利用Mimics软件对经颈静脉孔后组脑神经相关膜性结构的组织学研究

Histological study of meningeal structures associated with lower cranial nerves through jugular foramen with Mimics software

目的掌握经颈静脉孔后组脑神经处相关的软脑膜、蛛网膜、硬脑膜及髓鞘的组织学解剖特点。方法选取9例（18侧）足月死婴的尸头（28～36周），随机分为3组，每组3例（6侧）。分别制备经颈静脉孔后组脑神经处标本的矢状面、轴面、冠状面切片，采用固定、脱水、透明、浸蜡、包埋、切片及Masson法染色的方法处理，之后在显微镜下观察不同软脑膜、蛛网膜、硬脑膜及髓鞘的起止分布特点，并利用Mimics10．0软件将上述膜性结构进行三维重建。结果Mimics三维重建后可观察到后组脑神经进入颈静脉孔，在其周围存在硬脑膜、蛛网膜、软脑膜及中枢髓鞘段与周围髓鞘段之间的移行区；硬脑膜分为脑膜层和骨膜层，在颈静脉孔处形成硬脑膜口袋，在颈静脉孔内口上方形成硬脑膜返折；蛛网膜像袖套一样延续至上神经节，在神经节之后，蛛网膜随之消失；软脑膜紧贴于神经根出延髓处，在延髓后，软脑膜随之消失。结论Mimics三维重建可直观显示经颈静脉孔后组脑神经处相关的膜性结构，为相关病变及术中遵循膜性结构的层次和界面提供解剖学基础。

Objective To study histological and anatomical features of pia mater, arachnoid mater, dura mater and myelin sheath of lower cranial nerves through jugular foramen. Methods Nine （ 18 sides） fetal full-term cadaverie heads （28 -36 weeks ） were randomly divided into 3 groups and each group included 6 sides. The sagittal, horizontal and coronal plane slices were manufactured containing lower cranial nerves through jugular foramen, which were fixed, dehydrated, wax dipped, embedded, sliced and stained by the Masson method. The starting and ending positions as well as distribution of related pia mater, arachnoid mater, dura mater and myelin sheath were observed under surgical microscope. The meningeal structures underwent three-dimensional reconstruction using the software of Mimics 10.0. Results The lower cranial nerves went though jugular foramen, where dura mater, araehnoid mater, pia mater and the transitional zone between central myelin sheath and peripheral myelin sheath were observed. Dura mater included meningeal layer and periosteal layer, formed a dura pocket at jugular foramen and a dura fold above the inner orifice. Arachnoid mater extended to superior ganglia and looked like sleeves which disappeared past ganglia. Pia mater clung to medulla oblongata where nerve roots were and disappeared after that. Conclusions The microanatomy of meningeal structures of lower cranial nerves could be visually demonstrated with Mimics 10.0 software, which provides anatomical information for related disorders and operations based on layers and interfaces of meningeal structures.