大脑沟、回在轴位断层影像上的定位
|
摘要
为给脑功能的影像学研究提供断层解剖学依据及精确定位大脑内微小占位性病变，采用30例国人成年男性头部标本，以AC-PC线为基线，用Phillips超导全身MRI系统扫描,获得4㎜层厚的颅脑连续横断层MRI图像。将扫描后的标本,开颅取脑,正中矢状切后,在大脑半球内侧面上首先确定AC-PC线,然后将重要脑回以不同颜色着色,用甲醛及明胶固定后以自制脑切片仪切制成与MRI扫描一致的脑连续横断层标本,与相应MR图像对照观察, 对每个断面上出现的结构运用大体解剖及断层解剖知识,分析描述并对有关沟、回的出现情况进行统计。
1．(1)在胼胝体出现之前的断面中,“丁”形沟的出现率左半球为73%,右半球为60%,可以以此为标志寻找中央沟。（2）未出现“丁”形沟和外侧沟尚未呈“L”形的断面上，中央前沟、中央沟、中央后沟形成三条平行沟，并且中央前回厚于中央后回或中央后回末端髓突分叉或呈底向外的三角形的特点较明显，左右半球中分别占93%和92%,可以作为辨认中央沟的标志。(3) 外侧沟呈“L”形的断面上，左半球85%、右半球93%的中央后回或中央沟对应于岛叶最后端的岛短回，可以利用此特点寻找中央沟。
2．尾状核体首次出现断面上，外侧沟后升支的出现率，左半球为17﹪，右半球为40﹪；尾状核头及内囊首次出现断面上，外侧沟后升支的出现率左右半球为100﹪，背侧丘脑的出现率约为
10﹪左右；外侧沟后升支首次出现断面上，尾状核头的出现率左右半球分别为87﹪和60﹪，背侧丘脑的出现率左右为13﹪和3﹪，尾状核体只存在于1－2个断面上，因此在尾状核体出现到尾状核头及内囊出现而背侧丘脑尚未出现的2－3个断面上，应重点寻找首次出现的外侧沟后升支。
3．（1）顶枕沟首次出现断面上钩形枕叶的出现率左右半球分别为77﹪和80﹪，胼胝体干的出现率左右分别为70﹪和63﹪，多数标本上基底核尚未出现；在胼胝体干首次出现断面顶枕沟的出现率为90﹪；在尾状核体首次出现断面上顶枕沟的出现率为90﹪；在尾状核头首次出现断面上顶枕沟的出现率为100﹪，说明顶枕沟的出现早于尾状核体和头的出现，一般提前1－2个尾状核体出现的断面，因此钩形枕叶及胼胝体干出现而尾状核体尚未出现的1－2个断面上应重点寻找首次出现的顶枕沟。（2）海马首次出现断面及其上一个断面中，顶枕沟的消失率左右半球分别为90%和80%，故海马的出现，可作为顶枕沟消失的标志。（3）顶枕沟形态呈“Y”形或“V”形(沟里有沟,回里有回)的左半球占66%,右半球占78%,其余为呈“一”形弯曲的深沟。
To provide the section anatomic data for imaging study of brain functions and MRI localization of cerebral local lesions, 30 cadaver heads were used. The heads were scanned by 4.0 mm thickness using Philips 1.5 Tesla MR scanner and taking out the brain from the scanned head, the important cerebral gyri were painted by different colors. The preparation of the brain slice in correspondence with MR scan took the perpendicular to midpoint line of AC-PC as base line. The brain slice was correspondent to the MR imaging by 4.0 mm thickness. The localization of cerebral sulci and gyri on the cross sections were studied by the comparison of the MR images with serial cross sections of the brains.
