【作者】 高炜；

【导师】 李云生； 刘谨； 翟丽东；

【作者基本信息】 天津医科大学 ， 人体解剖与组织胚胎学， 2010， 硕士

【摘要】 目的利用MRI技术对6具成人尸体及不同年龄段活体正常成人的前列腺扫描,观察前列腺带区尸体及活体MRI表现,然后采用改良的火棉胶包埋技术把6具标本制成前列腺区薄层连续切片。本文通过应用盆腔器官薄型化断层切片及MRI技术得到的影像图片进行对照研究,分析前列腺各带区的解剖学特点。并对前列腺整体和中央区的径线、体积等指标的变化规律研究,以期为影像学诊断提供形态学指导,并探讨前列腺带区随年龄变化的影像学特点。材料与方法：1、尸体标本前列腺解剖带区的MRI研究：选择经10%福尔马林固定的盆部完好无损6具男性尸体行前列腺MRI水平位、冠状位及矢状位扫描,所有尸体标本均无前列腺相关疾病,以及其它泌尿系统疾病史。观察尸体标本前列腺MRI上T1WI及T2WI的信号特点及带区划分。2、尸体标本前列腺解剖带区的断层解剖学研究：选择经10%福尔马林固定的盆部完好6具男性尸体标本(同上),分别制成250-750微米水平位、冠状位及矢状位切片。3、正常成人活体前列腺MRI研究：对684例健康志愿者行前列腺MRI检查,所有志愿者均无前列腺相关疾病,以及其它泌尿系统疾病史。志愿者年龄为20岁-79岁,按年龄段分成5组,观察前列腺各带区的信号特点。4、前列腺各带区解剖断面与MRI对照：前列腺基本断面有三组,即矢状断面(正矢状断面)、横断面(高位水平、精阜水平和低位水平)、冠状断面(通过前列腺尿道远段尿道长轴与射精管所在的层面)。5、前列腺老龄化研究：健康志愿者行前列腺MRI检查及分组(同上)。测量前列腺整体和前列腺中央区各自径线(前后径、左右径及上下径)、体积数值,并计算出中央区体积占前列腺总体积的比例,建立正常前列腺各径线、体积参考值范围,并分析其随年龄增长的变化特点。结果：1、尸体标本前列腺带区的MRI表现尸体标本T1WI上整个前列腺呈略低信号；T2WI上不同带区的表现基本与活体相同,即前列腺外周带呈高信号表现,信号强度高于中央区,中央区呈低信号。2、尸体标本前列腺带区的断层解剖学观察尸体断层解剖切片可根据尿道、精阜、射精管识别外周带、中央带、移行带、尿道周围组织及前列腺肌肉基质区的大体位置,但其间未见明显界限。3、正常前列腺MRI的观察结果正常前列腺在T2WI上,前列腺外周带呈高信号表现,信号强度高于中央区,中央区呈低信号。在T1WI上,仅能显示前列腺的轮廓,各带区都表现为等或略低信号,无法进一步区分。4、前列腺各带区解剖断面与MRI对照：前列腺基本断面有三组,即矢状断面(正矢状断面)、横断面(高位水平、精阜水平和低位水平)、冠状断面(通过前列腺尿道远段尿道长轴与射精管所在的层面),观察各带区的详细解剖特点。5、正常前列腺MRI的观察结果及各自径线和体积测量及统计学结果前列腺整体体积范围约在(11.59～47.01cm3)之间,其上下径、前后径、左右径、体积随年龄增加而增大,其统计结果显示均具有统计学意义(P<0.05)。前列腺中央区体积约在(2.89～12.46cm3)之间,其上下径、前后径、左右径、体积随年龄增加而增长,中央区体积占前列腺总体积百分比约为(22%～36%),其随着年龄增大呈比例增加,统计结果均具有统计学意义(P<0.05)。结论(1)在火棉胶系列连续切片上能观察到前列腺各带区的空间分布和划分。(2)尸体与活体前列腺带区MRI信号表现基本一致。(3)选取前列腺连续薄层断面切片与相应的MRI图像进行对照研究,完成横断面、矢状断面及冠状断面解剖图像与MRI的对照观察研究。(4)通过对684例健康志愿者前列腺MRI扫描分析,前列腺整体的各个径线和体积随着年龄增长均呈增加趋势,并且前列腺中央区各个径线和体积随着年龄的增长均呈增加趋势,中央区所占百分比随着年龄的增加呈比例增长,对前列腺疾病的早期发现与诊断具有重要的临床价值。更多还原

