發(fā)布時(shí)間：2018-06-15 08:13

  本文選題：連續(xù)切片 + 子宮主韌帶��； 參考：《南方醫(yī)科大學(xué)》2014年碩士論文

【摘要】：經(jīng)典的廣泛性子宮切除術(shù)(Radical hysterectomy, RH)是早期宮頸癌患者的標(biāo)準(zhǔn)治療術(shù)式,獲得了較好的臨床療效,但由于在術(shù)中損傷了盆腔自主神經(jīng)(pelvic autonomic nerve, PAN),在獲得明顯療效的同時(shí)也帶來(lái)了膀胱、肛門直腸、性功能障礙等多種術(shù)后并發(fā)癥。PAN由腹下神經(jīng)(Hypogastric nerve, HP),盆腔內(nèi)臟神經(jīng)(Pelvic splanchnic nerves, PSN)和盆叢(Plvic plexus, PP)組成。相關(guān)研究表明腹下神經(jīng)走行于骶子宮韌帶(Uterosacral ligament, USL)的外下方,盆腔內(nèi)臟神經(jīng)及盆叢走行于子宮主韌帶(Cardinal ligament, CL)的下半部分,盆叢的分支走行于陰道旁復(fù)合體內(nèi)。而在RH術(shù)中對(duì)上述韌帶進(jìn)行處理時(shí)損傷了PAN是導(dǎo)致上述并發(fā)癥主要原因,其中對(duì)子宮主韌帶的損傷是并發(fā)癥產(chǎn)生的關(guān)鍵原因之一。1921年日本學(xué)者岡林首先提出在RH術(shù)中保留神經(jīng)的想法,1961年小林隆在岡林的基礎(chǔ)上進(jìn)行改良,提出在切除子宮主韌帶時(shí)保留支配膀胱的副交感神經(jīng),從一定程度上降低了膀胱功能障礙的發(fā)生率。1988年Sakamoto等對(duì)保留盆腔自主神經(jīng)叢技術(shù)進(jìn)行了第一次英文報(bào)道,即東京術(shù)式,他提出可將子宮主韌帶分為血管部和神經(jīng)部,通過(guò)觸診可識(shí)別血管和神經(jīng),并據(jù)此可保留子宮主韌帶中的神經(jīng)。1991年Yabuki正式命名該術(shù)式為保留神經(jīng)的廣泛性子宮切除術(shù)(nerve sparing radical hysterectomy, NSRH)。NSRH在經(jīng)典RH術(shù)式的基礎(chǔ)上保留了子宮主韌帶神經(jīng)部的盆腔內(nèi)臟神經(jīng)和部分下腹下神經(jīng)叢,明顯地降低上述并發(fā)癥的發(fā)生。但由于只切除了子宮主韌帶的血管部,即部分子宮主韌帶,引起專家學(xué)者對(duì)療效的質(zhì)疑。因此,為了切除更多的子宮主韌帶,并有效地保留PAN,有必要對(duì)子宮主韌帶內(nèi)神經(jīng)脈管等結(jié)構(gòu)進(jìn)行詳細(xì)的研究。雖然文獻(xiàn)報(bào)道和本課題組前期研究已證實(shí)子宮主韌帶主要由PAN、血管、淋巴管及各種結(jié)締組織構(gòu)成,也對(duì)神經(jīng)分布進(jìn)行了初步的定性定量研究,但目前對(duì)子宮主韌帶內(nèi)神經(jīng)和脈管之間的立體結(jié)構(gòu)缺乏詳細(xì)的了解,國(guó)內(nèi)外尚未見子宮主韌帶內(nèi)神經(jīng)脈管結(jié)構(gòu)重建的報(bào)道,而上述結(jié)構(gòu)的解剖特點(diǎn)及關(guān)系恰恰為NSRH術(shù)中解剖的關(guān)鍵。因此,本課題選擇計(jì)算機(jī)重建技術(shù)對(duì)子宮主韌帶內(nèi)神經(jīng)脈管之間的立體結(jié)構(gòu)進(jìn)行數(shù)字化三維重建,為NSRH術(shù)式的改良提供立體解剖學(xué)依據(jù)。 數(shù)字化三維重建技術(shù)是數(shù)字醫(yī)學(xué)中的一個(gè)重要技術(shù),它是指利用計(jì)算機(jī)技術(shù)將連續(xù)的二維圖像變成三維圖像,直觀的立體圖形更便于臨床醫(yī)師的觀察研究。目前可利用的二維數(shù)據(jù)集主要有數(shù)字人數(shù)據(jù)集,CT或MRI數(shù)據(jù)集,組織連續(xù)切片數(shù)據(jù)集。數(shù)字人是通過(guò)對(duì)尸體標(biāo)本的薄層銑切而獲得數(shù)字化的二維人體數(shù)據(jù)集,繼而通過(guò)計(jì)算機(jī)三維重建技術(shù)實(shí)現(xiàn)人體數(shù)據(jù)的三維可視化,其存在彩色、直觀的優(yōu)點(diǎn),但采集難度大,重建困難較大地限制了其在臨床中的廣泛應(yīng)用。近年來(lái),隨著影像學(xué)技術(shù)的發(fā)展,基于CT或MRI數(shù)據(jù)集的三維重建已逐漸在醫(yī)學(xué)發(fā)揮其重要的作用,由于其來(lái)源廣泛且具有個(gè)性化的特點(diǎn),目前已較廣泛地應(yīng)用于臨床并取得了較好的效果,顯示了其在解剖研究中的優(yōu)越性。