Three-dimensional reconstruction of the upper limb from anatomical slices of the Korean visible human: simulation and educational application.

PURPOSE: Digital anatomy is a novel emerging discipline. Use of virtual reality brings a revolution in educational anatomy by improving retention and learning outcomes. Indeed, virtual dissection is a new learning tool for students and surgeons. Three-dimensional vectorial models of the human body can be created from anatomical slices obtained by lengthy series of cryosection from the visible human projects. The aim of this paper is to show how these mesh models could be embedded into an Acrobat® 3dpdf interface, to produce an easy-to-use fully interactive educational tool. METHODS: The learning of this method and its practical application were evaluated on a multicentric cohort of 86 people divided into 3 groups, according to the duration of their training (1, 2 or 3 days, respectively). Participants learned how to use the Mesh tool and how to model 3D structures from anatomical sections. At the end of the training, they were given a survey form. Participants were also asked to rate the training (Poor; Average; Good; Very Good; Excellent). RESULTS: Ninety four percent of the subjects rated the device as excellent and would continue to use digital anatomy in their practice. CONCLUSION: This result is the Diva3d® virtual dissection table, a powerful educational tool for anatomists and students. It could also be the basis of future simulation tools for hand surgeons training.

The transverse facial artery and the mandibular condylar process: An anatomic and radiologic study.

INTRODUCTION: In surgical approaches to condylar fractures, there is a risk of damage to the transverse facial artery (TFA) which may in turn account for impaired blood supply to the temporomandibular joint (TMJ). In order to investigate the risk of damage to the TFA, and prevent lesions to this artery resulting from TMJ surgical procedures, we studied the distance between the TFA and the head of the condylar process. METHODOLOGY: A dissection study was conducted on 10 fresh cadavers (20 condylar specimens dissected), involving fifty CT scans of the face with intravenous contrast. Vertical distance from the TFA to the top of the mandibular condyle head and distance from the TFA to the lateral aspect of the mandibular condyle were measured. RESULTS: The lateral aspect of the mandibular condyle is vascularized by branches emanating from the superficial temporal artery (STA) and the TFA. The TFA was located 1.84 ± 0.6 cm below the condylar process of the mandible and ran 1.09 ± 0.54 mm lateral to the head of the mandibular condyle. DISCUSSION: In order to spare the TFA in fractures involving the condylar neck, surgical approaches to the condyle should preserve the uppermost 2 cm of the lateral surface of the condyle during dissection. Due to the necessity for periosteal elevation of the lateral surface of the condyle in condylar head fractures, it is possible to spare the TFA, running lateral to the condylar neck, and the medial condylar surface in order to leave the branches that derive from the maxillary artery (MA) intact.

[3D modeling of the female pelvis by Computer-Assisted Anatomical Dissection: Applications and perspectives]. / Modélisation anatomique 3D du pelvis féminin par dissection anatomique assistée par ordinateur : applications et perspectives.

OBJECTIVES: To achieve a 3D vectorial model of a female pelvis by Computer-Assisted Anatomical Dissection and to assess educationnal and surgical applications. MATERIALS AND METHOD: From the database of "visible female" of Visible Human Project(®) (VHP) of the "national library of medicine" NLM (United States), we used 739 transverse anatomical slices of 0.33mm thickness going from L4 to the trochanters. The manual segmentation of each anatomical structures was done with Winsurf(®) software version 4.3. Each anatomical element was built as a separate vectorial object. The whole colored-rendered vectorial model with realistic textures was exported in 3Dpdf format to allow a real time interactive manipulation with Acrobat(®) pro version 11 software. RESULTS: Each element can be handled separately at any transparency, which allows an anatomical learning by systems: skeleton, pelvic organs, urogenital system, arterial and venous vascularization. This 3D anatomical model can be used as data bank to teach of the fundamental anatomy. CONCLUSION: This 3D vectorial model, realistic and interactive constitutes an efficient educational tool for the teaching of the anatomy of the pelvis. 3D printing of the pelvis is possible with the new printers.

Effect of compression stockings on cutaneous microcirculation: Evaluation based on measurements of the skin thermal conductivity.