1. (1)On the sections in front of corpus callousm, the appearing rate of 丁-shaped sulci was 73% on the left side and 60% on the right side. It could be useful to identify the central sulcus. (2)On the sections before the -shaped sulci and L-shaped lateral sulci appeared, three parallel sulci were constructed the precentral sulcus, the central sulcus and the postcentral sulcus, and the precentral gyrus was thicker than postcentral gyrus, or the characters of the medullary branch of postcentral gyrus were obvious. It could be useful to identify the central sulcus. (3)On the section appearing insular lobe with L-shaped lateral sulcus, the postcentral gyrus or central sulcus was corresponded the short gyri of insula. The appearing rate was 85% on the left side and 93% on the right side.
2. On the section appearing body of caudate nucleus for the first time, the appearing rate of the posterior ascending rami of lateral sulcus was 17% on the left side and 40% on the right side. On the section appearing head of caudate nucleus and internal capsule for the
first time, the appearing rate of the posterior ascending rami of lateral sulcus was 100% and the rate of the dorsal thalamus was 10%. On the section appearing posterior ascending ramus of lateral sulcus for the first time, the appearing rate of the head of caudate nucleus was 87% on the left side and 60% on the right side, and the appearing rate of the dorsal thalamus was 13% on the left side and 3% on the right side. The body of caudate nucleus only appeared on the 1 or 2 sections. It means that the posterior ascending ramus of lateral sulcus appearing for the first time could be identified on the 2-3 sections from with body of caudate nucleus to with head of caudate nucleus and internal capsule without dorsal thalamus.
3. (1)On the section appearing parietooccipital sulcus for the first time, the appearing rate of the hook-shaped occipital lobe was 77% on the left side and 80% on the right side, and the rate of trunk of corpus callousm was 70% on the left side and 63% on the right side. Basal nuclei didn't appear in the most of sections. On the section appearing corpus callousm for the first time, the appearing rate of the parietooccipital sulcus was 90%. On the section appearing the head of caudate nucleus for the first time, the appearing rate of parietoociipital sulcus was 100%. It means the parietooccipital sulcus was appeared 1-2 slices before the head and body of caudate nucleus. (2)On the section appearing hippocampuss for the first time and its upper sections, the disappearing rate of the parietooccipital sulcus was 90% on the left side and 80% on the right side. It means the parietooccipital sulcus disappered as soon as the hippocampuss appeared. (3)The appearing rate of the Y-shaped or V-shaped parietooccipital sulcus was 66% on the left side and 78% on the right side, the others was strait shaped.
1．(1)在胼胝体出现之前的断面中,“丁”形沟的出现率左半球为73%,右半球为60%,可以以此为标志寻找中央沟。（2）未出现“丁”形沟和外侧沟尚未呈“L”形的断面上，中央前沟、中央沟、中央后沟形成三条平行沟，并且中央前回厚于中央后回或中央后回末端髓突分叉或呈底向外的三角形的特点较明显，左右半球中分别占93%和92%,可以作为辨认中央沟的标志。(3) 外侧沟呈“L”形的断面上，左半球85%、右半球93%的中央后回或中央沟对应于岛叶最后端的岛短回，可以利用此特点寻找中央沟。
2．尾状核体首次出现断面上，外侧沟后升支的出现率，左半球为17﹪，右半球为40﹪；尾状核头及内囊首次出现断面上，外侧沟后升支的出现率左右半球为100﹪，背侧丘脑的出现率约为
10﹪左右；外侧沟后升支首次出现断面上，尾状核头的出现率左右半球分别为87﹪和60﹪，背侧丘脑的出现率左右为13﹪和3﹪，尾状核体只存在于1－2个断面上，因此在尾状核体出现到尾状核头及内囊出现而背侧丘脑尚未出现的2－3个断面上，应重点寻找首次出现的外侧沟后升支。
3．（1）顶枕沟首次出现断面上钩形枕叶的出现率左右半球分别为77﹪和80﹪，胼胝体干的出现率左右分别为70﹪和63﹪，多数标本上基底核尚未出现；在胼胝体干首次出现断面顶枕沟的出现率为90﹪；在尾状核体首次出现断面上顶枕沟的出现率为90﹪；在尾状核头首次出现断面上顶枕沟的出现率为100﹪，说明顶枕沟的出现早于尾状核体和头的出现，一般提前1－2个尾状核体出现的断面，因此钩形枕叶及胼胝体干出现而尾状核体尚未出现的1－2个断面上应重点寻找首次出现的顶枕沟。（2）海马首次出现断面及其上一个断面中，顶枕沟的消失率左右半球分别为90%和80%，故海马的出现，可作为顶枕沟消失的标志。（3）顶枕沟形态呈“Y”形或“V”形(沟里有沟,回里有回)的左半球占66%,右半球占78%,其余为呈“一”形弯曲的深沟。
