摘要
目的研究先天性寰枕融合时椎动脉入颅方式的解剖学特征。方法通过三维可视化技术分析23例寰枕融合患者颅颈交界CT数据。患者经CT增强扫描后,CT数据传送至由Amira软件和UNIX操作系统构成的三维可视化工作站,于工作站虚拟环境下分析椎动脉走行的解剖学特点。结果23例患者的46支椎动脉中44支三维影像重建满意,其中43支的解剖学特点可以归纳为三种类型。Ⅰ型：经融合的枕骨髁与寰椎侧块之间的独立骨孔入颅;Ⅱ型：经融合或未融合的枕骨大孔后缘与寰椎后弓之间入颅;Ⅲ型：于融合后的枕骨大孔结构与枢椎关节间部之间入颅,同侧寰椎后半弓未发育或无明显残余后弓结构。另外1例特殊者,未经枢椎横突孔,于枢椎与C_3之间入椎管。结论寰枕融合时椎动脉多以几种有规律的方式入颅,入颅方式的不同与患者间骨性畸形的细节差别有一定关系,并且提示了寰枕融合胚胎期的病理变化过程差异。
Objective To study the intracranial entrance of the vertebral artery （VA） in patients with occipitalization of arias. Methods The courses of the VA in craniovertebral junction of 23 patients with oecipitalization of atlas were evaluated via three-dimensional visualizing techniques for CT data set. After enhanced CT scan, the DICOM files were transferred to the three-dimensional visualization workstation based on a set of Amira software under UNIX platform. Anatomical characteristics of VA and adjacent bony structures were studied in the virtual environment. Results Satisfied reconstructed images of VA were obtained in 44 out of 46 arteries in 23 patients. The entrance of the all VAs except one could be classified into three types. Type Ⅰ （44.2%） was characterized as an intracranial pathway via a stand-alone osseous foramen between the fused structure of lateral mass of atlas and condylus of occiput. Type Ⅱ （27.9%） characterized as an intracranial pathway between the fused or unfused structure of semiarch of atlas and foramen magnum. And type Ⅲ （27.9%） took an intracranial route between axis and the fused posterior edge of foramen magnum, where an obvious remnant semiarch of atlas can not be found. The one exception, other than the three regular types, ran into spinal canal between axis and C3, without passing through transverse foramen of the axis. Conclusion In patients with occipitalization of atlas, the VA takes several regular patterns of intracranial route. These patterns accompanied by some detailed variation of the bony malformation, which may suggest some embryologic discrepancy in the formation process of these diseases. The surgeons should familiar to these anatomic characteristics in order to avoid the compromise of the VA during the surgery.
出处
《中华神经外科杂志》
CSCD
北大核心
2007年第5期336-339,共4页
Chinese Journal of Neurosurgery
关键词
寰枕关节
计算机断层扫描
解剖学
三维重建
Atloido -occiptal joint
CT
Anatomy
Tridimensional reconstruction