OBJECTIVE: To study of the microcirculatory effects of elastic compression stockings. MATERIALS AND METHODS: In phlebology, laser Doppler techniques (flux or imaging) are widely used to investigate cutaneous microcirculation. It is a method used to explore microcirculation by detecting blood flow in skin capillaries. Flux and imaging instruments evaluate, non-invasively in real-time, the perfusion of cutaneous micro vessels. Such tools, well known by the vascular community, are not really suitable to our protocol which requires evaluation through the elastic compression stockings fabric. Therefore, we involve another instrument, called the Hematron (developed by Insa-Lyon, Biomedical Sensor Group, Nanotechnologies Institute of Lyon), to investigate the relationship between skin microcirculatory activities and external compression provided by elastic compression stockings. The Hematron measurement principle is based on the monitoring of the skin's thermal conductivity. This clinical study examined a group of 30 female subjects, aged 42 years ±2 years, who suffer from minor symptoms of chronic venous disease, classified as C0s, and C1s (CEAP). RESULTS: The resulting figures show, subsequent to the pressure exerted by elastic compression stockings, an improvement of microcirculatory activities observed in 83% of the subjects, and a decreased effect was detected in the remaining 17%. Among the total population, the global average increase of the skin's microcirculatory activities is evaluated at 7.63% ± 1.80% (p < 0.0001). CONCLUSION: The results from this study show that the pressure effects of elastic compression stockings has a direct influence on the skin's microcirculation within this female sample group having minor chronic venous insufficiency signs. Further investigations are required for a deeper understanding of the elastic compression stockings effects on the microcirculatory activity in venous diseases at other stages of pathology.

Three-dimensional reconstruction of the lower limb's venous system in human fetuses using the computer-assisted anatomical dissection (CAAD) technique.

OBJECTIVE: The aim of the present study was to show the feasibility and describe the first results of a 3D reconstruction of the venous network of the lower limbs in human fetus using the computer-assisted anatomical dissection (CAAD) technique. MATERIALS AND METHODS: We used limbs from two human fetuses, respectively, 14 and 15 weeks gestation old. Specimens were fixed in 10% formalin, embedded in paraffin wax and serially sectioned at 10 m. The histological slices were stained using HES and Masson Trichrome for soft tissues identification. Immunolabeling techniques using the Protein S-100 marker and the D2-40 marker were used to identify nerves and vessels, respectively. Stained slices were aligned manually, labeled and digitalized. The segmentation of all anatomical structures was achieved using the WinSurf(®) software after manual drawing. RESULTS: A 3D interactive vectorial model of the whole leg, including skin, bone, muscles, arteries, veins, and nerves was obtained. In all limbs, we observed the presence of a big axial vein traveling along the sciatic nerve. In addition, the femoral vein appeared as a small plexus. Although this is a common anatomical feature at the end of organogenesis, this feature is observed in only 9% of adults. Usually interpreted as an "anatomical variation of the femoral vein" it should be considered as a light truncular malformation. These observations bring further support to our proposed "angio-guiding nerves" hypothesis. CONCLUSION: This preliminary study shows that the CAAD technique provided an accurate 3D reconstruction of the fetal leg veins anatomy. It should bring a new insight for the understanding of the different steps of development of the human venous system.

Anatomy of the Hunter's canal and its role in the venous outlet syndrome of the lower limb.

BACKGROUND: The "Adductor canal syndrome" has been described as an unusual cause of acute arterial occlusion inside the Hunter's canal in young sportsmen. It may also produce a compressive neuropathy of the saphenous nerve. To our knowledge, femoral vein compression in the canal has never been reported. OBJECTIVE: To describe the anatomy, to propose a physiology of this canal, and to show that the femoral vein is much more exposed than the artery to compression inside this adductor hiatus, particularly at the outlet. MATERIAL AND METHODS: The whole adductor canal was exposed in 100 limbs for anatomical study following latex injection. A series of 200 phlebographies and 100 CT venograms were also analyzed. RESULTS: Anatomically, we found a musculotendinous band called the "vastoadductor membrane," which jointed the adductor tendon to the vastus medialis in all the cases. The femoral vein, located more posteriorly, was frequently narrowed at this level. This band can create a notch with a venous stenosis at the outlet of the Hunter's canal, usually located 12-14 cm above the femoral condyle. Two femoral valves constitute the landmark of the canal on the venograms: the lower is just below the outlet, 9 cm above the condyle. The second valve is 3 cm higher inside the canal.Functionally, the cadaveric simulations showed that the contraction of the adductor longus closes the hiatus, while the adductor magnus opens it. Our hypothesis is that Hunter's canal prevents femoropopliteal axis reflux by synchronizing with calf pump ejection during ambulation. CONCLUSION: Compression of the femoral vein inside the adductor's canal is an underestimated and misdiagnosed cause of postural stenosis of the femoral vein. Ultrasound investigation of both limbs in patients with chronic venous disease (CVD) should be systematically carried out at this precise level in order to prevent future occlusion and onset of acute deep vein thrombosis.

