膜迷路的三维重建及解剖结构测量

Three-dimensional reconstruction and anatomic structure measurement of the membranous labyrinth

目的观测不同妊娠周龄人胚胎、正常成人及先天性内耳畸形患者膜迷路的三维建模,分析膜迷路空间立体结构数据。方法利用7、10、12及16周龄的人胚胎连续序列切片与正常成人内耳和先天性内耳畸形患者影像学资料进行比较分析。人胚胎标本利用数字切片扫描获得高清二维图。测量不同妊娠周龄人胚胎与成人内耳结构。应用Mimics 21.0软件进行膜迷路三维建模。结果数字切片扫描后高清二维图中清楚分辨内耳各结构,三维重建优于影像学结果。7、10、12、16周龄胚胎、正常成人及内耳畸形患者的前、后侧半规管总膜脚的夹角分别为157.36°、155.19°、153.79°、150.58°、121.36°及121.88°,耳蜗相对于前庭部分内弯,分别为130.15°、120.68°、146.12°、112.73°、104.61°及121.88°。除内耳畸形患者以外的外侧半规管的平面与颅骨水平轴面的夹角分别为36.86°、21.08°、18.37°、15.25°及15.65°。7、10与16周龄与正常成人内耳的3条半规管均互相垂直,12周龄人胚胎的前侧半规管与后、外侧半规管的夹角<90°。胚胎标本中绕蜗轴螺旋管在16周与12周龄已形成2.5圈,10周龄时为2圈,而7周龄时尚未形成1圈。先天性内耳畸形患者前庭囊状扩张大小约6.1 mm×4.6 mm,外侧半规管显示不清。结论通过不同方法成功重建出发育阶段及出生后人内耳膜迷路,反映内耳各结构的空间位置关系并得出相关解剖测量值,推测先天性内耳畸形在胚胎期的发育停滞时间,为婴幼儿早期耳聋的诊断提供了初步依据。

Objective To observe the three-dimensional modeling of the membrane labyrinth of human embryo and fetus of different period,adults and congenital inner ear malformations patient,analyze the difference of the three-dimensional reconstruction data of labyrinth space.Methods Imaging data of human embryos at 7,10,12 and 16 weeks of age were compared with normal adult inner ear and congenital inner ear malformations.High-resolution 2D images of human embryo specimens were obtained by digital slice scanning.The inner ear structure of human embryo and adult was measured at different gestation weeks.Mimics 21.0 software was used for 3D modeling of membrane labyrinth.Results The structures of the inner ear were clearly distinguished in high-definition 2D images after digital slice scanning and 3D reconstruction of histological images were clearly than MRI imaging.The angles of the anterior and posterior semicircular canal common membrane feet of the 6 groups,each of 7,10,12,16-week,normal adults and inner ear deformities was 157.36°,155.19°,153.79°,150.58°,121.36°and 121.88°.The cochlea curved median side of vestibule,each angle was 130.15°,120.68°,146.12°,112.73°,104.61°and 121.88°,respectively.Except of patients with inner ear malformation,the angles between the plane of the lateral semicircular canal and the horizontal axis of the skull were 36.86°,21.08°,18.37°,15.25°and 15.65°.The three semicircular canals of the inner ear of 7,10,16-week and adults were vertical to each other.The angle between the anterior semicircular canal and the posterior and lateral semicircular canals in 12-week was less than 90°.The spiral tube around the worm axis in specimen were formed 2.5 circles at 16 weeks and 12 weeks,2 circles at 10 weeks,and less than 1 circle at 7 weeks.In patients with congenital inner ear malformations,the size of the vestibular cystic dilation was about 6.1 mm × 4.6 mm,and the lateral semicircular canal was unclear.Conclusions Different methods are used to reconstruct the labyrinth of the inner ear during the development stage and after birth,which can reflect the spatial position of the inner ear structures and obtain the relevant anatomical measurement values,so we can predict the developmental stagnation time of congenital inner ear malformation in the embryonic stage,providing a preliminary basis for the diagnosis of early deafness in infants.