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输卵管-腹膜瘘、异位妊娠与输卵管残端:人输卵管病变的共聚焦显微断层扫描分析及三维重建

Tuboperitoneal fistula, ectopic pregnancy, and remnants of fallopian tube: a confocal microtomography analysis and 3D reconstruction of human fallopian tube pathologies.

作者信息

Castro Pedro Teixeira, Matos Ana Paula Pinho, Aranda Osvaldo Luiz, Marchiori Edson, Alves Haimon Diniz Lopes, Machado Alessandra Silveira, Lopes Ricardo Tadeu, Werner Heron, Araujo Júnior Edward

机构信息

a Department of Radiology , Federal University of Rio de Janeiro (UFRJ) , Rio de Janeiro , Brazil.

b Department of Radiology , Clínica Diagnóstico por Imagem (CDPI) , Rio de Janeiro , Brazil.

出版信息

J Matern Fetal Neonatal Med. 2019 Sep;32(18):3082-3087. doi: 10.1080/14767058.2018.1455181. Epub 2018 Apr 6.

Abstract

The aim of this study was to provide a three-dimensional (3D) microscopic reconstruction of morphological modifications of the fallopian tube (FT) following surgical sterilization (including tuboperitoneal fistula) and ectopic pregnancy (EP) using confocal microtomography (micro-CT). Six specimens of FT from elective and emergency surgeries were selected: three remnants of the FT (RFT) from surgical sterilization, including one presenting tuboperitoneal fistula, and three FTs with EP. The specimens were fixed in formalin and stained with Lugol solution. Micro-CT studies were conducted on the specimens using protocols adapted from biological studies. Three RFTs from surgical sterilization and three FTs affected by EPs were successfully scanned using micro-CT. There was good contrast impregnation, allowing tissue segmentation and analysis of different sections of the FTs. Three FT specimens from EP exhibited considerable distortion of the tubal anatomy, mainly from the blood clot in the tubal abortion. Three RFT specimens exhibited some features observed in traditional microscopy, such as tubal distension and loss of normal anatomical characteristics of a normal FT, and indicated the presence of a tuboperitoneal fistula in one of the three specimens. Micro-CT can identify morphological characteristics of FT pathologies previously described in a microscopic scale, with tissue contrast and the possibility of 3D reconstruction. Micro-CT is also useful in guiding traditional sectioning of specimens for histopathological studies.

摘要

本研究的目的是使用共聚焦显微断层扫描(显微CT)对绝育手术(包括输卵管腹膜瘘)和异位妊娠(EP)后输卵管(FT)的形态学改变进行三维(3D)显微重建。从择期和急诊手术中选取了6个FT标本:3个绝育手术后的输卵管残端(RFT),其中1个存在输卵管腹膜瘘,以及3个患有EP的FT。标本用福尔马林固定,并用卢戈氏溶液染色。使用从生物学研究改编的方案对标本进行显微CT研究。使用显微CT成功扫描了3个绝育手术后的RFT和3个受EP影响的FT。有良好的对比剂灌注,允许对FT的不同部分进行组织分割和分析。3个EP的FT标本显示出输卵管解剖结构的显著扭曲,主要是由于输卵管流产中的血凝块。3个RFT标本表现出一些在传统显微镜下观察到的特征,如输卵管扩张和正常FT正常解剖特征的丧失,并表明3个标本中的1个存在输卵管腹膜瘘。显微CT可以识别先前在微观尺度上描述的FT病变的形态特征,具有组织对比度和3D重建的可能性。显微CT在指导用于组织病理学研究的标本传统切片方面也很有用。

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