本文選題：經(jīng)皮 + 腰椎間盤　； 參考：《第三軍醫(yī)大學(xué)》2005年博士論文

【摘要】：目的: 1. 闡明腰椎間盤及其毗鄰關(guān)系的影像學(xué)特征,比較CT 和MRI 的價(jià)值和限度。 2. 制作人體脊柱腰段及其周圍結(jié)構(gòu)的連續(xù)薄層斷面解剖圖像數(shù)據(jù)集,說明其形態(tài)學(xué)特征及規(guī)律,比較薄層斷面解剖和影像斷面解剖的特點(diǎn)。 3. 尋求解決經(jīng)皮腰椎間盤穿刺中“工作三角”或“安全三角”的確切定義,探明穿刺并發(fā)癥的解剖學(xué)基礎(chǔ)。 4. 結(jié)合PLDD 臨床實(shí)踐,為選擇穿刺入路和提高穿刺水平提供有力的佐證。 5. 建立脊柱腰段的CT 三維重建、三維解剖模型,闡明脊柱腰段及其周圍主要結(jié)構(gòu)的立體形態(tài)、三維空間位置及其毗鄰關(guān)系。 6. 構(gòu)建基于PC 的經(jīng)皮穿刺椎間盤手術(shù)入路可視化模型。 材料與方法: 1. 在53 例正常腰椎間盤的CT 圖像、40 例正常腰椎間盤的MRI 圖像上,對(duì)腰椎間盤主要結(jié)構(gòu)及其毗鄰關(guān)系的影像學(xué)特征進(jìn)行影像學(xué)觀察和測(cè)量。 2. 選取2 例中國(guó)數(shù)字化可視人體數(shù)據(jù),對(duì)腰椎間盤主要結(jié)構(gòu)及其毗鄰關(guān)系的連續(xù)斷面形態(tài)進(jìn)行解剖學(xué)觀測(cè),并與上述的CT、MRI 圖像對(duì)照研究。 3. 選取腰椎間盤突出癥患者86 例,經(jīng)皮腰椎間盤穿刺定位進(jìn)行激光汽化減壓治療,觀察其穿刺成功率和治療效果。 4. 選擇4 例正常脊柱腰段,進(jìn)行CT 三維重建,對(duì)脊柱腰段、腰動(dòng)脈走行、髂動(dòng)脈與L5-S1 椎間盤的空間關(guān)系進(jìn)行觀測(cè)。 5. 選取2 例CVH 數(shù)據(jù)集脊柱腰段連續(xù)斷層圖像,進(jìn)行分割和三維重建,觀察其空間位置關(guān)系。 6. 應(yīng)用三維重建軟件,將脊柱腰段的三維結(jié)構(gòu)可視化并進(jìn)行穿刺路徑虛擬演示。 結(jié)果: 1. 獲得腰椎間盤主要結(jié)構(gòu)及其毗鄰關(guān)系的影像學(xué)特征和相關(guān)測(cè)量參數(shù),左、右側(cè)之間腰神經(jīng)長(zhǎng)度及寬度、穿刺線到腰神經(jīng)的距離無顯著性差異。CT 對(duì)穿刺線的骨性標(biāo)志點(diǎn)上關(guān)節(jié)突顯示優(yōu)于MRI,MRI 對(duì)軟組織密度分辨力較CT 高。
[Abstract]:Objective: 1. To elucidate the imaging features of lumbar intervertebral disc and its adjacent relationship and compare the value and limitation of CT and MRI. 2. The continuous thin sectional anatomical image data set of the lumbar segment of the human spine and its surrounding structure was made to illustrate the morphological characteristics and regularity of the data. The characteristics of thin sectional anatomy and image sectional anatomy were compared. 3. To find a solution to the exact definition of "working triangle" or "safety triangle" in percutaneous lumbar disc puncture, and to find out the anatomical basis of puncture complications. 4. Combined with PLDD clinical practice, it provides strong evidence for selecting puncture approach and improving puncture level. 5. Three-dimensional CT reconstruction and three-dimensional anatomical model of spinal lumbar segment were established to clarify the stereomorphology of spinal lumbar segment and its surrounding main structures, three-dimensional spatial position and its adjacent relationship. A visual model of percutaneous disc surgery based on PC was constructed. Materials and methods: 1. On the CT images of 53 normal lumbar intervertebral discs and 40 normal lumbar intervertebral discs, the imaging features of the main structures and adjacent relations of the lumbar intervertebral discs were observed and measured. 2. The anatomy of the main structures of lumbar intervertebral disc and its contiguous relationship were observed in 2 cases of Chinese digital visible human body data, and the results were compared with the CT MRI images mentioned above. 3. 86 patients with lumbar disc herniation were treated with laser vaporization decompression for percutaneous lumbar disc puncture localization. The success rate and therapeutic effect of laser vaporization were observed. 4. Three dimensional CT reconstruction was performed in 4 cases of normal lumbar spine. The spatial relationship between iliac artery and L5-S1 intervertebral disc was observed. Two consecutive CT images of lumbar spine from CVH data set were selected for segmenting and 3D reconstruction, and the spatial position relationship was observed. 6. 6%. The 3D reconstruction software was used to visualize the three-dimensional structure of the lumbar spine and perform a virtual demonstration of the puncture path. Results: 1. The main structure and adjacent relationship of lumbar intervertebral disc were obtained. The length and width of lumbar nerve between left and right were obtained. There was no significant difference in the distance between puncture line and lumbar nerve. Ct was superior to MRI MRI in the resolution of soft tissue density.
【學(xué)位授予單位】：第三軍醫(yī)大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2005
【分類號(hào)】：R322

【引證文獻(xiàn)】

相關(guān)期刊論文 前1條

1 李克棟;武娟;;經(jīng)皮穿刺頸椎間盤摘除術(shù)的臨床研究[J];臨床和實(shí)驗(yàn)醫(yī)學(xué)雜志;2012年05期

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本文編號(hào)：2042422