To provide the section anatomic data for imaging study of brain functions and MRI localization of cerebral local lesions, 30 cadaver heads were used. The heads were scanned by 4.0 mm thickness using Philips 1.5 Tesla MR scanner and taking out the brain from the scanned head, the important cerebral gyri were painted by different colors. The preparation of the brain slice in correspondence with MR scan took the perpendicular to midpoint line of AC-PC as base line. The brain slice was correspondent to the MR imaging by 4.0 mm thickness. The localization of cerebral sulci and gyri on the cross sections were studied by the comparison of the MR images with serial cross sections of the brains.
1. (1)On the sections in front of corpus callousm, the appearing rate of 丁-shaped sulci was 73% on the left side and 60% on the right side. It could be useful to identify the central sulcus. (2)On the sections before the -shaped sulci and L-shaped lateral sulci appeared, three parallel sulci were constructed the precentral sulcus, the central sulcus and the postcentral sulcus, and the precentral gyrus was thicker than postcentral gyrus, or the characters of the medullary branch of postcentral gyrus were obvious. It could be useful to identify the central sulcus. (3)On the section appearing insular lobe with L-shaped lateral sulcus, the postcentral gyrus or central sulcus was corresponded the short gyri of insula. The appearing rate was 85% on the left side and 93% on the right side.
2. On the section appearing body of caudate nucleus for the first time, the appearing rate of the posterior ascending rami of lateral sulcus was 17% on the left side and 40% on the right side. On the section appearing head of caudate nucleus and internal capsule for the
first time, the appearing rate of the posterior ascending rami of lateral sulcus was 100% and the rate of the dorsal thalamus was 10%. On the section appearing posterior ascending ramus of lateral sulcus for the first time, the appearing rate of the head of caudate nucleus was 87% on the left side and 60% on the right side, and the appearing rate of the dorsal thalamus was 13% on the left side and 3% on the right side. The body of caudate nucleus only appeared on the 1 or 2 sections. It means that the posterior ascending ramus of lateral sulcus appearing for the first time could be identified on the 2-3 sections from with body of caudate nucleus to with head of caudate nucleus and internal capsule without dorsal thalamus.
3. (1)On the section appearing parietooccipital sulcus for the first time, the appearing rate of the hook-shaped occipital lobe was 77% on the left side and 80% on the right side, and the rate of trunk of corpus callousm was 70% on the left side and 63% on the right side. Basal nuclei didn't appear in the most of sections. On the section appearing corpus callousm for the first time, the appearing rate of the parietooccipital sulcus was 90%. On the section appearing the head of caudate nucleus for the first time, the appearing rate of parietoociipital sulcus was 100%. It means the parietooccipital sulcus was appeared 1-2 slices before the head and body of caudate nucleus. (2)On the section appearing hippocampuss for the first time and its upper sections, the disappearing rate of the parietooccipital sulcus was 90% on the left side and 80% on the right side. It means the parietooccipital sulcus disappered as soon as the hippocampuss appeared. (3)The appearing rate of the Y-shaped or V-shaped parietooccipital sulcus was 66% on the left side and 78% on the right side, the others was strait shaped.