Relationship between medical compression and intramuscular pressure as an explanation of a compression paradox.

BACKGROUND: Using standing magnetic resonance imaging (MRI), we recently showed that medical compression, providing an interface pressure (IP) of 22 mmHg, significantly compressed the deep veins of the leg but not, paradoxically, superficial varicose veins. OBJECTIVE: To provide an explanation for this compression paradox by studying the correlation between the IP exerted by medical compression and intramuscular pressure (IMP). MATERIAL AND METHODS: In 10 legs of five healthy subjects, we studied the effects of different IPs on the IMP of the medial gastrocnemius muscle. The IP produced by a cuff manometer was verified by a Picopress® device. The IMP was measured with a 21G needle connected to a manometer. Pressure data were recorded in the prone and standing positions with cuff manometer pressures from 0 to 50 mmHg. RESULTS: In the prone position, an IP of less than 20 did not significantly change the IMP. On the contrary, a perfect linear correlation with the IMP (r = 0.99) was observed with an IP from 20 to 50 mmHg. We found the same correlation in the standing position. CONCLUSION: We found that an IP of 22 mmHg produced a significant IMP increase from 32 to 54 mmHg, in the standing position. At the same time, the subcutaneous pressure is only provided by the compression device, on healthy subjects. In other words, the subcutaneous pressure plus the IP is only a little higher than 22 mmHg-a pressure which is too low to reduce the caliber of the superficial veins. This is in accordance with our standing MRI 3D anatomical study which showed that, paradoxically, when applying low pressures (IP), the deep veins are compressed while the superficial veins are not.

[Computerized three-dimensional reconstruction of the retrohepatic segment of inferior vena cava of a 20 mm human embryo]. / Reconstruction tridimensionnelle informatisée du segment rétrohépatique de la veine cave inférieure d'un embryon humain de 20mm.

The subdiaphragmatic venous drainage of the embryo is provided by the two caudal cardinal veins to which is added the subcardinal vein system, draining the mesonephros, the perispinal supracardinal veins and the umbilical and vitelline venous system. The anastomosis of certain segments of the embryonic venous structures and the disappearance of others are at the origin of the inferior vena cava. Since the 19th century, three-dimensional reconstruction of solid models from histological sections were developed. At present, the development of computerized three-dimensional reconstruction techniques allowed to operate a multitude of techniques of image processing and modeling in space. Three-dimensional reconstruction is a tool for teaching and research very useful in embryological studies because of the obvious difficulty of dissection and the necessity of introducing time as the fourth dimension in the study of organogenesis. This method represents a promising alternative compared to previous three-dimensional reconstruction techniques including Born technique. The aim of our work was to create a three-dimensional computer reconstruction of the retrohepatic segment of the inferior vena cava of a 20mm embryo from the embryo collection of Saints-Pères institute of anatomy (Paris Descartes university, Paris, France) to specify the path relative to the liver and initiate a series of computerized three-dimensional reconstruction that will follow the evolution of this segment of the inferior vena cava and this in a pedagogical and morphological research introducing the time as the fourth dimension.

Venous symptoms in C0 and C1 patients: UIP consensus document.

This UIP document provides an update on venous symptoms in CO and C1 patients. The correlation between venous symptoms and the presence of telangiectases and/or reticular veins is one of the most controversial topics in chronic venous disorders. As symptoms may be non-specific of chronic venous disease, it is important to differentiate venous symptoms from symptoms of other causes. Some data from the Bonn Vein Study suggest that the risk to develop venous symptoms is increased in women, advanced age and obesity. Treatment is based on physical advice, elastic compression, venoactive drugs, sclerotherapy, correction of foot static disorders and reduction of body weight. Future research should be promoted on venous symptoms in epidemiological and follow-up studies, about the relationship between female hormone levels and symptomatic telangiectasias, and between venous pain and foot static disorders in C0s C1s patients.