但由于層距的限制,分辨率有限,同時(shí)受圖像灰度的制約,目前尚未能完成毫米級(jí)以下的血管、神經(jīng)、淋巴管的構(gòu)建�；诮M織連續(xù)切片的計(jì)算機(jī)三維重建技術(shù)即指通過(guò)對(duì)某一組織結(jié)構(gòu)進(jìn)行連續(xù)薄層切片并獲得這一系列切片截面的二維圖像,通過(guò)計(jì)算三維重建的方法而得到組織結(jié)構(gòu)立體形態(tài)的一種方法。該方法對(duì)一些傳統(tǒng)的影像學(xué)無(wú)法清晰、系統(tǒng)顯示的結(jié)構(gòu)如神經(jīng)及毫米級(jí)以下的結(jié)構(gòu)進(jìn)行重建是一種很好的研究方法,目前已在小鼠腎小管、子宮內(nèi)膜微血管、胎兒神經(jīng)分布等方面得到了初步應(yīng)用。本研究擬進(jìn)一步在前期數(shù)字化三維重建研究的基礎(chǔ)上,利用子宮主韌帶組織連續(xù)切片染色數(shù)據(jù)集,結(jié)合圖像識(shí)別、定位配準(zhǔn)、三維重建等技術(shù),構(gòu)建子宮主韌帶內(nèi)神經(jīng)及脈管的數(shù)字化三維模型,為NSRH手術(shù)提供子宮生韌帶立體解剖結(jié)構(gòu)依據(jù)。 第一部分：基于組織連續(xù)切片子宮主韌帶內(nèi)神經(jīng)脈管數(shù)字化三維重建定位材料的探討 [目的] 比較經(jīng)不同染色前后四種定位材料在玻璃切片上的粘附能力,探討一種適合子宮主韌帶組織連續(xù)切片三維重建的定位材料。 [方法] 獲取因IB1期宮頸癌行廣泛性子宮切除術(shù)的新鮮子宮主韌帶標(biāo)本1例(左側(cè)),經(jīng)固定、脫水、浸蠟后分別將1根普通縫線(3-0)、1根人發(fā)、1根可吸收縫線(8-0)及利用穿刺針將1條生物組織(利用穿刺針取自于肝臟組織,直徑約0.6mm)作為定位桿標(biāo)記與標(biāo)本一起進(jìn)行石蠟包埋,采用石蠟切片機(jī)對(duì)所取標(biāo)本進(jìn)行連續(xù)切片,切片厚度為5μm,共切取120張切片,用組織防脫載玻片進(jìn)行貼片。將切片隨機(jī)分成四組,各30張,分別進(jìn)行常規(guī)HE染色、TH染色、VIP染色和D2-40染色,在顯微鏡下觀察并記錄各種材料染色前后定位點(diǎn)的數(shù)目,比較分析不同定位材料染色前后標(biāo)記點(diǎn)的粘附情況。 [結(jié)果] 1、在人發(fā)、普通縫線、可吸收縫線與生物組織四種定位材料中,生物組織在染色后貼片率較其它三種材料高,經(jīng)統(tǒng)計(jì)學(xué)檢驗(yàn)差異有統(tǒng)計(jì)學(xué)意義(P0.01)。 2、在以上四種定位材料中,生物組織定位點(diǎn)脫失最少,四種染色前后貼片數(shù)量差異均無(wú)統(tǒng)計(jì)學(xué)意義(P=0.98)；非吸收性縫線、可吸收縫線與人發(fā)定位點(diǎn)染色前后均脫失嚴(yán)重,數(shù)量差異比較有統(tǒng)計(jì)學(xué)意義(P0.01)。 [結(jié)論] 利用穿刺針獲取生物組織作為定位材料成功解決了定位標(biāo)記點(diǎn)的脫失問(wèn)題,其在HE染色和各種免疫組化染色中均具有很好的粘附效果。 第二部分：子宮主韌帶內(nèi)神經(jīng)脈管數(shù)字化三維模型的構(gòu)建 [目的] 利用子宮主韌帶組織連續(xù)切片數(shù)據(jù)集,構(gòu)建子宮主韌帶內(nèi)血管、交感神經(jīng)、副交感神經(jīng)及淋巴管數(shù)字化三維模型,明確神經(jīng)、血管及淋巴管在子宮主韌帶中三維立體走行與分布情況。 [方法] 獲取因IB1期宮頸癌行廣泛性子宮切除術(shù)的新鮮子宮主韌帶標(biāo)本1例(左側(cè)),將子宮主韌帶用脫水盒固定方向。10%福爾馬林固定8-12h后進(jìn)行脫水,利用穿刺針穿取4條生物組織(直徑約0.6mm)作為定位桿標(biāo)記與標(biāo)本一起進(jìn)行石蠟包埋,冰凍30min后進(jìn)行連續(xù)切片,切片厚度為5gm,連續(xù)4層為一組,每組間隔80μm。65℃烤箱中烘烤2-3h后進(jìn)行分層染色。在第一層,切片用常規(guī)HE染色;在第二層,切片經(jīng)TH染色,特異標(biāo)記交感神經(jīng)纖維；在第三層,切片經(jīng)VIP染色,特異標(biāo)記副交感神經(jīng)纖維；在第四層,切片經(jīng)D2-40染色,特異標(biāo)記淋巴管。 將4種染色后的組織切片置于顯微鏡下,對(duì)其中的各種顯微組織成分觀察。采用數(shù)字切片掃描系統(tǒng)對(duì)每張切片進(jìn)行掃描。先用2×10倍下掃描地圖,確定掃描范圍,再轉(zhuǎn)到10×10倍下對(duì)切片進(jìn)行全自動(dòng)掃描。利用Photoshop軟件和Matlab軟件的圖像配準(zhǔn)方法分別對(duì)4組組織切片圖像進(jìn)行自動(dòng)配準(zhǔn)。