The 3D reconstructions of female pelvic autonomic nerves and their related organs based on MRI: a first step towards neuronavigation during nerve-sparing radical hysterectomy
The 3D reconstructions of female pelvic autonomic nerves and their related organs based on MRI: a first step towards neuronavigation during nerve-sparing radical hysterectomy
复制标题
基于 MRI 的女性盆腔自主神经及其相关器官的 3D 重建：神经保留根治性子宫切除术中神经导航的第一步
DOI：
10.1007/s00330-018-5453-8
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发表时间：
2018-11-01
影响因子：
5.9
通讯作者：
Ognami, Oldevie Hugueth
中科院分区：
文献类型：
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作者：
Li, Pengfei;Liu, Ping;Ognami, Oldevie Hugueth
目的通过磁共振成像（MRI）三维重建，了解女性盆腔内自主神经支配及其与相关器官的关系。方法30例宫颈癌患者接受盆腔MRI检查，并同意接受额外的磁共振神经成像（MRN）序列检查。使用t2加权脂肪饱和度（T2W FS）和3D-STIR-SPACE序列获得同一患者的MRI图像。基于这两个序列的图像，利用三维重建软件对盆腔自主神经（PAN）进行详细的二维（2D）分割和三维重建。基于T2W FS图像对盆腔器官进行二维分割和三维重建。分析比较两序列构建的盆腔自主神经支配三维模型的一致性，展示盆腔自主神经支配，表征神经与相关器官的关系。结果30例患者PAN的3D- stir - space和T2W FS序列均获得了PAN的三维重建，显示出高度的一致性。T2W FS图像还可以对盆腔器官进行三维重建，以显示PAN的三维分布以及神经与其相关器官之间的位置关系。结论在保留神经的根治性子宫切除术（NSRH）中，基于MRI重建盆腔自主神经及其相关器官可提供个性化的三维解剖信息，为个体化指导提供依据。•保留神经的根治性子宫切除术是宫颈癌手术的发展趋势•MRI可以重建盆腔自主神经及其相关器官•三维重建提供详细的神经三维解剖信息
ObjectivesTo present in vivo female pelvic autonomous innervation and the relationship between nerves and their related organs by three-dimensional (3D) reconstruction based on magnetic resonance imaging (MRI).MethodsThirty patients with cervical cancer who underwent pelvic MRI and agreed to undergo additional magnetic resonance neurography (MRN) sequences were enrolled in the present study. MRI images from the same patient were acquired using T2-weighted fat saturation (T2W FS) and 3D-STIR-SPACE sequences. Detailed two-dimensional (2D) segmentation and 3D reconstruction of pelvic autonomic nerves (PAN) were performed on the basis of the images of the two sequences using 3D reconstruction software. The 2D segmentation and 3D reconstruction of pelvic organs were based on T2W FS images. The consistency of the 3D models of pelvic autonomous innervation constructed from the two sequences were analysed and compared, the pelvic autonomous innervation was presented, and the relationship between nerves and their related organs was characterised.ResultsThe 3D reconstructions of PAN were successfully obtained from 3D-STIR-SPACE and T2W FS sequences in 30 patients and showed high correspondence. T2W FS images also enabled 3D reconstructions of pelvic organs to visualise the 3D distribution of PAN and the positional relationships between nerves and their related organs.ConclusionThe pelvic autonomic nerves and their related organs can be reconstructed on the basis of MRI to present personalised 3D anatomical information and offer individualised guidance during nerve-sparing radical hysterectomy (NSRH).Key points•Nerve-sparing radical hysterectomy is a developing trend in cervical cancer surgery•MRI allows reconstructions of pelvic autonomic nerves and their related organs•The 3D reconstructions provide detailed 3D anatomical information on nerves