女性盆底結(jié)構(gòu)的三維可視化研究
發(fā)布時(shí)間：2018-09-18 15:32
【摘要】：研究背景與目的精準(zhǔn)醫(yī)療(precision medicine,PM)是以個(gè)體化醫(yī)療為基礎(chǔ),結(jié)合患者生活環(huán)境和臨床數(shù)據(jù),實(shí)現(xiàn)精準(zhǔn)的疾病分類及診斷,制定具有個(gè)性化的疾病預(yù)防和治療方案。目前精準(zhǔn)醫(yī)療在婦科手術(shù)中的運(yùn)用研究尚缺乏。女性盆底解剖結(jié)構(gòu)復(fù)雜,且位置深在,可及性差,但該部位是諸多婦科手術(shù)的關(guān)鍵部位,尤其是宮頸癌(cervical cancer,CC)和盆腔器官脫垂(pelvic organ prolapse,POP)病人的手術(shù)治療與此間結(jié)構(gòu)關(guān)系密切,是手術(shù)成敗和術(shù)后并發(fā)癥發(fā)生的關(guān)鍵部位所在。宮頸癌的發(fā)病率居?jì)D科惡性腫瘤之首,廣泛子宮切除術(shù)(radical hysterectomy,RH)是治療早期宮頸癌的主要方法,但是術(shù)中并發(fā)癥如出血,膀胱、直腸、輸尿管損傷,術(shù)后并發(fā)癥如排便、排尿功能障礙不能完全避免,重要原因是因?yàn)榕璧捉馄饰恢蒙钤?結(jié)構(gòu)毗鄰復(fù)雜,尤其是宮頸周圍結(jié)構(gòu)(pericervical structures,PS),包括主韌帶(cardinal ligament,CL)、骶韌帶(uterosacral ligament,USL)、膀胱宮頸韌帶(vesico-cervical ligament,VCL)、宮頸周圍環(huán)(pericervical ring,CR)的三維結(jié)構(gòu)及其毗鄰關(guān)系未能完全了解。關(guān)于這一部分的研究各學(xué)者存在很大爭議[1],影響到廣泛子宮切除術(shù)的手術(shù)療效以及宮頸癌后續(xù)的綜合治療。女性盆底功能障礙性疾病(pelvic floor dysfunction,PFD)是指盆底支持組織因損傷或退化等原因所致松弛而引發(fā)的疾病。主要包括壓力性尿失禁(stress urinary incontinence,SUI)和POP。隨著人口老齡化,PFD發(fā)病率逐年增高,嚴(yán)重影響中老年婦女身心健康及生活質(zhì)量[2]。PFD程度較重的需要外科手術(shù)治療,但傳統(tǒng)手術(shù)的并發(fā)癥和術(shù)后復(fù)發(fā)率均較高[3],原因在于術(shù)前對POP程度掌握不準(zhǔn)確,未發(fā)現(xiàn)明確的復(fù)雜的盆底結(jié)構(gòu)缺陷。隨著盆底重建(pelvic floor reconstruction,PFR)外科的發(fā)展,術(shù)前準(zhǔn)確評估盆腔器官及各結(jié)構(gòu)之間的解剖關(guān)系、脫垂的程度并明確缺陷的具體部位,是制定綜合診療措施、使患者獲得有效的個(gè)性化治療的前提,這些均需要對盆底解剖結(jié)構(gòu)更詳盡的了解。既往對女性盆底的解剖學(xué)研究主要依靠尸體解剖[4],近年來許多學(xué)者提出利用不同的方法研究盆底解剖[5-8],以加強(qiáng)對盆底結(jié)構(gòu)的了解,目前關(guān)于盆底解剖結(jié)構(gòu)的三維可視化研究已越來越受到重視。但是,前期的工作缺乏更為精細(xì)的形態(tài)解剖學(xué)研究,前期研究多為尸體解剖,尸體解剖有一定局限性:組織破壞較大,標(biāo)本的可重復(fù)利用性差,空間可視化程度較差;磁共振成像(magnetic resonance imaging,MRI)和計(jì)算機(jī)斷層掃描(computed tomogtaphy,CT)均為影像學(xué)研究,辨認(rèn)精準(zhǔn)結(jié)構(gòu)特征不夠準(zhǔn)確,所以無法真正還原復(fù)雜精細(xì)的女性盆底解剖。因此需要在原有研究基礎(chǔ)上優(yōu)化相關(guān)指標(biāo),發(fā)現(xiàn)新的研究方法完善女性盆底解剖學(xué)研究。MRI具有較高的軟組織分辨率,能多方位進(jìn)行盆底結(jié)構(gòu)掃描,已越來越多地運(yùn)用于盆底結(jié)構(gòu)的研究和POP的診斷;MRI無輻射,屬于非侵入性檢查,具有軟組織分辨率高、動靜態(tài)功能和多平面成像等特點(diǎn),可全面評價(jià)盆腔器官脫垂和盆底形態(tài),無疑是研究盆底解剖較好的手段[9,10]。但MRI屬于影像學(xué),所生成的圖像色彩為灰階,在辨認(rèn)解剖結(jié)構(gòu)細(xì)部特征時(shí)相對困難,尤其是軟組織邊界的界定較模糊,二維掃描圖像質(zhì)量易受體位、呼吸、腸蠕動等影響,因而不能最真實(shí)準(zhǔn)確地體現(xiàn)女性盆底的精細(xì)解剖及毗鄰關(guān)系。中國數(shù)字化人體(chinese visible human,CVH)數(shù)據(jù)集圖像為真彩色,分辨率高,圖像形變小,厚度薄,圖像相互之間配準(zhǔn)度高,隨著數(shù)字醫(yī)學(xué)的發(fā)展在多個(gè)領(lǐng)域有著廣泛的應(yīng)用前景[11,12]。結(jié)合MRI圖像資料,CVH可望成為研究女性盆底解剖新的途徑,真正實(shí)現(xiàn)女性盆底結(jié)構(gòu)可視化,對指導(dǎo)各種婦科手術(shù)的實(shí)施有著指導(dǎo)意義。本研究擬利用CVH盆腔段數(shù)據(jù)集,結(jié)合健康正常志愿者女性盆腔橫斷位薄層MRI掃描圖像,采用腹腔鏡下廣泛子宮切除術(shù)(laparoscope radical hysterectomy,LRH)中相關(guān)活體解剖,對正常女性宮頸周圍結(jié)構(gòu)進(jìn)行三維重建,為婦科手術(shù)特別是RH及PFR手術(shù)的模擬教學(xué)、影像學(xué)診斷提供有力的形態(tài)學(xué)依據(jù),為婦科臨床和解剖基礎(chǔ)教學(xué)提供三維可視化模型;同時(shí)利用子宮脫垂患者盆底矢狀位MRI圖像,建立POP盆底結(jié)構(gòu)三維可視化模型,探討子宮脫垂患者盆底MRI三維影像特征及臨床診斷意義,真正實(shí)現(xiàn)女性盆底結(jié)構(gòu)的精準(zhǔn)化研究,為婦科臨床精準(zhǔn)診治奠定基礎(chǔ)。實(shí)驗(yàn)方法:1、選擇3例無器質(zhì)性病變的女性CVH數(shù)據(jù)集盆腔段數(shù)據(jù),對盆腔器官和宮頸周圍結(jié)構(gòu)包括膀胱宮頸韌帶、子宮骶韌帶、子宮主韌帶、宮頸周圍環(huán)、盆腔血管、直腸系膜、膀胱側(cè)間隙、直腸側(cè)間隙及毗鄰結(jié)構(gòu)進(jìn)行識別、分割,并進(jìn)行三維重建;同時(shí)選擇3例正常未生育女性志愿者,對盆腔進(jìn)行橫斷位薄層MRI掃描,與CVH圖像進(jìn)行對照研究;選擇LRH相關(guān)解剖圖片進(jìn)行對比。2、選取2013年9月至2014年6月子宮脫垂患者30例為研究組,選取健康女性20例為對照組,于靜息位和Valsalva動作時(shí)行盆底MRI掃描;利用Amira軟件,對圖像進(jìn)行測量及3D建模,對比研究各參數(shù)。3、統(tǒng)計(jì)學(xué)分析:數(shù)據(jù)處理采用SPSS 19.0統(tǒng)計(jì)分析軟件,計(jì)量資料用均數(shù)±標(biāo)準(zhǔn)差表示,正態(tài)分布的數(shù)據(jù)采用的獨(dú)立樣本t檢驗(yàn)或配對t檢驗(yàn)。P0.05被認(rèn)為差異有統(tǒng)計(jì)學(xué)意義。實(shí)驗(yàn)結(jié)果:1、基于CVH,利用Amira 5.2.2軟件重建了女性骨盆、盆腔器官、膀胱宮頸韌帶、子宮骶韌帶、子宮主韌帶、宮頸周圍環(huán)、盆腔血管、直腸系膜、膀胱側(cè)間隙、直腸側(cè)間隙及毗鄰結(jié)構(gòu)的三維可視化模型,很好地顯示了宮頸周圍結(jié)構(gòu)及其毗鄰關(guān)系。