Abstract
The exact inner 3D microstructure of the human peripheral nerve has been a mystery for decades. Therefore, it has been difficult to solve several problems regarding peripheral nerve injury and repair. We used high-resolution X-ray computed microtomography (microCT) to scan a freeze-dried human acellular nerve allograft (hANA). The microCT images were then used to reconstruct a 3D digital model, which was used to print a 3D resin model of the nerve graft. The 3D digital model of the hANA allowed visualization of all planes. The magnified 3D resin model clearly showed the nerve bundles and basement membrane tubes of the hANA. Scanning electron microscopy (SEM) was used to analyse the microstructure of the hANA. Compared to the SEM images, the microCT image clearly demonstrated the microstructure of the hANA cross section at a resolution of up to 1.2 μm. The 3D digital model of the hANA facilitates a clear and easy understanding of peripheral nerve microstructure. Furthermore, the enlarged 3D resin model duplicates the unique inner structure of each individual hANA. This is a crucial step towards achieving 3D printing of a hANA or nerve that can be used as a nerve graft.
Highlights
It is well acknowledged that the peripheral nerve autograft is the gold standard for reconstruction of peripheral nerve gaps
Much progress has been made in the application of confocal optical microscopy and serial block face scanning electron microscopy to visualize the 3D structures of soft tissues[11,12]
Because the freeze-dried human acellular nerve allograft (hANA) was solid, it did not shrink in the cylinder as most soft tissue would
Summary
It is well acknowledged that the peripheral nerve autograft is the gold standard for reconstruction of peripheral nerve gaps. The human acellular nerve allograft is a safe and effective nerve scaffold because it maintains most of the natural structure and micro-bioenvironment of the human peripheral nerve, with no immunogenicity[8] It is associated with many drawbacks, such as limited sources and applicable lengths. We believe that microCT imaging followed by 3D reconstruction and printing of the hANA will allow accurate recreation of the cross sectional area of the human acellular nerve allograft (hANA) along its entire length. This analysis will display improved accuracy and greater detail than SEM. The characteristics of the transverse section of the freeze-dried hANA were analysed by SEM
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