引文
[1] Buchel C,josephs O, Rees G,et al.The functional anatomy of attention to visualmotion:a functional MRI study.Brain,1998,121
(Pt7):1281～1294
[2] Rosen BR,Buckner RL,Dale AM.Event-related functional MRI: past,present,and future.Proc Natl Acad Sci USA,1998,95(3):773
～780
[3]张淑倩，刘连祥，吴杰.人脑视皮质功能MRI的初步研究及临床应用.中华放射学杂志，2001，35（7）：524～527
[4]张淑倩，刘连祥.磁共振脑功能成像研究进展.国外医学临床放射学分册，2000，（6）：348～352
[5]张伟国，巫北海.MR脑功能成像的临床应用.中国医学影像技术，2000，16（2）：94～95
[6]Frost JA,Binder JR,Springer JA,et al.Languag Processi ng is strongly left later alized in both sexes:evidence from functional MRI.Brain,1999,122:199～208
[7]Hansson T et al.Neurosci Lett,1999,271(1):29～32
[8]王瑞玉，张贵霞，井旭明.脑颅内病灶立体定向放射神经外科
治疗计划系统[J] .国外医学 生物医学工程分册，1998，21（1）：48～51
[9]田增民.现代立体定向手术在神经外科中的应用[J] .世界医疗器械，1997，3（3）：2～6
[10] 岩崎圣，田冈俊昭，福住明夫等.脑肿疡の局在诊断に必要な脑解剖.画像诊断，1997，17（12）：1254～1265
[11] Achten E,Jackson GD, Cameron JA,etal.Presurgical evaluation of the motor hand area with functional MR imaging in patients with tumors and dysplastic lesions.Radiology,1999,210:529～538
[12]陈炳桓.立体定向放射神经外科学.北京：北京出版社，1994，47～59
[13]Minoshima S,Koeppe RA,Mintun MA,et al.Automated detection of the intercommissural line for stereotactic localization of
functional brain images..Jnucl Med,1993,34:322～329
[14]田菊霞，卢洪煊，楼佳庆等.丘脑枕三维空间的形态和位置.解剖学杂志，1999，22（3）：236～238
[15]王跃，姜均本.大脑语言区断面解剖学研究.重庆医科大学学报，1992，17（2）：100～10
[16]王跃，姜均本.大脑语言区不对称性与半球不对称性的定量分析.重庆医科大学学报，1992，17（1）：19～25
[17]Iwasaki S,Nakagawa H,Fukusumi A.Identification of pre-and
postcentral gyri on CT and MR images on the basis of the
medullary pattem of cetebral white matter Radiology,1991,179: 207~213
[18]Steinmetz H,Furst G,Freund HJ.Variation of perisylvian and
calcarine anatomic landmarks within stereotaxic proportional
coordinates.AJNR,1990,11:1123～1130
[19]耿道颖，沈馨亚，沈宗文等.正常国低中凸面脑沟回定位体系的MRI研究.解剖学杂志，1999，22（2）：128～131
[20]耿道颖，沈天真，陈星荣.低中凸面脑沟回矢状面MRI定位体系的临床应用价值初探.中国医学计算机成像杂志，1999，5（1）1～4
[21]Ebeling U,Steinmetz H,Huang Y,et al.Topigraphy and
identification of the inferior precentral sulcus in MR imaging.