將配準(zhǔn)后的4組切片數(shù)據(jù)集圖片導(dǎo)入Photoshop軟件中,應(yīng)用畫筆工具分別畫出血管、交感神經(jīng)、副交感神經(jīng)及淋巴管的輪廓。 利用ACDSEE軟件將各組圖片調(diào)至合適大小,分別導(dǎo)入Mimics軟件中,經(jīng)過(guò)自動(dòng)定位圖像、組織圖片、內(nèi)插值處理后,經(jīng)三維重建分別構(gòu)建出子宮主韌帶、血管、交感神經(jīng)、副交感神經(jīng)、淋巴管的數(shù)字化三維模型,并對(duì)模型進(jìn)行配準(zhǔn)融合。利用Mimics軟件的透明化、測(cè)量等功能對(duì)模型進(jìn)行分析。 [結(jié)果] 基于子宮主韌帶組織連續(xù)切片數(shù)據(jù)集,成功構(gòu)建出了子宮主韌帶內(nèi)神經(jīng)脈管數(shù)字化三維模型,通過(guò)對(duì)模型的分析與測(cè)量,我們發(fā)現(xiàn)： 1、子宮主韌帶寬為26.77mm,長(zhǎng)度為50.09mm,血管主要走行于上半部分,神經(jīng)主要走行于下半部分,從宮頸側(cè)至盆壁側(cè)近、中、遠(yuǎn)段神經(jīng)主干上緣與血管下緣的距離分別為8.59mm,7.18mm,4.87mm。 2、子宮主韌帶內(nèi)血管主要走行于子宮主韌帶上半部分,從宮頸側(cè)至盆壁側(cè)近、中、遠(yuǎn)段血管上緣距離子宮主韌帶上緣分別為11.99mm,9.36mm,4.89mm;血管下緣距離子宮主韌帶下緣分別為14.01mm,13.74mm,12.70mm。 3、神經(jīng)主要走行于子宮主韌帶底部,在距離宮頸側(cè)31.27mm處明顯增多直至盆壁；交感神經(jīng)主要走行于子宮主韌帶下半部的底部,從宮頸側(cè)向盆壁側(cè)逐漸增多,從宮頸側(cè)至盆壁側(cè)近、中、遠(yuǎn)段交感神經(jīng)主干距離韌帶上緣分別為22.11mm,22.16mm,19.56mm;副交感神經(jīng)相對(duì)較少,主要走行于子宮主韌帶的底部,從宮頸側(cè)至盆壁側(cè)近、中、遠(yuǎn)段副交感神經(jīng)距離韌帶上緣分別為22.58mm,21.34mm,18.62mm。 4、淋巴管細(xì)小,在子宮主韌帶中分布無(wú)明顯規(guī)律,主要沿血管周圍走行。 [小結(jié)] 本研究通過(guò)子宮主韌帶連續(xù)切片的計(jì)算機(jī)輔助三維重建技術(shù),構(gòu)建了子宮主韌帶內(nèi)神經(jīng)脈管數(shù)字化三維模型,精確地顯示了子宮主韌帶內(nèi)的解剖結(jié)構(gòu)及其之間的空間關(guān)系,形象地展示了子宮主韌帶內(nèi)神經(jīng)、血管、淋巴管的分布與走行,真實(shí)地再現(xiàn)了子宮主韌帶的三維立體結(jié)構(gòu)。重建模型可以在空間位置上以任意軸線旋轉(zhuǎn)任意角度,以便從不同位置對(duì)各結(jié)構(gòu)的形態(tài),空間位置及相互關(guān)系進(jìn)行觀察。同時(shí),還可利用Mimics軟件的測(cè)量工具對(duì)各個(gè)結(jié)構(gòu)的距離進(jìn)行測(cè)量,更加精確的顯示子宮主韌帶內(nèi)結(jié)構(gòu)的準(zhǔn)確分布情況。
[Abstract]:The classic Radical hysterectomy (RH) is a standard treatment for early cervical cancer and has a good clinical effect. But because of the damage to the pelvic autonomic nerve (pelvic autonomic nerve, PAN) during the operation, the bladder, anorectal, sexual dysfunction and so on are also brought about. The postoperative complications of.PAN were composed of Hypogastric nerve (HP), pelvic visceral nerve (Pelvic splanchnic nerves, PSN) and pelvic plexus (Plvic plexus, PP). The lower part of ament, CL), the branches of the pelvic plexus walk in the paraplex compound. And the damage to PAN during the treatment of the ligaments during RH is the main cause of the complications, and the damage to the main ligament of the uterus is one of the key causes of the complications. In.1921, the