2、在三維模型的基礎(chǔ)上對膀胱宮頸韌帶、子宮骶韌帶、子宮主韌帶、宮頸周圍環(huán)等結(jié)構(gòu)的長度、寬度、厚度進(jìn)行量化及分段。3、基于MRI TSE T2WI序列,利用Amira 5.2.2商業(yè)軟件,建立了脫垂組和對照組盆底結(jié)構(gòu)的三維可視化模型,利用3D測量器分別量化PCL線、G1角、G2角、H線、M線、宮頸長度、C線、B線等參數(shù)。4、脫垂組和對照組組間兩相位分別比較:PCL、H線、G1角、G2角、宮頸長度無顯著性差異(p㧐0.05),M線、C線有顯著性差異(P0.05),B線靜息時(shí)無顯著性差異(p㧐0.05),Valsalva動作時(shí)有顯著性差異(P0.05);組內(nèi)兩相位差值比較:兩組PCL均無顯著性差異(p㧐0.05),M線、G1角、G2角、B線、C線有顯著性差異(P0.05),H線對照組有顯著性差異(P0.05),脫垂組無顯著性差異(p㧐0.05)。結(jié)論:1、中國可視化人體數(shù)據(jù)集(CVH)提供了完整而精準(zhǔn)的數(shù)據(jù),利用該數(shù)據(jù)庫,結(jié)合活體女性盆腔橫斷面薄層MRI影像資料,對比LRH相關(guān)解剖,分別重建了女性骨盆、盆腔器官、宮頸周圍結(jié)構(gòu)及重要的腹膜后解剖間隙以及盆腔血管神經(jīng),建立了正常女性盆腔三維可視化模型。2、在三維模型的基礎(chǔ)上對膀胱宮頸韌帶、子宮骶韌帶、子宮主韌帶、宮頸周圍環(huán)等結(jié)構(gòu)的長度、寬度、厚度進(jìn)行量化及分段,對臨床治療宮頸癌及盆腔器官脫垂疾病有很好地臨床指導(dǎo)意義,可望為臨床精準(zhǔn)診治提供解剖依據(jù)。MRI TSE T2WI序列能清楚顯示盆底結(jié)構(gòu)且各項(xiàng)測量指標(biāo)精準(zhǔn),是盆腔器官脫垂診斷分期和治療決策的好方法。4、盆底三維可視化重建模型能清楚地顯示各結(jié)構(gòu)之間的關(guān)系,可以明確盆底缺陷的精確位置,是盆底手術(shù)模擬的好途徑,可為解剖教學(xué)及進(jìn)一步力學(xué)研究提供支持。
[Abstract]:BACKGROUND & OBJECTIVE Precision medicine (PM) is based on individualized medical care, combined with patient's living environment and clinical data, to achieve accurate disease classification and diagnosis, and to formulate a personalized disease prevention and treatment program. The structure is complex, and the location is deep, poor accessibility, but this part is the key part of many gynecological surgery, especially cervical cancer (CC) and pelvic organ prolapse (POP) patients with surgical treatment and this structure is closely related to the success of surgery and postoperative complications of the key location. Radical hysterectomy (RH) is the main treatment for early cervical cancer. However, intraoperative complications such as bleeding, bladder, rectum, ureter injury, postoperative complications such as defecation, urinary dysfunction can not be completely avoided. The important reason is that the anatomical position of the pelvic floor is deep and the structure is abundant. Complex adjacent structures, especially pericervical structures (PS), including the main ligament (CL), sacral ligament (USL), vesico-cervical ligament (VCL), pericervical ring (CR), and their adjacent relationships are not fully understood. Female pelvic floor dysfunction (PFD) refers to a disorder caused by relaxation of the pelvic floor supporting tissue due to injury or degeneration, including stress urinary incontinence (stre). With the aging of the population, the incidence of PFD increases year by year, which seriously affects the physical and mental health and quality of life of middle-aged and elderly women [2].Surgical treatment is needed for the patients with severe PFD, but the complications and recurrence rate of traditional surgery are higher [3], because the degree of POP is not accurately grasped before operation, and no clear results have been found. With the development of pelvic floor reconstruction (PFR) surgery, accurate preoperative assessment of the anatomical relationship between pelvic organs and structures, the extent of prolapse and the specific location of the defect are the prerequisites for comprehensive diagnosis and treatment and for effective personalized treatment of patients. In the past, the anatomy of female pelvic floor mainly relied on autopsy. In recent years, many scholars have proposed using different methods to study pelvic floor anatomy [5-8] in order to enhance the understanding of pelvic floor structure. At present, more and more attention has been paid to the three-dimensional visualization of pelvic floor anatomy. However, the previous work lacked more detailed morphological and anatomical studies. Most of the previous studies were autopsy, which