AJNR,1989,10:937~942
[22] 刘丰春.大脑皮质机能区CT定位的研究.中国临床解剖学杂-志,1998,16（1）：1~4
[23]Naidich TP,Valavanis AG,Kubik S.Anatomic relationships along
the low-middle convexity:part I-normal specimens and magnic
resonance imaging.Neurosurgery,1995,36(3):517～532
[24]刘树伟，李传福，丁娟等.大脑沟、回在冠状断面上定位的初步探讨.解剖学报，1998，29（增刊）：50～53
[25]李振平，丁娟，刘树伟等.成人大脑沟、回在MRI矢状图像上
的定位研究.山东医科大学学报，1999，37（4）275～277
[26]耿道颖，沈天真，沈馨亚.正常脑标本解剖标志中断层解剖与MRI对照研究.中国临床神经科学，2000，8（1）：50～52
[27]丁娟，刘树伟，郑金勇.成人大脑中央后沟及缘上回在冠状断面上的定位.中国临床解剖学杂志，2001，19（4）：295～298
[28]丁娟，李振平，刘树伟.成人大脑中央沟在冠状面MRI上的定位.中华放射学杂志，2001，35（7）：519～523
[29]郭锁成,朱文珍,薛德麟.MR像上中央前回定位的解剖学标志:手结.临床放射学杂志,2001,20(8):575～577
[30]Kido DK,LeMay M,Levinson AW,et al .Computed tomographic
localization of the precentral gyrus .Radiology,1980,135:373～377
[31]Coffey CG,Wilkinson WE,Parnshos IA,et al.Quantitative cerebral
anatomy of the aging human brain:a cross-sectional study using magmetic resonance imaging.Neurology,1992,42:527~536
[32]刘丰春,夏玉军,单涛等.大脑脑回、脑叶CT定位的医学影像学研究.临床医学影像杂志,1997,8（3）：208~210
[33] 刘丰春.端脑髓突的断面解剖学观测.解剖学杂志，1998，21
（3）：189~191
[34] 刘丰春.端脑髓质不对称性的研究.解剖学杂志，1998，21（3）：193~195
[35]Yousry TA,Schmid UD,Alkhadhi H,et al .Localization of the
motor hand area to a knob on the precentral gyrus .A new
landmark:Brain,1997,120:141
[36]Boroojerdi B,Foltys H,Krings T,et al .Localization of the motor
hand areausing transcranial magnetic stimulation and functional
magnetic resonance imaging .Clin Neuroph ysiol,1999,110:699
[37]丁娟，刘树伟，郑金勇.大脑Broca区在冠状面磁共振图像上的定位.中枢神经系统放射学,2002,36(1):25~29
(Pt7):1281～1294
[2] Rosen BR,Buckner RL,Dale AM.Event-related functional MRI: past,present,and future.Proc Natl Acad Sci USA,1998,95(3):773
～780
[3]张淑倩，刘连祥，吴杰.人脑视皮质功能MRI的初步研究及临床应用.中华放射学杂志，2001，35（7）：524～527
[4]张淑倩，刘连祥.磁共振脑功能成像研究进展.国外医学临床放射学分册，2000，（6）：348～352
[5]张伟国，巫北海.MR脑功能成像的临床应用.中国医学影像技术，2000，16（2）：94～95
[6]Frost JA,Binder JR,Springer JA,et al.Languag Processi ng is strongly left later alized in both sexes:evidence from functional MRI.Brain,1999,122:199～208
[7]Hansson T et al.Neurosci Lett,1999,271(1):29～32
[8]王瑞玉，张贵霞，井旭明.脑颅内病灶立体定向放射神经外科
治疗计划系统[J] .国外医学 生物医学工程分册，1998，21（1）：48～51
[9]田增民.现代立体定向手术在神经外科中的应用[J] .世界医疗器械，1997，3（3）：2～6
[10] 岩崎圣，田冈俊昭，福住明夫等.脑肿疡の局在诊断に必要な脑解剖.画像诊断，1997，17（12）：1254～1265
[11] Achten E,Jackson GD, Cameron JA,etal.Presurgical evaluation of the motor hand area with functional MR imaging in patients with tumors and dysplastic lesions.Radiology,1999,210:529～538
[12]陈炳桓.立体定向放射神经外科学.北京：北京出版社，1994，47～59
