Morphological Study Of Uterine Round Ligament With Digital Technique

Objective: The three-dimensional model of the round ligament(RL)of the uterus was constructed by using the round ligament of the uterus of two-dimensional image data sets,combined with the three-dimensional reconstruction of digital technology,contrast with the living body to identify the form,describe its starting point,position,shape and ending point,point of description of its morphology.Not only provide a reference for clinical auxiliary diagnosis of clinical surgery in the treatment of gynecological diseases,but also for the female pelvic structure of three-dimensional reconstruction used in surgical navigation platform.Methods: Fifty patients,were recruited from November 2015~October 2016.All experienced laparoscopic extensive hysterectomy in the department of gynecology in the second hospital of Hebei medical university.Inclusion criteria: Without clinical symptoms,by gynecological examination,using International Continence Society(ICS)and Pelvic organ prolapse quantitive examination(POP-Q)standard except pelvic organ prolapse;Without Round ligament disease;Magnetic Resonance Imaging(MRI)examination before operation.Exclusion criteria: POP patients,Patient with lesion of round ligament,MRI Contraindication.Preoperative examination with Philips Achieve 3.0 MRI,adoption SENSE-XL-Torso coils,scan parameter to all adopt a TSE sequence,images were collected from three directions of oblique coronal,sagittal and oblique axial positions.The Digital Imaging and Communications in Medicine(DICOM)images obtained by MRI scanning are written in MATLAB R2016 a to read and convert images,enhance the image.The image is directly mapped into computer 3D reconstruction software Mimics17.0.The software organizes the image,divides the extracted image,and reconstructs the three-dimensional model of the uterine round ligament,uterus and pelvis with the mask.The initial top and bottom diameter of the round ligament was measured by vernier caliper after operation,The same method is used to measure anteroposterior diameter,the upper and lower diameters of the distance from the initial 1cm,the anteroposterior diameter of 1cm.Measurement of anteroposterior diameter of round ligament on MRI scan sequence,the anteroposterior diameter of 1cm.Using the same method to measure the 3D reconstruction of the diameter of theround ligament of the uterus.Comparison between the data of both sides of in vitro round ligament measurement,the data of both sides of the 3D reconstruction of the diameter of the round ligament to do likewise;Comparison between the data of in vitro round ligament measurement and MRI measurement of uterine round ligament,between the data of invitro round ligament measurement and 3D measurement of uterine round ligament.Results: There was no significant difference between the upper and lower diameters of the two sides of the round ligament of the uterus,the distance from the beginning and the lower part of the 1.0cm,and there was no statistical significance(n=50;P>0.05).There was significant difference between the two sides of the anteroposterior diameter of the round ligament(n=50;P<0.05),Although the statistics show that the anteroposterior diameter of the round ligament of initial size differences,and there are indeed some specimens on both sides of the round ligament of the appearance is not the same,but because the measuring sample size is small,need to increase the sample size measurements further confirmed.There was no significant difference in the two sides of the 3D model include the diameter of the upper and lower diameters,the anteroposterior diameter of the anterior and posterior diameters,the upper and lower diameters and the anteroposterior diameter of the 1.0cm(n=45;P>0.05).Comparison between three dimensional reconstruction of the uterine round ligament and in vitro specimens of uterine ligament diameter measurement line is different,there was statistical significance(n=45;P>0.05),Three dimensional reconstruction of the round ligament model failed to coincide with the live ligament.There was no significant difference between the anteroposterior diameter of the round ligament of MRI and the diameter of uterine ligament in vitro(n=50;P>0.05),The data of MRI scan is conform to the data of live round ligament measurement.Conclusion:1 The most critical of three dimensional model reconstruction is the image segmentation.Using the Matlab software,which makes the image display better,in the image processing is of great significance in the subsequent three-dimensional reconstruction.It is expected to change the parameters and conditions of MRI scanning,combined with the development of software program by computer personnel.2 Reconstruction of the 3D model of the round ligament of uterus based on MRI scanning data set,but the construction of three-dimensional model is rough,there are more details of defects,can further improve the conditions of sequence scanning,using image processing software for pretreatment,reducing the difficulty,shortening reconstruction time,improving the reconstruction effect of reconstruction.3 It has great significance and value in order to realize “Anatomy of Reality”.It is necessary to provide the platform foundation in order to realize the surgery navigation in the future.