Japanese scholar, Kang Lin, first proposed to retain the nerve during RH. The idea that in 1961, Xiao Lin long was improved on the basis of the Kumin. It was proposed to retain the parasympathetic nerve that dominates the bladder during the removal of the main ligament of the uterus. To a certain extent, the incidence of bladder dysfunction was reduced to a certain extent by.1988 Sakamoto, the first English report on the preservation of the pelvic autonomic plexus technology, that is, the Tokyo operation. The main ligament of the uterus can be divided into the vascular and nerve parts, and the blood vessels and nerves can be identified by palpation. According to this, the.1991 year Yabuki of the main ligament of the uterus can be retained to formally name the operation for the extensive hysterectomy (nerve sparing radical hysterectomy, NSRH).NSRH to retain the uterus on the basis of the classical RH operation. The pelvic visceral nerve in the main ligament of the main ligament and the inferior lower abdominal nerve plexus obviously reduce the occurrence of the above complications. But because only the vascular part of the main ligament of the uterus is removed, that is, the main ligament of the uterus is a part of the main ligament of the uterus, which causes the experts and scholars to question the curative effect. Therefore, in order to excise more uterine main ligaments and retain the PAN effectively, it is necessary against the children. A preliminary study of the main ligaments of the uterus, including PAN, blood vessels, lymphatic vessels and various connective tissues, has also been preliminarily studied, although the preliminary studies of the main ligaments of the uterus have also been conducted preliminarily and quantitatively. There is no detailed understanding of the structure, and there is no report on the reconstruction of the vascular structure in the main ligament of the uterus at home and abroad. The anatomical features and relationships of the above structures are the key to the anatomy of the NSRH. Therefore, the computer reconstruction technique is selected to digitize the three-dimensional structure of the nerve vessels in the main ligament of the uterus. Provides the anatomical basis for the improved NSRH method.