had some limitations: large tissue destruction, poor reusability of specimens, poor spatial visualization; magnetic resonance imaging (MRI) and computed tomography (CT). It is difficult to restore the complicated and fine anatomy of the female pelvic floor. Therefore, it is necessary to optimize the relevant indicators on the basis of the original study and find new research methods to improve the anatomy of the female pelvic floor. MRI has a high soft tissue resolution and can carry out the pelvic floor structure in many directions. Scanning has been used more and more in the study of pelvic floor structure and the diagnosis of POP; MRI is non-invasive, non-radiation, with high soft tissue resolution, dynamic and static functions and multi-plane imaging characteristics, can be used to evaluate the pelvic organ prolapse and pelvic floor morphology, is undoubtedly a better means to study pelvic floor anatomy [9,10]. The color of the image is gray scale, and it is difficult to identify the details of anatomical structure, especially the boundary of soft tissue is blurred. The quality of the two-dimensional scanning image is easy to be affected by location, respiration, intestinal peristalsis and so on. Therefore, it can not reflect the precise anatomy and adjacent relationship of the female pelvic floor most truly and accurately. Visible human (CVH) dataset images are true color, high resolution, small deformation, thin thickness and high registration between images. With the development of digital medicine, it has a broad application prospect in many fields [11,12]. In this study, we intend to use the CVH pelvic segment data set, combined with the thin-slice MRI scan images of the normal female volunteers, to dissect the cervical periphery of the normal female by laparoscope radical hysterectomy (LRH). Surrounding structure is reconstructed in three-dimensional, which provides powerful morphological basis for gynecological surgery, especially RH and PFR surgery simulation teaching and imaging diagnosis, and provides three-dimensional visualization model for gynecological clinical and anatomical basic teaching; meanwhile, using the sagittal MRI image of the pelvic floor of patients with uterine prolapse, the three-dimensional visualization model of the POP pelvic floor structure is established, and the discussion is made. Three-dimensional MRI features and clinical diagnostic significance of pelvic floor in patients with uterine prolapse can truly realize the precise study of female pelvic floor structure and lay a foundation for gynecological clinical diagnosis and treatment. The uterosacral ligament, the main uterine ligament, the pericervical ring, pelvic vessels, mesorectal, bladder lateral space, rectal lateral space and adjacent structures were identified, segmented and reconstructed in three dimensions. Pictures were compared. 2. 30 patients with uterine prolapse from September 2013 to June 2014 were selected as the study group, 20 healthy women as the control group, pelvic floor MRI scanning was performed in resting position and Valsalva movement; the image was measured and 3D modeled by Amira software, and the parameters were compared. 3. Statistical analysis: SPSS 19.0 was used for data processing. Results: 1. Based on CVH, the female pelvis, pelvic organs, bladder and cervical ligaments, uterosacral ligaments, main uterine ligaments, cervical ligaments were reconstructed with Amira 5.2.2 software. The three-dimensional visualization model of the peripheral ring, pelvic vessels, mesorectal, bladder lateral space, rectal lateral space and adjacent structures shows the structure around the cervix and its adjacent relationship. 