CAJ | 학술논문

背景:颈部神经阻滞麻醉易引起严重麻醉意外与并发症,目前在建立颈部神经三维可视化模型并对颈部神经节阻滞进行虚拟仿真方面还处在临床探索阶段. 目的:寻求三维虚拟穿刺仿真在颈部神经阻滞中的应用方法. 方法:取健康志愿者颈部连续CT动脉造影/MRI脊髓造影断面图像,Mimics软件对骨骼、肌肉、动静脉、甲状腺、喉软骨、脊髓等组织进行半自动分割和重建,医学计算机辅助设计模块对神经等细小解剖结构进行重建,三维化显示颈部神经及周围相关解剖结构,并进行颈部神经穿刺虚拟仿真,包括模拟颈浅丛阻滞,颈深丛阻滞和星状神经节阻滞. 结果与结论:成功模拟颈浅丛阻滞,颈深丛阻滞和星状神经节阻滞,显示虚拟穿刺针和骨性结构、动静脉、肌肉、脊髓、颈丛深浅支和星状神经节等解剖结构的三维毗邻关系,并测量穿刺进针的安全角度,深度和最佳穿刺路径.说明三维虚拟穿刺仿真技术可以为颈部神经阻滞术提供直观的形态学参考.
배경:경부신경조체마취역인기엄중마취의외여병발증,목전재건립경부신경삼유가시화모형병대경부신경절조체진행허의방진방면환처재림상탐색계단. 목적:심구삼유허의천자방진재경부신경조체중적응용방법. 방법:취건강지원자경부련속CT동맥조영/MRI척수조영단면도상,Mimics연건대골격、기육、동정맥、갑상선、후연골、척수등조직진행반자동분할화중건,의학계산궤보조설계모괴대신경등세소해부결구진행중건,삼유화현시경부신경급주위상관해부결구,병진행경부신경천자허의방진,포괄모의경천총조체,경심총조체화성상신경절조체. 결과여결론:성공모의경천총조체,경심총조체화성상신경절조체,현시허의천자침화골성결구、동정맥、기육、척수、경총심천지화성상신경절등해부결구적삼유비린관계,병측량천자진침적안전각도,심도화최가천자로경.설명삼유허의천자방진기술가이위경부신경조체술제공직관적형태학삼고.
BACKGROUND:Neck nerve block anesthesia could easily cause a serious anesthetic accidents and complications. Til now, we are in the clinical exploration stage in establishment of three-dimensional visual model of the cervical nerve and virtual simulation of cervical nerve block. @@@@OBJECTIVE:To explore the application of three-dimensional virtual punctuation simulation in cervical nerve block. @@@@METHODS:Continuous CT angiography and MRI myelography sectional images were selected from the cervical part of one healthy volunteer, half-auto cut and reconstruction were taken to skeleton, muscles, artery, veins, thyroid gland, laryngeal cartilages and spinal cord etc. with the Mimics software. Medical computer-aided design module was used to reconstruct the nerve and other smal anatomical structures. Three-dimensional model of cervical nerves and its surrounding relational local anatomic structure were successful y displayed and cervical nerves punctuation were virtual emulated, including simulation of superficial cervical plexus block, deep cervical plexus and stel ate block. @@@@RESULTS AND CONCLUSION:Superficial cervical plexus block, deep cervical plexus and stel ate block were successful y simulated, three-dimensions adjoin relation of the virtual pin with skeleton, carotid arteries, jugular veins, muscles, spinal cord, cervical plexus and stel ate ganglion were successful y displayed, and pin’s safe angle, depth or optimization path were measured. A three-dimensional virtual punctuation simulation can provide visualized morphologic data for cervical nerve block.