摘要
目的为侧颅底病变的影像诊断及手术入路提供解剖学基础。方法选取成人尸体头颈部20例和志愿者10名,沿眶耳线(OML)制成横断层标本和CT连续扫描图像,采用表面遮盖显示法(SSD)进行侧颅底三维重建。在颈动脉管水平段和咽隐窝层面上,观察侧颅底结构的关系,测量侧颅底内重要结构的径线及结构之间的距离。结果侧颅底的横断层影像可清晰显示颈动脉管水平段、茎突等侧颅底结构及其毗邻关系和咽旁间隙内的结构,在标本及影像上颈内动脉、颈内静脉、咽隐窝至茎突的距离分别为(9.56±1.37)mm和(9.80±1.54)mm、(4.05±0.85)mm和(4.24±0.90)mm、(31.48±2.45)mm和(32.02±2.66)mm。茎突是侧颅底影像诊断及手术入路时观察各结构间位置关系、咽旁间隙分区和寻找神经、血管等的骨性标志。两侧侧颅底结构呈对称性分布,重要结构的径线及结构之间的距离均无显著性差异。SSD三维重建可清晰显示侧颅底结构的立体形态、空间位置及其相互关系,并可进行距离的测量。结论侧颅底的横断层影像是显示咽旁间隙的最佳方式和SSD三维重建,对侧颅底病变的影像诊断和设计手术入路等具有重要意义。
Objective To provide anatomical basis forimaging diagnosis and surgical approach of the diseases of lateral cranial base.Methods 20 headneck specimens from adult corpse and 10 volunteers were selected,which were cut into the transverse sections or scanned in series by CT from the OML respectively. Three-dimensional images of the lateral cranial base were reconstructed by the SSD.At the horizontal part of carotid canal and pharyngeal recess level,relationship of the structures of lateral cranial base were observed, and measured in the diameter and distance among the important structures of lateral cranial base.Results The transverse sections and CT images could clearly display the horizontal part of carotid canal,styloid process of lateral cranial base and its adjacent structures,and the structures in parapharyngeal space of the lateral cranial base.The distance from the internal carotid artery,internal jugular vein,pharyngeal recess to the styloid process were（9.56±1.37）mm and（9.80±1.54）mm,（4.05±0.85）mm and（4.24±0.90）mm,（31.48±2.45）mm and （32.02±2.66）mm in the sections and imaging data separately.Styloid process was a bony mark for observing relationship among the structures,zoning the parapharyngeal space and searching the nerve and vessels during imaging diagnosis and surgical approach of the lateral cranial base.The structures of this area were symmetrical of both side,there were no significant differences in the diameter and distance among the important structures. Three-dimensional SSD reconstruction could clearly display the tridimensional shape,spatial location and relationship among the structures,and be used to measure the distance among the structures of lateral cranial base.Conclusions It is the valuable way to expose the parapharyngeal space under transverse sections,CT imaging data and three-dimensional SSD reconstruction of the lateral cranial base,which is significant on imaging diagnosis and surgical approach of the diseases of lateral cranial base.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2010年第4期401-404,共4页
Chinese Journal of Clinical Anatomy
基金
河南省教育厅科技攻关课题(2004923041)
关键词
侧颅底
断层解剖
影像解剖
三维重建
Lateral cranial base
Sectional anatomy
Imaging anatomy
Three-dimensional reconstruction