Three-dimensional modelling of the venous system by direct multislice helical computed tomography venography: technique, indications and results.

The aim of multislice helical computed tomography venography (CTV) is to provide a precise, global and three-dimensional (3D) anatomical depiction of the venous network of the lower limbs. A multislice and multidetector spiral CT acquisition of the lower limbs with contrast injection of the dorsal foot produces about 1000 slices in 30 seconds. Dedicated volume-rendering software can compute a realistic and interactive 3D model of the venous system in realtime. This new tool furnishes an accurate 3D representation of the whole venous system of the lower limb with a realistic 3D model of the limbs, providing a road map of the varicose networks complementary to the duplex ultrasound (DUS). CTV allows a complete morphological study of the deep veins, including the detection of anatomical variations and proximal venous obstruction, not easily detectable by DUS. In the case of deep vein thrombosis, it has been shown to be a good diagnostic tool, well correlated with sonography. It also demonstrates, in some cases, haemodynamic patterns which are not available by DUS, particularly for perforator veins and congenital vascular malformations. The use of virtual reality techniques enables a complete anatomical study of both deep and superficial veins including a virtual dissection of the limbs. CTV is also a great educational tool to learn anatomy of the venous system and a powerful research tool to improve our knowledge of venous anatomy.

Anatomy of the foot venous pump: physiology and influence on chronic venous disease.

The aim of this paper is to demonstrate the location of the venous foot pump using an anatomical study. Four hundred cadaveric feet were injected with green neoprene latex followed by a dissection. A coloured segmentation of the venous system was achieved. The Lejars' concept of the venous sole of the foot is incorrect: the true blood venous reservoir of the foot is located deeply in the plantar veins, between the plantar muscles. The medial and mostly lateral plantar veins converge into the plexus shaped calcaneal crossroad, where the blood is ejected upwards into the two posterior tibial veins. In addition, the several medial perforators of the foot directly connect the deep system (medial plantar veins) to the superficial venous system (medial marginal vein). This forms a true 'medial functional unit' which is unique in the limb given its directional flow is from deep to superficial. In conclusion, the plantar veins play an important role in the physiology of the venous return since a venous reservoir of 25 mL of blood is mobilized upwards with each step during walking. Therefore, the impairment of the foot pump by a static foot disorder should be considered as an important risk factor for chronic venous disease, and should be evaluated and corrected in any patient with venous insufficiency.

Static foot disorders: a major risk factor for chronic venous disease?

OBJECTIVE: To study the relationship between the static foot disorders (SFDs) and chronic venous disease (CVD). MATERIAL AND METHODS: A retrospective study of 824 feet in unselected 412 patients seen by one phlebologist using a standardized record form. A complete clinical, aetiological, anatomical and pathological elements (CEAP) classification was determined. Alleged venous symptoms were recorded using a 10-point visual analogue scale and scored using a customized questionnaire. A standardized measurement of the Djian-Annonier angle was used to quantify and identify the presence of any static disorder of the foot. RESULTS: There were 156 men (37.8%) and 256 women (62.2%) who were included in this study. A majority of patients (59.3%) had a CEAP classification of C3 or greater. Static disorders of the feet were found to be very common in the study population: 137 feet were hollow feet (16.6%) and 120 flat feet (14.5%). Thus, 31% of all of the feet had some form of SFD. A significant correlation was found between the incidence of SFD and body mass index (P < 0.01), the presence of symptoms (P<0.001) and prolonged standing during the day (>5 hours, P < 0.05). The severity of the CVD, represented by the CEAP clinical classes, was also found to be very significantly related to the SFD (P < 0.001). This correlation was found to be independent of age. CONCLUSION: Static disorders of the foot can be considered as an important risk factor that negatively affects CVD. In daily practice, it is often underestimated. This emphasizes the crucial importance of the detection of SFD during the clinical exam of all CVD patients. Correction of static disorders of the feet will improve symptoms due to the SFD, as well as those related to venous stasis. These results can easily be explained by improvement of foot pump efficacy during walking.

Lymphatic and blood microvasculature organisation in pulmonary sarcoid granulomas.

