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准确的大脑皮层损伤的脑沟定位对于改善医生之间的沟通,预测和预防术后损伤是非常有必要的。这一过程有赖于对皮质解剖和图像的系统分析有很好的了解,然而,在神经和神经外科训练中常被忽视[1-3]。涉及大脑运动中枢的肿瘤、缺血性疾病等精准诊疗,精确定位和测定大脑中央沟空间三维坐标方法学至关重要[3]。本研究以大脑AC-PC为扫描定位基线,将31名健康成年人大脑横断位、冠状位、矢状位MRI的Dicom3.0格式文件转化为JPG格式后导入Photoshop软件,利用该软件的图像旋转、坐标轴平移、坐标值读取等功能,建立以AC-PC中点为原点、以AC-PC为Y轴的大脑立体定位坐标系,实现大脑结构的准确三维立体定位,并制作大脑中央沟的定位图谱。现作报道。
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大脑前、后上下径普遍大于前后径,前、后联合在断面上呈长椭圆形,而非圆形。连合间径最大值均值23.651 3±1.675 53 mm,最大值25.330 mm,最小值21.976 mm,数值相对稳定(见表 1)。
结构 均值(x±s) 范围 前连合上下径 4.040 1±1.432 1 2.234 5~5.023 4 前连合前后径 2.661 2±0.703 1 2.126 2~4.367 4 后连合上下径 2.263 9±0.554 1 1.678 2~3.345 0 后连合前后径 1.798 9±0.452 0 1.467 1~2.234 1 连合间径 23.651 3±1.675 53 1.903 1~25.634 2 表 1 大脑前、后连合及连合间径的MRI测量(mm)
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中央沟横断层MR定位方格例图,每方格大小10 mm×10 mm,红色实线相当于坐标轴X(横轴),Y(纵轴),为Photoshop产生,其交叉点即相当于坐标原点(0, 0)。黄色虚线为识别后手工标记的中央沟。中央沟的各取样点的X,Y值可以由定位方格直观给出,也可以由软件精确给出。Z轴数值则由所在层面距离经连合间径层面确定。中央沟横断层定位例图显示中央沟在断层上的中心位置相对逐渐前移,愈向下愈接近坐标轴横轴,同时长度减小,经胼胝体干层面以上层面均位于横轴前侧,即取样点Y>0(见图 3)。
头颅MRI立体定位坐标系及中央沟定位图谱的构建
Study on MRI stereotactic coordinate system of head and localization map of central sulcus
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摘要:
目的探讨基于标准头颅MRI的立体定位方法,验证定位精度。 方法31例头颅连续MRI断层扫描数据,以Dicom 3.0格式导入eFlim 2.1工作站并以JPG格式导出,后者再导入Photoshop软件。分别通过图像大小校正、图像旋转、坐标轴平移等步骤使系统坐标原点与大脑原点重合、系统Y轴与大脑连合间线重合,建立标准坐标系。通过软件坐标直接读取功能获得断层上X、Y坐标值。Z值由所在层面距离双连合层面层数及层厚乘积决定。选取前连合后缘中点、后连合前缘中点的坐标值、两点距离等作为验证,在建立的立体定位坐标系中,计算连合间径长度并与eFilm软件直接测量结果对照。 结果31例头颅连续MRI断层扫描数据均实现准确三维立体定位,制定定位图谱。2种方法测得的连合间径长度一致。 结论基于标准头颅MRI的立体定位法可以应用于大脑中央沟三维立体定位的研究。 Abstract:ObjectiveTo study the stereotactic localization method based on standard head MRI, and verify the localization accuracy. MethodsThe continuous head MRI scan data with Dicom 3.0 format of 31 cases were imported into eFlim 2.1 workstation, exported as JPEG format, then imported into Photoshop.The standard coordinate system was established by image size correction, image rotation and coordinate axis translation to make the system coordinate origin coinciding with brain origin point, and system Y-axis coincide with the intersynaptic wiring of brain.The coordinate values(X, Y) of the fault were obtained through the coordinate direct reading function of software, and the Z value was determined by product of the number of layers and thickness beyween two connected layers.During establishing stereotactic coordinate system, the coordinate value of the midpoint of posterior margin of anterior commissure, midpoint of leading edge of the posterior commissure, and distance between two points were used to calculate the length of interstitial diameter, which was compared with eFilm software direct measuring. ResultsThe accurate three-dimensional stereotactic localization could be established using continuous MRI scan data in 31 cases, and the localization map was formulated.The interstitial diameter length detected by two methods was the same. ConclusionsThe stereotactic localization method based on standard MRI can be used in studying the rolandic fissure. -
表 1 大脑前、后连合及连合间径的MRI测量(mm)
结构 均值(x±s) 范围 前连合上下径 4.040 1±1.432 1 2.234 5~5.023 4 前连合前后径 2.661 2±0.703 1 2.126 2~4.367 4 后连合上下径 2.263 9±0.554 1 1.678 2~3.345 0 后连合前后径 1.798 9±0.452 0 1.467 1~2.234 1 连合间径 23.651 3±1.675 53 1.903 1~25.634 2 -
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