[13]Minoshima S,Koeppe RA,Mintun MA,et al.Automated detection of the intercommissural line for stereotactic localization of
functional brain images..Jnucl Med,1993,34:322～329
[14]田菊霞，卢洪煊，楼佳庆等.丘脑枕三维空间的形态和位置.解剖学杂志，1999，22（3）：236～238
[15]王跃，姜均本.大脑语言区断面解剖学研究.重庆医科大学学报，1992，17（2）：100～10
[16]王跃，姜均本.大脑语言区不对称性与半球不对称性的定量分析.重庆医科大学学报，1992，17（1）：19～25
[17]Iwasaki S,Nakagawa H,Fukusumi A.Identification of pre-and
postcentral gyri on CT and MR images on the basis of the
medullary pattem of cetebral white matter Radiology,1991,179: 207~213
[18]Steinmetz H,Furst G,Freund HJ.Variation of perisylvian and
calcarine anatomic landmarks within stereotaxic proportional
coordinates.AJNR,1990,11:1123～1130
[19]耿道颖，沈馨亚，沈宗文等.正常国低中凸面脑沟回定位体系的MRI研究.解剖学杂志，1999，22（2）：128～131
[20]耿道颖，沈天真，陈星荣.低中凸面脑沟回矢状面MRI定位体系的临床应用价值初探.中国医学计算机成像杂志，1999，5（1）1～4
[21]Ebeling U,Steinmetz H,Huang Y,et al.Topigraphy and
identification of the inferior precentral sulcus in MR imaging.
AJNR,1989,10:937~942
[22] 刘丰春.大脑皮质机能区CT定位的研究.中国临床解剖学杂-志,1998,16（1）：1~4
[23]Naidich TP,Valavanis AG,Kubik S.Anatomic relationships along
the low-middle convexity:part I-normal specimens and magnic
resonance imaging.Neurosurgery,1995,36(3):517～532
[24]刘树伟，李传福，丁娟等.大脑沟、回在冠状断面上定位的初步探讨.解剖学报，1998，29（增刊）：50～53
[25]李振平，丁娟，刘树伟等.成人大脑沟、回在MRI矢状图像上
的定位研究.山东医科大学学报，1999，37（4）275～277
[26]耿道颖，沈天真，沈馨亚.正常脑标本解剖标志中断层解剖与MRI对照研究.中国临床神经科学，2000，8（1）：50～52
[27]丁娟，刘树伟，郑金勇.成人大脑中央后沟及缘上回在冠状断面上的定位.中国临床解剖学杂志，2001，19（4）：295～298
[28]丁娟，李振平，刘树伟.成人大脑中央沟在冠状面MRI上的定位.中华放射学杂志，2001，35（7）：519～523
[29]郭锁成,朱文珍,薛德麟.MR像上中央前回定位的解剖学标志:手结.临床放射学杂志,2001,20(8):575～577
[30]Kido DK,LeMay M,Levinson AW,et al .Computed tomographic
localization of the precentral gyrus .Radiology,1980,135:373～377
[31]Coffey CG,Wilkinson WE,Parnshos IA,et al.Quantitative cerebral
anatomy of the aging human brain:a cross-sectional study using magmetic resonance imaging.Neurology,1992,42:527~536
[32]刘丰春,夏玉军,单涛等.大脑脑回、脑叶CT定位的医学影像学研究.临床医学影像杂志,1997,8（3）：208~210
[33] 刘丰春.端脑髓突的断面解剖学观测.解剖学杂志，1998，21
（3）：189~191
[34] 刘丰春.端脑髓质不对称性的研究.解剖学杂志，1998，21（3）：193~195
[35]Yousry TA,Schmid UD,Alkhadhi H,et al .Localization of the
motor hand area to a knob on the precentral gyrus .A new
landmark:Brain,1997,120:141
[36]Boroojerdi B,Foltys H,Krings T,et al .Localization of the motor
hand areausing transcranial magnetic stimulation and functional
magnetic resonance imaging .Clin Neuroph ysiol,1999,110:699
[37]丁娟，刘树伟，郑金勇.大脑Broca区在冠状面磁共振图像上的定位.中枢神经系统放射学,2002,36(1):25~29