Pulmonary sarcoid granulomas are characterised by their elective distribution along collecting lymphatics. However, relationships between granulomas and intralobular lymphatics or blood microvascularisation have not been investigated. Therefore, we undertook a specific analysis of blood capillaries and lymphatics supplying sarcoid granulomas to identify additional clues to understanding the pathophysiogenesis of these lesions. Six pulmonary samples were immunolabelled with D2-40, anti-CD34 and anti-CD31 antibodies, paying particular attention to the relationships between lymphatics and granulomas, and the pattern of blood microvessels supplying sarcoid lesions. A morphometric study of granulomas included their distance to lymphatics and a three-dimensional reconstruction of a granuloma in its lymphatic context. Intralobular granulomas were closely associated with lymphatics; apart from a few granulomas, blood capillaries stopped at the outer border of the fibrous ring surrounding granulomas, and perigranuloma capillaries were particularly scarce. Our observations of the lymphatic and blood microvascular environment of intralobular pulmonary sarcoid granulomas provide evidence for the critical role of lymphatics in the emergence of these lesions. Moreover, pulmonary sarcoid lesions could be considered avascular structures, thereby providing new insights into the understanding of the granuloma physiology and the distribution of blood-borne therapeutic agents.

3D multislice CT to demonstrate the effects of compression therapy.

The aim of this paper was to show the value of the 3D modelling of the leg by multislice computed tomography (MSCT) in demonstrating the effects of compression therapy on both the superficial veins and on the limb's volume. The spiral CT with 3D reconstruction of the lower limbs (with or without injection of contrast) is an accurate method to assess the 3D shape of the leg and the diameter of the superficial/deep veins. It is possible to obtain a realistic 3D model of the leg and its anatomical structures. This makes the evaluation of the interface pressure and effects due to the compression stocking possible. The real interface pressure in vivo between the skin and compression material is verified during the CT and recorded by a probe. It is measured by using the Kikuhime device at the B1 and B points of the calf. Technical limits: are exposure to X rays, a venous injection is usually not advisable, and this exam is strictly limited to the lying position. To assess the limb's volume by MSCT, we use metallic landmarks and dedicated modeling software. According to the Laplace's law, the variations of the shape of the leg i.e. cross sections at different levels, give a radius for each location, and so different interface pressures all around the limb, can be measured. The results of these theoretical values of the interface pressure are close to the real values measured at the same location by a probe: the compression of the saphenous veins in the lying position is observed below the knee providing the pressure at the ankle (B point) is at least 25 mmHg. It is not possible to make a compression of the veins at the thigh level without a pad. Regarding the assessment of the limb's volume, it it possible to localize a limb's edema and to quantify it with a precision of less than 1%. The multislice CT is a great research tool to provide a 3D model of the limb, making the assessment of the interface pressure of stockings and the evaluation of the effects on the superficial veins possible, but its main possible limitations are the lying position, and the use of X-rays. It is also possible to make an accurate measurement of the limb's volume, and to assess the specific location of edema int he soft tissues (fat, sub-cutaneous, muscle).

[An enlarged dismantable anatomical model of the ear by Auzoux: observation and photographical tridimensional reconstruction]. / Un modèle d'oreille agrandie, démontable par Auzoux : observation et reconstruction photographique tridimensionnelle.

The aim of the study was to determine the accuracy of a 19th century anatomical model of an ear by Auzoux (a French manufacturer). It measured 63 cm in length; 43 cm in width; 37 cm in height. The disassembled parts were studied on the morphological aspect in its whole and after removing of its components: external ear (43 cm x 23 cm x 15 cm), tympanic drum and middle ear ossicles; cochleo-vestibular apparatus. The main dimensions of each part were recorded. The arterial vascularisation of the three components of the ear and its sensitive and sensorial nervous system were established on the model which represented the external carotid artery with its terminal bifurcation, several collateral branches specially the posterior auricular artery and the middle meningeal artery; the internal carotid artery at the two extremities of the carotid canal. The cochleo-vestibular and facial nerve as well as other elements of small calibre were exactly figured and labelled by a number. The middle ear components were disassembled. The ossicles of the middle ear and a dried peritoneal tympanic membrane were dismountable as a whole. Only a few minor modification from the admitted data of anatomy as well as the cutaneous muscles of the external ear were observed on this sample, the anatomical aspects of which were very precisely represented. The material was typical of the Auzoux manner: a special papier-mâché whose conception and realization remains unequalled. This kind of very rare model can be dated at the earliest 1835 (Lemire, 1990).

Compression bandages: influence of techniques of use on their clinical efficiency and tolerance.