2. Based on the three-dimensional model, the length, width and thickness of the bladder cervical ligament, uterosacral ligament, main uterine ligament, and the surrounding ring of the cervix are calculated. Quantification and segmentation.3. Based on MRI TSE T2WI sequence and Amira 5.2.2 commercial software, three-dimensional visualization models of pelvic floor structure in prolapsed group and control group were established. PCL line, G1 angle, G2 angle, H line, M line, cervical length, C line, B line and other parameters were quantified by 3D measuring instrument.4. Two phases of prolapsed group and control group were compared respectively: PCL, H line, G1 angle, G2 line. Angle, cervical length had no significant difference (p? 0.05), M line, C line had significant difference (P 0.05), B line had no significant difference at rest (p? 0.05), Valsalva action had significant difference (P 0.05); two phase difference between the two groups: there was no significant difference in PCL between the two groups (p? 0.05), M line, G1 angle, G2 angle, B line, C line had significant difference (P 0.05), H line control group had significant difference (P 0.05). Conclusion: 1. The Chinese Visual Human Data Set (CVH) provides complete and accurate data. Using this database, we reconstructed the female pelvis, pelvic organs, cervical pericervical structures and their importance by comparing LRH-related anatomy with thin-slice MRI images of female pelvis in vivo. The length, width and thickness of the bladder cervical ligament, uterosacral ligament, main uterine ligament and pericervical ring were quantified and segmented on the basis of the three-dimensional model. MRI TSE T2WI sequence can clearly show the pelvic floor structure and the measurement indexes are accurate. It is a good method for diagnosis and treatment decision of pelvic organ prolapse. 4. The three-dimensional visualization reconstruction model of pelvic floor can clearly show the relationship between the structures. Defining the exact location of pelvic floor defect is a good way to simulate pelvic floor surgery, which can provide support for anatomy teaching and further mechanical research.
【學(xué)位授予單位】：第三軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R711
本文編號：2248345
[Abstract]:BACKGROUND & OBJECTIVE Precision medicine (PM) is based on individualized medical care, combined with patient's living environment and clinical data, to achieve accurate disease classification and diagnosis, and to formulate a personalized disease prevention and treatment program. The structure is complex, and the location is deep, poor accessibility, but this part is the key part of many gynecological surgery, especially cervical cancer (CC) and pelvic organ prolapse (POP) patients with surgical treatment and this structure is closely related to the success of surgery and postoperative complications of the key location. Radical hysterectomy (RH) is the main treatment for early cervical cancer. However, intraoperative complications such as bleeding, bladder, rectum, ureter injury, postoperative complications such as defecation, urinary dysfunction can not be completely avoided. The important reason is that the anatomical position of the pelvic floor is deep and the structure is abundant. Complex adjacent structures, especially pericervical structures (PS), including the main ligament (CL), sacral ligament (USL), vesico-cervical ligament (VCL), pericervical ring (CR), and their adjacent relationships are not fully understood. Female pelvic floor dysfunction (PFD) refers to a disorder caused by relaxation of the pelvic floor supporting tissue due to injury