在体成年女性骶前血管网数字化三维模型构建及意义

The construction and significance of digital three-dimensional model of living adult female presacral vascular net based on computer tomography angiography.

目的探讨基于CT血管成像(CTA)原始数据集的在体成年女性骶前血管网数字化三维模型的构建及其意义。方法 2011年9月至2012年9月采用南方医科大学南方医院成年女性腹盆腔CTA原始数据集并运用Mimics 10.01软件成功构建18例在体女性骶前血管网三维模型,观察骶前区域血管并测量其与周围结构的距离。结果 (1)66.7%(12/18)骶正中血管走行于骶岬中点偏右,且在第一骶前孔水平距左侧第一骶前孔内侧缘的平均距离为(20.37±3.44)mm;33.3%(6/18)骶正中血管走行于骶岬中点偏左,且在第一骶前孔水平距右侧第一骶前孔内侧缘的平均距离为(28.40±4.32)mm。(2)在骶岬水平,与骶正中血管左右毗邻最近的大血管分别是左侧髂内静脉和右侧髂内动脉,平均距离分别为(22.08±7.34)mm和(24.31±8.79)mm。(3)骶岬至骶前第一横干静脉的平均距离为(42.10±7.46)mm。结论 (1)基于CTA原始数据集并利用Mimics软件能构建出在体成年女性骶前血管网数字化三维模型,该模型可清晰显示骶前血管网并能测量相关数据,为骶前手术安全区域提供解剖学依据。(2)根据测量结果推测出骶前最大相对无血管区域是上界为骶岬下10 mm、下界为骶岬下方40 mm、30mm×20mm的矩形区域。

Objective To construct a digital three-dimensional （3D） model of adult female presacral vascular net based on computer tomography angiography （CTA） data and explore its potential in clinical practice. Methods Collecting a- dult female abdominal and pelvic CTA raw data sets and using Mimics 10. 01 software to construct 18 cases of adult fe- male presacral vascular net model at Nanfang Hospital of Southern Medical University between 2011 September and 2012 September,to observe the presacral region vessels and measuring the distance from surrounding structures. Results （ 1 ） There were 66. 7% （12/18） of the median sacral vessels located at the right of the sacral promontory point. The average distance between those vessels and the medial edge of left first anterior sacral foramina was （20. 37±3.44） mm at the first anterior sacral foramina level. And 33.3% （6/18） of the median sacral vessels located at the left of the sacral prom- ontory point. The average distance between those vessels and the medial edge of right first anterior sacral foramina was （28.40±4. 32） mm at the first anterior sacral foramina level. （2） In the sacral promontory level, the nearest large vessels from the median sacral vessels were the left internal iliac vein and the right internal iliac artery. The average distance was （22. 08±7.34） mm and （24. 31±8.79） ram. （3）The average distance between the sacral promontory and the presa- oral first cross stem vein was （42. 10±7.46） ram. Conclusion （1）Using Mimics 10. 01 software could construct the digital three-dimensional （3D） model of adult female presacral vascular net based on The CTA raw data sets. The model can clearly display the presaeral vascular net and raeasure related data,to provide aaatomical basis for the safety of presa- cral region operation. （2）The presacral maximum non vascular region is a rectangle which upper bound is l Omm under the sacral promontory and lower bound is 40ram under,with 20ram in width,which rectangle is （30mm × 20mm）.