Gatellier Marie-Anne, Dit Gautier Estelle Jean, Mayeur Olivier, Brieu Mathias, Cosson Michel, Rubod Chrystele
University of Lille, Faculty of Medicine, F-59000, Lille, France; Gynecologic Surgery Unit, Lille University Hospital Center, Hopital Jeanne de Flandre, Rue Eugene Avinee, F-59000, Lille, France.
University of Lille, Faculty of Medicine, F-59000, Lille, France; Gynecologic Surgery Unit, Lille University Hospital Center, Hopital Jeanne de Flandre, Rue Eugene Avinee, F-59000, Lille, France; CNRS - FRE 2016 - LaMcube, Laboratoire de mécanique multiphysique multiéchelle, Ecole Centrale de Lille, Cite scientifique, F-59650, Villeneuve d'Ascq, France.
J Gynecol Obstet Hum Reprod. 2020 Jan;49(1):101635. doi: 10.1016/j.jogoh.2019.101635. Epub 2019 Sep 6.
The women pelvic floor is a complex system, which seems to endure several modifications during pregnancy and childbirth. Our primary purpose was to build an extensive 3 dimensional (3D) numerical anatomical model of the women pelvic floor.
First, the role and the location of each organ, muscle, or ligament, were identified through an extensive literature review. Then, different entities were selected because of their visibility and importance in the pelvic floor. Each entity was identified using anatomical knowledge, and outlined on 2 dimensional (2D) MRI images, that were carried out on 4 pregnant women, using sequences T1, T2 and proton density weighted, through AVIZO program. The overlay of these 2D outlines produced a 3D geometrical reconstruction, which was then reworked with the program CATIA to obtain a usable geometric model.
We identified and integrated 15 anatomical structures to the geometrical model, including organs, ligament and muscles from the pelvis and perineum. This geometrical model allowed us to obtain a visual interactive representation with 3D images. These different steps resulted in the creation of a complete numerical model of the female pelvic floor, which might be used in Finite Element simulation.
A new complete and accurate 3D numerical anatomical model of the women pelvic floor was elaborated. It presents simultaneously analytical prospects, through the observation of the strains and deformations that are imposed on the different structures, and educational prospects, through the detailed visual representation of several situations.
女性盆底是一个复杂的系统，在妊娠和分娩过程中似乎会经历多种变化。我们的主要目的是构建一个广泛的女性盆底三维（3D）数字解剖模型。
首先，通过广泛的文献综述确定每个器官、肌肉或韧带的作用和位置。然后，由于其在盆底的可见性和重要性，选择了不同的实体。利用解剖学知识识别每个实体，并在4名孕妇的二维（2D）MRI图像上勾勒出来，这些图像通过AVIZO程序使用T1、T2和质子密度加权序列进行采集。这些二维轮廓的叠加产生了三维几何重建，然后使用CATIA程序对其进行重新处理，以获得可用的几何模型。
我们在几何模型中识别并整合了15个解剖结构，包括骨盆和会阴的器官、韧带和肌肉。这个几何模型使我们能够获得带有3D图像的视觉交互表示。这些不同的步骤导致创建了一个完整的女性盆底数字模型，可用于有限元模拟。
精心制作了一个全新的、完整且准确的女性盆底三维数字解剖模型。它通过观察施加在不同结构上的应变和变形展现了分析前景，同时通过对多种情况的详细视觉呈现展现了教育前景。
