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目的利用磁共振成像(MRI)和传统解剖学相结合的方法研究人体眼外肌Pulley结构的空间定位及解剖组织构成,探索Pulley定位量化分析的方法。设计非对照性试验研究。研究对象4例人体尸头标本。方法采用高分辨率MRI对人体尸头标本进行冠状、矢状及水平位的逐层扫描,在冠状位MRI图像上对Pulley空间位置进行测量。同时在直视下对其进行空间定位测量。并采用Masson三色、Gieson染色及免疫组化方法对Pulley结构组织学观察。主要指标MRI扫描图像,MRI以及解剖定位数据。组织学成分验证。结果MRI冠状位扫描Pulley结构较清晰,角膜顶点平面至首张出现Pulley结构扫描面的平均距离在内、外、上、下直肌分别是(11．25±1．04)、(14．50±0．93)、(15．75±1．28)、(13．25±1．04)mm。水平位扫描上、下直肌Pulley结构不清。直视下角膜顶点平面至Pulley间距在内、外、上、下直肌分别是(11．81±0．53)、(14．38±0．52)、(15．75±1．04)、(13．75±0．60)mm。免疫组化染色可见Pulley结构中胶原蛋白、弹力纤维及平滑肌组织的存在。结论高分辨率MRI可以作为眼外肌Pulley结构的定位量化分析的方便工具而服务于临床。(眼科,2006．15：304-308)
Objective To study the spatial location and anatomic structure of Pulley structure in human extraocular muscles by using the combination of magnetic resonance imaging (MRI) and traditional anatomy and to explore the method of Pulley localization quantitative analysis. Design non-control study. Study object 4 cases of human cadaver head specimens. Methods The coronal, sagittal and horizontal scans of human cadaver heads were scanned by high resolution MRI and the spatial position of Pulley was measured on coronal MRI images. At the same time under the direct vision of its space positioning measurements. The structure of Pulley was observed by Masson trichrome, Gieson staining and immunohistochemistry. The main indicators of MRI scan images, MRI and anatomical positioning data. Histological verification. Results The Pulley structure of MRI coronal scan was relatively clear. The average length of the Pulley structure scanning surface from the vertex plane to the first appearance of the Pulley was (11.25 ± 1.04), (14.50 ± 0.93), (15.75 ± 1.28), (13.25 ± 1.04) mm. Horizontal scan, lower rectus Pulley structure is unclear. The distance between the apex of cornea and Pulley under direct vision were (11.81 ± 0.53), (14.38 ± 0.52) and (15.75 ± 1.04) , (13.75 ± 0.60) mm. Immunohistochemical staining showed the presence of collagen, elastin and smooth muscle in Pulley’s structure. Conclusion High-resolution MRI can be used as a convenient tool for quantitative localization analysis of Pulley structures in extraocular muscles. (Ophthalmology, 2006.15: 304-308)