AIM: A bandage is characterized by its components and by its properties evaluated in vitro: stretch theoretical pressures calculated with a dynamometer. A bandage is also characterized by properties evaluated in vivo: interface pressures at rest and during contraction. The aims of this study were to evaluate interface pressures and stiffness of medium stretch bandages and to vary the techniques of bandage in order to obtain a bandage with the lowest possible resting pressure and the highest possible working pressure. METHODS: The interface pressures of Biflex 16 bandages of 7 mx8 cm and of Biflex 17 of 5 mx8 cm were measured with the Kikuhime device. Five techniques to make a bandage were used: two with an overlap of 50% and 75% respectively and a stretch of 30%, two with a superimposition of 2 bandages used in the same conditions as above, and one in spica (in turns of 8-technique). RESULTS: The achieved pressures are related to the technique of making a bandage and the number of layers at the measurement points. The best result is obtained with the Biflex 16 with an use in spica without stretch: the resting pressure is low and the working pressure is high. The stiffness index and the low resting pressure are sufficient to give a good clinical efficacy. CONCLUSION: This technique of use should be appropriate for the treatment of trophic disorders with a satisfactory effect of auto-massage and a maximum of safety even in a patient confined to bed or with a decreased ankle-brachial index (between 0.6 and 0.9).

Foam sclerotherapy combined with surgical treatment for recurrent varicose veins: short term results.

OBJECTIVE: To study the short term results of combined peroperative foam sclerotherapy (PFS) and surgical treatment for recurrent varicose veins. METHODS: PFS was used to treat 129 limbs with recurrent varices: 100 great saphenous (GSV), 29 small saphenous veins (SSV). Foam was prepared with 1% polidocanol mixed with 4 times its volume of air. The 100 GSVs comprised 28 trunks directly connected with the femoral vein, 28 connected to a lymph node venous network, 11 associated with perforators and 33 isolated trunks. The 29 SSVs comprised 4 trunks directly connected to the popliteal vein, 7 isolated trunks, 15 popliteal perforators and 3 recanalisations after SSV stripping. All operations included phlebectomies. In twenty limbs re-ligation of the SFJ and 4 SPJs was carried out. All were performed under local anaesthesia in an ambulatory setting. Patients were assessed clinically and by colour duplex ultrasound after 3 and 40 days follow-up. RESULTS: 120 patients (93%) showed complete obliteration of saphenous trunks, junctions and varices. The 9 incomplete obliterations were 3 venous recanalisations in the SSV compartment and 6 perforators (4 popliteal and 2 femoral). Two asymptomatic deep venous thromboses were detected by colour duplex 3 days after operation. CONCLUSION: PFS facilitates surgical treatment of recurrent varicose veins. There is a small risk of post-operative deep vein thrombosis.

Embryology and three-dimensional anatomy of the superficial venous system of the lower limbs.

OBJECTIVES: The purpose of this study is to better understand the anatomy of the venous network of the lower limbs by using new imaging techniques, particularly the three-dimensional modelling by computerized tomographic (CT) venography. This new tool is combined with anatomical dissection techniques and the results of Duplex ultrasound imaging. METHODS: The embryogenesis of the venous network, which explains the main variations of the venous system, and a description using the new terminology of the veins. RESULTS: Physiologically, the muscular veins play a crucial role, owing to the effect of the muscular pumps by their aspiration power on the superficial system via the perforators. They always act at the same level. This explains the fixity of the main perforator veins and the interest of their anatomical knowledge. CONCLUSION: The new imaging techniques and treatments dedicated to the venous system of the lower limbs make their descriptive anatomy increasingly useful. It will be the basis of a common language between radiologists, phlebologists and surgeons.

[3D modeling in the field of morphology: methods, interest and results]. / La modelisation tridimensionnelle en morphologie: méthodes, intérêt et résultats.

The aim of this paper is to show the major role played by the new computerized imaging tools available today in the fields of morphology and anatomy. For anatomical studies or educational purpose, they enhance the classical techniques. The 3D reconstruction, already used in daily clinical practice, will be the basis for computation of validated volumetric protocols enhancing our diagnosis and prognosis means. It is also a fantastic educational tool: the interactivity makes it simple, efficient, attractive and easily accessible and diffusable. For the research, mathematical modeling of embryogenesis and morphogenesis using finite elements method will open new ways for biomecanics and a dynamic quantification approach.