脊柱颈胸段前路手术重要血管结构的螺旋CT三维重组和测量研究
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摘要
目的探讨螺旋CT增强扫描三维重组对脊柱颈胸段前路手术区域重要血管解剖结构的显示和测量。方法选取100例颈动脉CT血管造影病例行后重组处理,在后重组图像上设定有关重要血管解剖结构测量点,相关测量数据行统计学分析。结果各重要血管解剖结构测量数值男、女性不同,存在统计学差异。头臂干、左颈总动脉、左锁骨下动脉与主动脉弓夹角、右颈总动脉与右锁骨下动脉夹角则男、女性无统计学差异。结论螺旋CT增强扫描三维重组图像能够提供颈胸段脊柱前路手术重要血管解剖结构的三维影像学资料,术前进行重要血管结构的测量,能给临床提供可靠的测量数据,直观、立体的图像,对颈胸段前路手术方案的制定具有重要指导作用。
Objective To investigate the display and measurement of important vascular anatomical structures in the anterior spproach surgery area of cervicothoracic spine by spiral CT enhanced scan,which provided guidance for the surgical approach.Methods 100 cases of carotid artery CT angiography were selected for recombinant processing,and the measurement points ofimportant vascular anatomical structures were set on the post-recombinant images,and the relevant measurements were analyzedstatistically. Results Between male and female,there are statistical differences in the measurement velues of the important vascu-lar anatomical structures,and there are no statistical differences in the intersection angle of the arteriae anonyma,the left commoncarotid artery,the left subclavian artery and the aortic arch,the right common carotid artery and the right subclavian artery. Con-clusion Enhanced spiral CT scanning and three-dimensional restructureimages can provide three-dimensional image data of theimportant vascular anatomy structure in the anterior approach of cervicothoracic spine. Preoperative measurement of important vas-cular structure can provide reliable clinical data,intuitive and three-dimensional images,which has important guiding role in the formulation of anterior spproachsurgical procedures.
Objective To investigate the display and measurement of important vascular anatomical structures in the anterior spproach surgery area of cervicothoracic spine by spiral CT enhanced scan,which provided guidance for the surgical approach.Methods 100 cases of carotid artery CT angiography were selected for recombinant processing,and the measurement points ofimportant vascular anatomical structures were set on the post-recombinant images,and the relevant measurements were analyzedstatistically. Results Between male and female,there are statistical differences in the measurement velues of the important vascu-lar anatomical structures,and there are no statistical differences in the intersection angle of the arteriae anonyma,the left commoncarotid artery,the left subclavian artery and the aortic arch,the right common carotid artery and the right subclavian artery. Con-clusion Enhanced spiral CT scanning and three-dimensional restructureimages can provide three-dimensional image data of theimportant vascular anatomy structure in the anterior approach of cervicothoracic spine. Preoperative measurement of important vas-cular structure can provide reliable clinical data,intuitive and three-dimensional images,which has important guiding role in the formulation of anterior spproachsurgical procedures.
引文
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[2]黄义星,王胜,池永龙,等.胸骨柄开窗显露脊柱颈胸段的影像学及解剖学研究[J].中医正骨,2012,24(12):7-10.
[3]洪锦炯,赵刘军,蒋伟宇,等.颈胸段前路椎弓根螺钉固定技术的影像学研究[J].中国脊柱脊髓杂志,2015,25(2):137-142.
[4] Moquin RR. Operative techniques for fusion across the cervical-thoracic junction[J]. The Spine Journal,2006,6(6):308-316.
[5]黄义星,王胜,滕毓静.脊柱颈胸段前路内固定手术相关的影像学测量及其临床意义[J].中国骨伤,2013,26(6):497-501.
[6]王军.颈椎前路手术入路相关解剖学研究进展[J].中国当代医药,2012,19(19):14-17.
[7]王险峰.颈胸段脊柱前路入路手术的应用解剖[J].中国医药导报,2013,10(16):165-166.
[8] Huang YX,Jin LZ,Lowe JA,et al. Three-dimensional recon-struction of the superior mediastinum from Chinese Visible HumanFemale[J]. Surg Radiol Anat,2010,32(7):693-698.
[9]王清,谭美云,冯大雄,等.胸骨柄开窗前方显露上胸椎的解剖学及临床可行性观察[J].中国脊柱脊髓杂志,2007,17(3):165-168.
[10]池永龙主编.脊柱微创外科学[M].北京:人民军医出版社,2006. 296-307.
[11]黄义星,池永龙,何家维,等.上胸椎前方手术入路的CT影像学研究[J].中国骨伤,2009,22(9):685-687.
[12]杨新文,王勇,杨开明.颈胸段脊柱椎体前方重要结构的解剖特点及其临床意义[J].中国临床解剖学杂志,2009,27(1):32-34.
[13]王长春,王兴文,沙成,等.颈胸交界区前入路手术的解剖学研究及临床意义[J].中国现代神经疾病杂志,2009,9(2):120-123.