20～26岁健康妇女的在体子宫动脉血管网数字化三维模型的构建及其特点分析

Reconstruction and characteristics of the three-dimensional models of uterine arterial vascular network for healthy females aged 20-26 years

目的 应用CT血管成像术（CTA）及数字化三维重建技术,构建20 ～ 26岁健康妇女的在体子宫动脉血管网数字化三维模型,分析子宫动脉的解剖特点及子宫的血液分布特点.方法 2012年8月至12月招募20～26岁健康女性志愿者共25例,行双源多层螺旋CT扫描并采集CTA原始数据集,利用三维重建软件（即Mimics软件）构建其在体子宫动脉血管网数字化三维模型,明确子宫各部分的供血动脉来源,并对子宫动脉血管网模型进行立体切割,分为子宫体、子宫颈动脉血管网,子宫体左侧部、右侧部动脉血管网,以及子宫颈左侧部、右侧部动脉血管网,并计算其血管容积比例.结果 本研究成功构建了25例20～26岁健康妇女的在体子宫动脉血管网数字化三维模型,这些模型清楚地显示了子宫动脉及其各级分支结构.在正常生理状态下,子宫体动脉血管网显影者21例（84％,21/25）,双侧动脉血管网均显影,分别由同侧子宫动脉供血,其中双侧供血均衡者18例,一侧供血为主者3例；子宫体左侧部、右侧部血管容积比例分别为0.51 ±0.14、0.44 ±0.13,两者比较,差异无统计学意义（t=1.817,P=0.077）；子宫体动脉血管网不显影者4例（16％,4/25）.子宫颈动脉血管网显影者仅2例（8％,2/25）,双侧子宫颈动脉血管网供血均衡；子宫颈动脉血管网不显影者23例（92％,23/25）.结论 本研究成功构建了20 ～ 26岁健康妇女的在体子宫动脉血管网数字化三维模型,证实正常子宫体的动脉血管网分布具有双侧性、同侧供血倾向性及均衡性的特点,而子宫颈动脉血管网显影率低.

Objective To analyze the characteristics of anatomy and blood distribution of uterine arterial vascular network in vivo for healthy women aged 20-26 years by reconstructing the digital three-dimensional models based on computerized tomographic angiography （CTA） scanning technology.Methods From August to December 2012,a total of 25 female volunteers aged 20-26 years were recruited.All of them accepted CTA scanning.Their datasets were collected for reconstructing the digital three-dimension models of normal uterine arterial vascular network by using Mimics Version 10.01 software.After recognizing the supply arteries of each part of uterus,the three dimension models were divided into corpus and cervix arterial vascular network,left and right corpus arterial vascular network,left and right cervical artery vasc ular network and then calculated the proportion of vascular volume.Results Digital three-dimension models of normal uterine arterial vascular network of 25 cases were successfully reconstructed,which clearly showed the structure of the uterine artery and its branches at all levels.Under normal physiological conditions,vascular network of corpus developed in 21 cases （84％,21/25）.In these cases,bilateral vascular network were developed and supplied by the ipsilateral uterine artery respectively,where the distribution of vascular were bilateral balanced in 18 cases and unilateral predominant in 3 cases.However,4 cases （16％,4/25） of vascular network of corpus were not developed.There were not statistically significant of vascular network volume between both sides of uterine corpus of 25 cases digital three dimension models of normal uterine arterial vascular network （t =1.817,P =0.077）.The cervical arterial vascular networks didn＇t develop in 23 cases （92％,23/25）,whereas it developed in 2 cases （8％,2/25）.Conclusions This study successfully reconstructed the three dimensional models of uterine arterial vascular network for healthy females aged 20-26 years,confirming that the overall normal uterine vascular network distribution has the characteristics of bilateral,ipsilateral blood tendentious and balanced.But the cervical vascular network is rarely developing.