Digital 3D reconstruction is an important technology in digital medicine. It refers to the use of computer technology to transform the continuous two-dimensional images into three-dimensional images. The visual stereogram is more convenient for the clinicians to observe. The available two-dimensional data sets are mainly digital human data sets, CT or MRI data sets, and the number of continuous slices is organized. According to the data collection, the digital human is digitized by the thin layer milling of the corpse specimen, and then the three-dimensional visualization of the human body data is realized by the computer 3D reconstruction technology. It has the advantages of color and intuition, but it is difficult to collect, and the reconstruction is difficult to restrict its wide application in clinical. With the development of imaging technology, 3D reconstruction based on CT or MRI data sets has gradually played an important role in medicine. Because of its extensive and individualized characteristics, it has been widely used in clinical and achieved good results, showing its advantages in the study of anatomy, but because of the limit of layer distance and resolution. Limited, at the same time restricted by the gray level of the image, it has not yet completed the construction of the blood vessels, nerves, and lymphatics below the millimeter level. The three-dimensional reconstruction technique based on the continuous slice of tissue section refers to a two-dimensional image of a serial section of a certain tissue structure and a series of sections of the slice, by calculating the three-dimensional reconstruction. It is a very good method to reconstruct the stereoscopic structure of the tissue structure. It is a good method for the reconstruction of some traditional images, such as the structure of the nerve and below the millimeter level, which has been preliminarily obtained in the renal tubules of mice, the microvascular of the endometrium and the distribution of the fetal nerve. On the basis of the study of the early digital three-dimensional reconstruction, this study intends to construct the digital three-dimensional model of the internal nerve and pulse tube in the main ligament of the uterus by using the data set of continuous section of the main ligament tissue of the uterus, combining the image recognition, positioning and registration, and three-dimensional reconstruction, so as to provide the stereoscopic anatomical structure of the uterine ligaments for the NSRH operation. Basis.
The first part: To explore neural vascular three-dimensional reconstruction of digital positioning material of main ligament tissue in the uterus based on serial sections
[Objective]
The adhesion ability of four kinds of location materials on glass slices before and after different dyeing is compared, and a three-dimensional reconstruction material suitable for the continuous section of the main ligament tissue of the uterus is discussed.
[method]
1 specimens of fresh uterine ligamentous ligaments for IB1 cervical cancer were obtained. After fixed, dehydrated, 1 common sutures (3-0), 1 human hair, 1 absorbable sutures (8-0) and 1 biological tissues (from the liver tissue with a diameter of about 0.6mm) were used as the positioning rod markers. Paraffin embedding was carried out with paraffin paraffin, and the specimens were sectioned continuously with the paraffin slice machine. The thickness of the slice was 5 mu m, 120 slices were cut and the slides were cut by tissue. The slices were divided into four groups randomly, each of them was divided into four groups, each with conventional HE staining, TH staining, VIP staining and D2-40 staining. Under the microscope, observe and record each other. The number of anchor points before and after dyeing materials, comparative analysis of different positioning materials before and after dyeing adhesion marker points.
[results]
1, among the four kinds of location materials, such as human hair, common suture, absorbable suture and biological tissue, the rate of the patch was higher than that of the other three materials after dyeing, and the statistical difference was statistically significant (P0.01).
2, among the above four kinds of location materials, the location of biological tissue location was the least, and the number of the four kinds of dyed patches had no statistical significance (P=0.98). The absorbable suture, the absorbable suture and the localization point of the human hair were both serious, and the difference of quantity was significant (P0.01).
[Conclusion]
The use of needle puncture needle to obtain biological tissue as a location material has successfully solved the problem of loss of location marker. It has good adhesion effect in HE staining and all kinds of immunohistochemical staining.
The second part: the construction of the main ligament of the uterus of nerves and vessels in the digital 3D model
[Objective]
The three-dimensional model of the internal vascular, sympathetic, parasympathetic and lymphatic vessels of the main ligament of the uterus was constructed by using the data set of the main ligament of the uterus, and the three-dimensional walking and distribution of the nerve, blood vessel and lymphatic tube in the main ligament of the uterus were clearly defined.
