Liu Ruilei, Dai Encheng, Chen Chunlin, Liu Ping
Department of Obstetrics and Gynecology, Shandong Province Linyi People's Hospital, Linyi 276000, China.
Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, 510515 Guangzhou. Email:
Zhonghua Fu Chan Ke Za Zhi. 2014 Feb;49(2):89-93.
To investigate the construction and significance of in vivo pelvis and abdominal-pelvic arterial vascular network in digital three-dimensional (3D) model for uterine artery embolization (UAE) in the application of surgical approach planning based on computerized tomographic angiography(CTA).
A series of digital imaging and communications in medicine 3.0 (Dicom 3.0) were obtained from a woman with myoma of uterus by CTA scanning. Then the software Mimics Version 10.01 was used to construct the pelvic and the arterial vascular network 3D model.
The digital model could clearly display the abdominal aorta, bilateral common iliac arteries, left and right external iliac artery, internal iliac artery and its branches around the stage; the right uterine artery emitted in the inferior gluteal artery opening below 15.91 mm, the left uterine artery in inferior gluteal artery below the opening of 15.21 mm, the adjacent artery of internal pudendal artery. At the same time, the artery length and angle of bifurcation were accurately measured. The bifurcation angle of abdominal aorta in fifth lumbar vertebral body edge, was 66.58°, the bifurcation angle of right internal iliac artery was 46.23°, the length of right common iliac artery was 51.43 mm, the bifurcation angle between left and external internal iliac artery was 36.45°, the length of left common iliac artery and 67.50 mm. According to the preoperative approach planning, guided wire across the inferior gluteal artery to the lower 15.00 mm and rotating digital subtraction angiography (DSA) tube, could clearly display the uterine artery opening outward by rotating guide wire, which was relatively easy to enter the uterine artery.
The female pelvic arterial network model in vivo could be successfully constructed by using Mimics Version 10.01 software with database collected through CTA, which may contribute to the materialization of digital models and be used for preoperative surgical simulator.
探讨基于计算机断层血管造影（CTA）构建的数字化三维（3D）模型中体内骨盆及腹盆腔动脉血管网络在子宫动脉栓塞术（UAE）手术入路规划应用中的构建及意义。
通过CTA扫描获取一名子宫肌瘤女性患者的一系列医学数字成像和通信（Dicom 3.0）数据。然后使用Mimics 10.01软件构建盆腔及动脉血管网络3D模型。
该数字模型可清晰显示腹主动脉、双侧髂总动脉、左右髂外动脉、髂内动脉及其周围分支；右子宫动脉发自臀下动脉开口下方15.91 mm处，左子宫动脉发自臀下动脉开口下方15.21 mm处，阴部内动脉相邻。同时，准确测量了动脉长度及分支角度。腹主动脉在第五腰椎椎体边缘处的分支角度为66.58°，右髂内动脉分支角度为46.23°，右髂总动脉长度为51.43 mm，左髂外动脉与髂内动脉之间的分支角度为36.45°，左髂总动脉长度为67.50 mm。根据术前入路规划，导丝穿过臀下动脉至下方15.00 mm并旋转数字减影血管造影（DSA）管，通过旋转导丝可清晰显示子宫动脉开口向外，较易进入子宫动脉。
利用Mimics 10.01软件结合CTA采集的数据库可成功构建女性体内盆腔动脉网络模型，这可能有助于数字模型的实体化，并用于术前手术模拟。
