Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Avenue, Guangzhou, 510515, China.
Department of Anatomy, Guangdong Province Key Laboratory of Medical Biomechanics, School of Basic Medicine Science, Southern Medical University, Guangzhou, China.
Arch Gynecol Obstet. 2019 May;299(5):1459-1465. doi: 10.1007/s00404-019-05108-w. Epub 2019 Mar 14.
To present the distribution of neurovascular and lymphatic vessels in uterine ligaments using 3D models based on the pathological staining of serial 2D sections of postoperative specimens.
Serial transverse sections of fresh uterine ligaments from a patient with stage IB1 cervical squamous cell carcinoma were studied using the computer-assisted anatomic dissection (CAAD) technique. The sections were stained with hematoxylin and eosin, Weigert elastic fibers, D2-40 and immunostainings (sheep anti-tyrosine hydroxylase and rabbit anti-vasoactive intestinal peptide). The sections were then digitalized, registered and reconstructed three-dimensionally. Then, the 3D models were analyzed and measured.
The 3D models of the neurovascular and lymphatic vessels in uterine ligaments were created, depicting their precise location and distribution. The vessels were primarily located in the upper part of the ligaments model, while the pelvic autonomic nerves were primarily in the lower part; the lymphatic vessels were scattered in the uterine ligaments, without obvious regularity.
CAAD is an effective anatomical method to study the precise distribution of neurovascular and lymphatic vessels in uterine ligaments. It can present detailed anatomical information about female pelvic autonomic innervation and the spatial relationship between nerves and vessels and may provide a better understanding of nerve-sparing radical hysterectomy.
通过对术后标本连续二维切片进行病理染色，利用 3D 模型呈现子宫韧带中的神经血管和淋巴管分布。
采用计算机辅助解剖（CAAD）技术研究了一名患有 IB1 期宫颈鳞状细胞癌患者的新鲜子宫韧带的横向连续切片。对切片进行了苏木精和伊红、Weigert 弹性纤维、D2-40 和免疫染色（绵羊抗酪氨酸羟化酶和兔抗血管活性肠肽）染色。然后对切片进行数字化、注册和三维重建。然后，对 3D 模型进行分析和测量。
创建了子宫韧带中神经血管和淋巴管的 3D 模型，描绘了它们的精确位置和分布。血管主要位于韧带模型的上部，而盆腔自主神经主要位于下部；淋巴管散在子宫韧带中，没有明显的规律性。
CAAD 是一种研究子宫韧带中神经血管和淋巴管精确分布的有效解剖方法。它可以呈现女性盆腔自主神经支配的详细解剖信息以及神经与血管之间的空间关系，可能有助于更好地理解神经保留根治性子宫切除术。
