盆底功能正常的未育青年女性静息状态下膀胱尿道的三维解剖

Digital fine anatomy of bladder and urethra in rest state of young nullipara with a normal pelvic floor function

目的研究正常青年未育女性静息状态膀胱尿道的三维精细解剖结构。方法收集2015年1月至2016年10月于本院妇科就诊患者的MRI影像及一般资料,选取满足入选要求的45例青年未育女性静息状态下MRI数据集,利用Mimics 10.01软件进行三维重建,联合UG软件对膀胱尿道与耻骨联合间的精细解剖参数进行三维测量和分析。结果45个数据集均可构建盆底器官三维模型,含骨盆、膀胱、尿道、子宫、阴道和直肠。测得膀胱尿道相关精细解剖参数如下:膀胱尿道后角(146.3±16.6)°,β角(144.5±14.1)°,尿道耻骨角(47.9±15.2)°,尿道倾斜角(18.5±9.2)°,α角(87.2±15.1)°。尿道横纹肌厚度(2.58±0.60)mm。耻骨后间隙(15.96±3.52)mm,膀胱颈距耻骨联合下缘中点连线距离(23.66±3.97)mm。结论计算机三维重建技术能够直观再现人体膀胱尿道三维解剖形态,提供膀胱尿道精细解剖的三维研究平台,通过多项径线和角度的测量,反映正常状态下膀胱尿道及周围支持结构的功能。

Objective To study digital fine anatomy from 3D models of bladder and urethra of normal young nullipara in rest state.Methods The MRI data and general clinical information of gynecological patients in Nanfang hospital from January 2013 to October 2016 were collected and analyzed.45 normal young nulliparas were selected according to the inclusion criteria,Mimics 10.01 software was used to reconstruct the 3D models,UG software was combined to measure most kinds of anatomy parameters,such as the length and the angle between bladder,urethra and pubic bone.Results 3D models of 45 patients were successfully built,including pelvis,uterus,bladder,urethra,vagina and rectum.The related anatomic parameters of bladder urethra were measured as follows:the angle of bladder and urethra:(146.3±16.6)°,βangle:(144.5±14.1)°,the angle of urethra pubic:(47.9±15.2)°,the angle of urethra:(18.5±9.2)°,αangle:(87.2±15.1)°.Urethral striated muscle thickness was(2.58±0.60)mm.Retropubic space was(15.96±3.52)mm.The distance between the bladder neck and the midpoint of lower margin of symphysis pubis was(23.66±3.97)mm.Conclusions 3D reconstruction technology is a good way to reproduce intuitively the three dimensional anatomical morphology of human bladder and urethra,providing a 3-D research platform for the fine anatomy of the bladder and urethra.By multiple diameters and angles measurement,it can reflect the functions of the bladder and urethra under normal conditions.