[method]
1 specimens of the main ligaments of the main ligament of the uterus (left) for IB1 stage cervical cancer were obtained. The main ligament of the uterus was dehydrated after the.10% formalin was fixed in the fixed direction of the dehydrated box with the dehydration box for 8-12h, and 4 biological tissues (diameter about 0.6mm) were taken with the needle to be labeled with the specimen for paraffin embedding and frozen 30min After continuous slice, the slice thickness was 5gm, 4 layers were consecutively divided into one group, each group was bake 2-3H in 80 m.65 centigrade intervals for stratified dyeing. On the first floor, the slice was stained with conventional HE; on the second layer, the slice was stained with TH, and the sympathic nerve fibers were marked by TH, and the slices were stained by VIP, and the parasympathetic nerve fibers were specifically labeled. Fourth layers were stained by D2-40, specific markers of lymphatic vessels.
4 kinds of stained tissue sections were placed under the microscope to observe the various microstructure components of them. The scanning system of digital slice scanning was used to scan each slice. First, the scanning range was determined with 2 x 10 times, and then the slice was automatically scanned with 10 x 10 times. The images of the Photoshop software and the Matlab software were used. 4 groups of tissue slices were registered automatically by the registration method. The 4 sets of slice data set after registration were introduced into the Photoshop software. The contour of the vessels, sympathetic, parasympathetic and lymphatic vessels was painted by the brush tool.
ACDSEE software is used to adjust the pictures to the appropriate size and into the Mimics software. After automatically locating the images, organizing pictures and interpolating, the three-dimensional model of the main ligament, blood vessel, sympathetic nerve, parasympathetic nerve, and lymphatic tube of the uterus is constructed by three-dimensional reconstruction, and the model is registered and fused with Mimics. Transparent parts, measurement and other functions to analyze the model.
[results]
Based on the data set of the continuous section of the main ligament of the uterus, the digital three-dimensional model of the nerve pulse tube in the main ligament of the uterus was successfully constructed.
1, the uterine main toughening bandwidth is 26.77mm, the length is 50.09mm, the blood vessels mainly walk in the upper half, the nerve mainly walks in the lower half, from the cervical side to the pelvic wall, and the distance between the superior margin of the distal nerve trunk and the inferior border of the vessel is 8.59mm, 7.18mm, 4.87mm., respectively.
2, the blood vessels in the main ligament of the uterus mainly walk in the upper part of the main ligament of the uterus, from the cervix to the side of the pelvic wall, and the upper margin of the distal segment of the uterus is 11.99mm, 9.36mm, 4.89mm, respectively, and the lower margin of the inferior border of the uterus is 14.01mm, 13.74mm, 12.70mm., respectively.
3, the nerve mainly walked at the bottom of the main ligament of the uterus and increased to the wall of the cervix. The sympathetic nerve mainly walked at the bottom of the lower part of the main ligament of the uterus and increased gradually from the lateral pelvic side of the cervix from the cervix to the side of the pelvic wall, and the distal segment of the sympathetic trunk of the distal segment was 22.11mm, 22.16mm, and 19, respectively. .56mm, the parasympathetic nerve is relatively small, mainly walking at the bottom of the main ligament of the uterus, from the cervical side to the pelvic wall, and the distal parasympathetic nerve distance from the ligament is 22.58mm, 21.34mm, 18.62mm., respectively.
4, the lymphatic distribution is small, no obvious regularity in the main ligament of the uterus, mainly along the walk around the vessels.
[summary]
In this study, the digital three-dimensional model of the internal nerve pulse tube in the main ligament of the uterus was constructed by computer aided three-dimensional reconstruction of the main ligament of the uterus. The anatomical structure and the spatial relationship between the main ligaments of the uterus were accurately displayed, and the distribution and movement of the nerve, blood vessels and lymphatic vessels in the main toughened uterus of the uterus were displayed. The three-dimensional structure of the main ligament of the uterus is realistically reproduced. The reconstruction model can rotate any angle at any axis in space, so as to observe the shape, the space position and the relationship of each structure from different positions. At the same time, the distance of each structure can be measured by the measuring tool of Mimics software. Accurately display the distribution of the main ligament of the uterus internal structure accurately.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R713.4

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本文編號(hào)：2021356