾病提供重要的参考数据。方法:选取3个无器质性病变男性尸头,行间隔1mm的冰冻水平切片,经数码摄影后存入计算机数据库,用自制软件对含内囊的层面图像行轮廓线的提取,并进行三维重建及数据测量。结果:确定大脑原点为连合间径线的中点,以此建立坐标系,测得内囊及各部分形心的坐标值。左侧内囊形心坐标为-15.7619、2.2032和10.1438mm,右侧内囊形心坐标为17.9320、2.6565和6.3844mm。同时测得左侧内囊体积为4009.1730mm3,右侧内囊体积为4217.2340mm3。经三维重建后的内囊形态不规则,略呈凸面向内凹面向外、前肢较矮后肢较高的"板状"区域。结论:重建内囊及其各部分形态结构真实,可伪彩和真彩显示,再现了各部分结构在脑内的自然形态及空间位置,为内囊部位的脑血管性疾病、功能性神经外科疾病及精神外科疾病的立体定向手术治疗提供解剖学依据。

Objective To reconstruct three-dimensional （3-D） structures of the internal capsule （including anterior limb, genu and posterior limb） with uhrathin freezing transection, and the length, width, volume, and centroid of the internal capsule were obtained and to provide an important theoretic basis for stereotactic surgery for multiple diseases of the internal capsule. Methods Three male skulls without structural diseases were selected. Each of these skulls was cut into 1-millimeter-thick layer, the photographs were taken with digital camera and the data was put into the computer. Then the border line in layers that contained the internal capsule was drawn with self-made software, the 3-D reconstruction was gotten and the data was measured. Results The midpoint of intercomissural distance was considered as original point of brain and then the centroid coordinates of the internal capsule was gotten. The centroid coordinates of the left internal capsule were 15. 761 9, 2. 203 2 and 10. 143 8 mm; the right were 17. 932 0. 2. 656 5 and 6. 381 4 mm. The volume of the left internal capsule was 4 009. 173 0 mm^3 , the right was 4 217. 234 0 mm^3. After three dimensional reconstruction, the appearance of the internal capsule looked llke irregular plate-form domian. Its inner surface was convex while the external surface was concave, and the anterior limb was short while the posterior limb was high. Conclusion The reconstructed internal capsule and its parts which demonstrate the natural shape and exact position of the structures are realistic, they can be displayed in artificial colour and true colour. It provides an anatomic basis for stereotactic surgery for the treatment of the vascular disease, functional neurosurgery disease and psychiatrical surgery disease of the internal capsule.