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背景: 手的解剖结构和运动特点是建立手模型的基础, 而手的运动特点又是由其解剖结构决定的, 因此建立基于手解剖结构的虚拟手模型是众多学者们所关注的课题。目的: 建立基于解剖结构的可视化手模型。设计: 单一样本实验。单位: 解放军第二五二医院和解放军第三军医大学中心实验室。对象: 实验于 2003- 10 在解放军第三军医大学中心实验室完成。取新鲜健康成人手标本 2 只( 保留腕关节, 标本由解放军第三军医大学解剖教研室提供) , 肉眼观无器质性损害。方法: 将标本包埋及铣切 ( 设定铣切的层厚为 0.2 mm) , 应用 Canon(ESO 1OD)数码相机 (630 万像素)进行图像采集, 每张图片的大小为31.5 MB, 共获得水平切断层 1 200 幅图像数据。用 Adobe Photo-shop7.0 软件进行图片的对位、裁切及格式转换, 然后行二维薄层断面图像数据抽取, 采用清华大学计算机科学技术系与解放军第三军医大学解剖教研室计算医学研究所联合开发的三维重建软件, 分别对手部的骨骼、指屈肌腱及手的外形进行了三维重建。主要观察指标: 手部的骨骼、指屈肌腱及手的外形的三维重建效果。结果: ①手外形: 经三维重建后, 各组成部分包括各指及指甲等得到良好显示, 并能任意旋转进行多方位观察。②手部骨骼: 重建的手部骨骼包括指骨、掌骨和腕骨以及各骨之间形成的关节, 可以单独显示或与重建的其他结构任意搭配。③指屈肌腱: 从重建的图像中可以看出包括 4 条指浅屈肌腱、4 条指深屈肌腱和 1 条拇长屈肌腱, 共同穿出狭窄的腕管进入掌部, 进而沿各手指的方向呈扇形散开。④手掌部筋膜间隙: 重建的图像中可以看到, 鱼际间隙的近端为盲端, 远端通向手背; 掌中间隙的近端与前臂屈肌后间隙相通, 远端分为 3 个小间隙, 并经相应的小间隙通向手背。结论: 初步建立了基于解剖结构的可视化手模型, 并精确显示手掌部主要解剖结构。
BACKGROUND: The anatomical structure and movement characteristics of hands are the foundation of hand model, and the movement characteristics of hands are determined by their anatomical structures. Therefore, it is a topic of concern for many scholars to establish virtual hand models based on hand anatomical structures. Objective: To establish a visual hand model based on anatomy. Design: Single sample experiment. Unit: Second Hospital of People's Liberation Army and the Third Military Medical University Central Laboratory. Subjects: The experiment was performed at the Central Laboratory of the Third Military Medical University of PLA in 2003-10. Take fresh and healthy adult hand specimens 2 (wrist, the specimen was provided by the Department of Anatomy, Third Military Medical University, People's Liberation Army, naked eye without organic damage. Methods: The specimens were embedded and milled (set to a milling thickness of 0.2 mm). Images were acquired with a Canon (ESO 1OD) digital camera (6.3 million pixels), each with a size of 31.5 MB, Horizontal cut 1 200 layers of image data. With Adobe Photo-shop7.0 software alignment, cutting and format conversion, and then two-dimensional thin-section image data extraction, using computer science and Technology Department of Tsinghua University and the Third Military Medical University, Department of Anatomy, Institute of Computing Medical Developed jointly by the three-dimensional reconstruction software, respectively, the skeleton of the hand, finger flexor tendon and hand shape three-dimensional reconstruction. MAIN OUTCOME MEASURES: Three-dimensional reconstruction of the hand's skeleton, flexor tendon, and hand shape. Results: ① hand shape: After three-dimensional reconstruction, the various components, including fingers and nails and so on are well displayed, and can be rotated to carry out multi-directional observation. ② hand bones: reconstruction of the hand bones, including the phalanx, metacarpal and carpal bones and joints formed between the bones, can be displayed alone or reconstructed with any other structure with any. ③ flexor tendons: From the reconstruction of the image can be seen, including the four fingers superficial flexor tendon, the four refers to the deep flexor tendon and a thumb flexor tendon, common wear out of the narrow carpal tunnel into the palm, and then along the fingers Fan-shaped direction of the spread. ④ palmar fascia gap: the reconstructed image can be seen, the proximal end of the interstitial space for the blind end, distal to the back of the hand; the proximal end of the palm gap and the forearm flexor gap after the gap, the distal is divided into three Small gap, and through the corresponding small gap leading to the back of the hand. Conclusion: A visual hand model based on anatomy was established and the main anatomy of the palm was accurately displayed.