or degeneration, including stress urinary incontinence (stre). With the aging of the population, the incidence of PFD increases year by year, which seriously affects the physical and mental health and quality of life of middle-aged and elderly women [2].Surgical treatment is needed for the patients with severe PFD, but the complications and recurrence rate of traditional surgery are higher [3], because the degree of POP is not accurately grasped before operation, and no clear results have been found. With the development of pelvic floor reconstruction (PFR) surgery, accurate preoperative assessment of the anatomical relationship between pelvic organs and structures, the extent of prolapse and the specific location of the defect are the prerequisites for comprehensive diagnosis and treatment and for effective personalized treatment of patients. In the past, the anatomy of female pelvic floor mainly relied on autopsy. In recent years, many scholars have proposed using different methods to study pelvic floor anatomy [5-8] in order to enhance the understanding of pelvic floor structure. At present, more and more attention has been paid to the three-dimensional visualization of pelvic floor anatomy. However, the previous work lacked more detailed morphological and anatomical studies. Most of the previous studies were autopsy, which had some limitations: large tissue destruction, poor reusability of specimens, poor spatial visualization; magnetic resonance imaging (MRI) and computed tomography (CT). It is difficult to restore the complicated and fine anatomy of the female pelvic floor. Therefore, it is necessary to optimize the relevant indicators on the basis of the original study and find new research methods to improve the anatomy of the female pelvic floor. MRI has a high soft tissue resolution and can carry out the pelvic floor structure in many directions. Scanning has been used more and more in the study of pelvic floor structure and the diagnosis of POP; MRI is non-invasive, non-radiation, with high soft tissue resolution, dynamic and static functions and multi-plane imaging characteristics, can be used to evaluate the pelvic organ prolapse and pelvic floor morphology, is undoubtedly a better means to study pelvic floor anatomy [9,10]. The color of the image is gray scale, and it is difficult to identify the details of anatomical structure, especially the boundary of soft tissue is blurred. The quality of the two-dimensional scanning image is easy to be affected by location, respiration, intestinal peristalsis and so on. Therefore, it can not reflect the precise anatomy and adjacent relationship of the female pelvic floor most truly and accurately. Visible human (CVH) dataset images are true color, high resolution, small deformation, thin thickness and high registration between images. With the development of digital medicine, it has a broad application prospect in many fields [11,12]. In this study, we intend to use the CVH pelvic segment data set, combined with the thin-slice MRI scan images of the normal female volunteers, to dissect the cervical periphery of the normal female by laparoscope radical hysterectomy (LRH). Surrounding structure is reconstructed in three-dimensional, which provides powerful morphological basis for gynecological surgery, especially RH and PFR surgery simulation teaching and imaging diagnosis, and provides three-dimensional visualization model for gynecological clinical and anatomical basic teaching; meanwhile, using the sagittal MRI image of the pelvic floor of patients with uterine prolapse, the three-dimensional visualization model of the POP pelvic floor structure is established, and