【Abstract】 Objective:Using magnetic resonance imaging (MRI) to quantitatively research prostate in each age section of normal person and 6 specimens, analyze the MRI changes of indicators of the whole prostate in the corpses and people alive, and then the corpses made series plans by using collodion embedding method. We analyzed the anatomy characteristic of the pelvic cavity region in the collodion-embedded plans, and compared with the MRI of normal people. The changes of indicators of the central zone diameter line and volume were valued which could provide anatomy data for the imaging, we also explore the prostate imaging characteristics and evolution with ageing.Methods:1. The MRI study of the prostate in specimen:6 male corpses fixed by 10% formalin which without prostate related disease, were selected to make MRI scan in axial, oblique, sagittal section. We view the boundary of the prostate’s zone.2. The anatomy study of the prostate in specimens:6 male corpses fixed by 10% formalin were selected, and then divided into 3 groups random,250μm -270μm collodion-embedded plans were made in axial, oblique, sagittal section.3. The MRI study of the prostate in people:684 volunteers, who without prostate related disease, they aged from 20 to 79, and divided into 5 groups according to the age:MRI signal intensity and characteristic with aging of the prostate were observed.4. A comparative study between cross-sectional anatomy and MRI of prostate zone: there are three basic cross-section:sagittal section (central), axial section (superior level, level of verumontanum, low level), oblique section (through the section of long axis in urethra and ejaculatory duct), to observe detailed characteristic.5. MRI study on ageing prostate. The contents of observation and measurement included the prostate’s MRI signal intensity and characteristic with aging; To survey the diameter line of prostate and volume, Set up the reference range of the normal prostate diameter, the volume and to analyze its characteristics.Results:1、MRI changes of indicators of the whole prostate zone in the corpses Whole prostate of corpses show low signal in T1WI; Representation of different corpses prostate zone same as alive in T2WI. Periphery zone of prostate showed high signal, central zone show low signal.2、Indicators of the whole prostate zone in the corpses of plansRecognize periphery zone、central zone, transitional zone, paraurethral gland zone and fibrous muscle zone on the basis of slice, but their bounds are not obvious.3、MRI changes of indicators of the whole prostate zone alivePeriphery zone of alive prostate show high signal, and higher than central zone; central zone show low signal. Only show outline of prostate in T1WI, each zone shows eaque or low signal, and not to distinguish further.4、A comparative study between cross-sectional anatomy and MRI of prostate zone: there are three basic cross-section:sagittal section (central), axial section (superior level, level of verumontanum, lower level), oblique section (through the section of long axis in urethra and ejaculatory duct), to observe detailed characteristic.5、The results of diameter line and volume statisticsAbout the scope of the overall volume of the prostate is (11.59～47.01cm3), Its upper and lower tracks, before and after the trail, trail around the volume increases with age, There were significant difference in various age groups(P<0.05). volume of prostatic central zone is (2.89～12.46cm3). Its upper and lower tracks, before and after the trail, trail around the volume increases with age, volume percentage of the total volume of the prostate accounted for (22%～36%), Its proportion increase with age (P<0.05).Conclusion:(1)Boundary line of different zones can be divided in every section.(2)Prostate zone’s signal of MRI is same between corpses and alive.(3)A comparative study between cross-sectional anatomy and magnetic resonance imaging of prostate zone. (4) The diameter line、volume of prostate gland and volume of the whole prostate grows gradually following increase of age. The diameter line、volume of central zone and volume of central zone to prostate proportion grows gradually following increase of age.更多还原