the discussion is made. Three-dimensional MRI features and clinical diagnostic significance of pelvic floor in patients with uterine prolapse can truly realize the precise study of female pelvic floor structure and lay a foundation for gynecological clinical diagnosis and treatment. The uterosacral ligament, the main uterine ligament, the pericervical ring, pelvic vessels, mesorectal, bladder lateral space, rectal lateral space and adjacent structures were identified, segmented and reconstructed in three dimensions. Pictures were compared. 2. 30 patients with uterine prolapse from September 2013 to June 2014 were selected as the study group, 20 healthy women as the control group, pelvic floor MRI scanning was performed in resting position and Valsalva movement; the image was measured and 3D modeled by Amira software, and the parameters were compared. 3. Statistical analysis: SPSS 19.0 was used for data processing. Results: 1. Based on CVH, the female pelvis, pelvic organs, bladder and cervical ligaments, uterosacral ligaments, main uterine ligaments, cervical ligaments were reconstructed with Amira 5.2.2 software. The three-dimensional visualization model of the peripheral ring, pelvic vessels, mesorectal, bladder lateral space, rectal lateral space and adjacent structures shows the structure around the cervix and its adjacent relationship. 2. Based on the three-dimensional model, the length, width and thickness of the bladder cervical ligament, uterosacral ligament, main uterine ligament, and the surrounding ring of the cervix are calculated. Quantification and segmentation.3. Based on MRI TSE T2WI sequence and Amira 5.2.2 commercial software, three-dimensional visualization models of pelvic floor structure in prolapsed group and control group were established. PCL line, G1 angle, G2 angle, H line, M line, cervical length, C line, B line and other parameters were quantified by 3D measuring instrument.4. Two phases of prolapsed group and control group were compared respectively: PCL, H line, G1 angle, G2 line. Angle, cervical length had no significant difference (p? 0.05), M line, C line had significant difference (P 0.05), B line had no significant difference at rest (p? 0.05), Valsalva action had significant difference (P 0.05); two phase difference between the two groups: there was no significant difference in PCL between the two groups (p? 0.05), M line, G1 angle, G2 angle, B line, C line had significant difference (P 0.05), H line control group had significant difference (P 0.05). Conclusion: 1. The Chinese Visual Human Data Set (CVH) provides complete and accurate data. Using this database, we reconstructed the female pelvis, pelvic organs, cervical pericervical structures and their importance by comparing LRH-related anatomy with thin-slice MRI images of female pelvis in vivo. The length, width and thickness of the bladder cervical ligament, uterosacral ligament, main uterine ligament and pericervical ring were quantified and segmented on the basis of the three-dimensional model. MRI TSE T2WI sequence can clearly show the pelvic floor structure and the measurement indexes are accurate. It is a good method for diagnosis and treatment decision of pelvic organ prolapse. 4. The three-dimensional visualization reconstruction model of pelvic floor can clearly show the relationship between the structures. Defining the exact location of pelvic floor defect is a good way to simulate pelvic floor surgery, which can provide support for anatomy teaching and further mechanical research.
【學(xué)位授予單位】：第三軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R711
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