大脑横断面和冠状断面脑回定位的影像解剖学研究
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摘要
目的 通过对成人大脑冠状面MRI图像和横断面CT图像与相应断层标本的对照观察,依据大脑髓质发出的髓突,利用表盘定位法追踪、定位相应脑回,为脑功能的影像学研究和术前病理学定位诊断提供诊断依据及形态学基础。
材料和方法:选取5例外观无异常的成人颅脑标本,以经外耳门中点的CM基线的垂线为冠状扫描基线,用Gesigna MRI/il.5Tesla超导MRI机,行冠状位MRI扫描,获得层厚6mm的颅脑连续冠状面MRI图像。随机选取30例外观无异常经10%福尔马林固定的成人尸头,理发并清洗后进行标记,用SCT-4800TF型CT机据CM基线以10mm层厚连续横断扫描,获取尸头标本的CT扫描图像。将扫描后的标本开颅取脑,辨别出主要的脑回并染以不同颜色,以便与用髓突追踪出的各脑回印证。再涂以20%的明胶固定。用自制的脑切片刀和切片台分别作6mm层厚的冠状位和10mm层厚的横断连续脑切片。综合地对脑冠状位MRI图像、横断面CT图像与相应的断层标本进行观察分析,并结合大量阅片找出髓突的分支走行特点。根据大脑髓突的分支、分布规律,利用表盘法通过髓突追踪、定位相应的脑回和划分脑叶。
结果:(1)在横断面上,由于脑沟在大脑顶部CT图像中较明显且大脑髓质又尚未出现,故该层面采用脑沟定位脑回。在大脑半球中部相当于3点位处有中央沟,其前、后密度略高的皮质影分别为中央前、后回。自此层面开始,中央前回髓突方向在1～2点位,中央后回髓突方向在2～3点位。冠状面上选取经尾状核头、豆状核内囊前支层面和经中脑中部层面两个典型层面观察中央前回和中央后回的髓突。从此层面开始分别套用两个表盘,自额顶叶髓质向上外(12点～3点位)发出宽大的中央前回的髓突,向外下方(3点～4点)位发出薄的中央后回的髓突,中央后回明显薄于中央前回。随着扫描层面的向后移动,中央后回逐渐增厚,到经中脑中部层面,中央前回的髓突方向为12点～2点位;中央后回的髓突方向为2点～5点位。中央前回的髓突较前一层面缩小,而中央后回的髓突则比前一层面明显增大。
(2)在额上、中、下回全部出现的横断面上,由额叶髓质向前内发出的髓突(11～12点位)为额上回髓突,向前外发出的髓突(1～2点位)为额中回髓突 向
Objective: In order to provide reliable morphological basis and new way for imaging study of brain function and the early diagnosis and treatment of small local disease, a new method of gyri localization on CT and MRI films was discussed using; the clock localization method.Material and methods: Choosing 5 normal cadaver heads to scan in Gessgna MR(?)Tesla MRI machine. The scanning base line is perpendicular to CM base line and 6mm slice thickness, then the brain slice was cut in correspondence with MRI scan. Choosing 30 normal cadaver heads to scan in SCT-4800TF CT machine according to CM base ine and 10mm slice thickness, then the brain slice was cut in correspondence with CT scan. The brain was obtained from the scanned cadaver heads, chen painring different water co ors on the major gyri and fasten it with 20% glutin. To cut the brain slice in corr espondence with MRI scan and CT scan with the brain knife on slice frame. Observing the medullary pattern and direction by the comparison of the MRI and CT images with serial sections of the brains, a new method of gyri localization on CT and MF I flms was discussed using the clock localization method.Result: Through our studying, the rules of localizing gyrus through the pattem of medullary branches on the transverse and coronal plane are described as follows.:(1). On cross section, because Sulcus of brain are clear on the CT film of cerebrum coping and cerebral medullary substance does not appear, gyri is Localized by sulcus. On the. middle department of cerebral hemisphere central sulcus is on 3 clock of dial plare, preoentral gyrus is anterior to central sulcus and postcentral gyrvs is posterior tc that. They are all high density. Medullary branch of precentral gyrus is on 1-2 clock of dial plare and postcentrai gyrus is on 2~3 clock of dial plate from this section. On coronal secien. medullary branch of precentral gyrus and postcentrai gyrus are observed or. the head of caudate nucleus lentiform nucleus\ anterior branch of internal capsule plane and
材料和方法:选取5例外观无异常的成人颅脑标本,以经外耳门中点的CM基线的垂线为冠状扫描基线,用Gesigna MRI/il.5Tesla超导MRI机,行冠状位MRI扫描,获得层厚6mm的颅脑连续冠状面MRI图像。随机选取30例外观无异常经10%福尔马林固定的成人尸头,理发并清洗后进行标记,用SCT-4800TF型CT机据CM基线以10mm层厚连续横断扫描,获取尸头标本的CT扫描图像。将扫描后的标本开颅取脑,辨别出主要的脑回并染以不同颜色,以便与用髓突追踪出的各脑回印证。再涂以20%的明胶固定。用自制的脑切片刀和切片台分别作6mm层厚的冠状位和10mm层厚的横断连续脑切片。综合地对脑冠状位MRI图像、横断面CT图像与相应的断层标本进行观察分析,并结合大量阅片找出髓突的分支走行特点。根据大脑髓突的分支、分布规律,利用表盘法通过髓突追踪、定位相应的脑回和划分脑叶。
结果:(1)在横断面上,由于脑沟在大脑顶部CT图像中较明显且大脑髓质又尚未出现,故该层面采用脑沟定位脑回。在大脑半球中部相当于3点位处有中央沟,其前、后密度略高的皮质影分别为中央前、后回。自此层面开始,中央前回髓突方向在1～2点位,中央后回髓突方向在2～3点位。冠状面上选取经尾状核头、豆状核内囊前支层面和经中脑中部层面两个典型层面观察中央前回和中央后回的髓突。从此层面开始分别套用两个表盘,自额顶叶髓质向上外(12点～3点位)发出宽大的中央前回的髓突,向外下方(3点～4点)位发出薄的中央后回的髓突,中央后回明显薄于中央前回。随着扫描层面的向后移动,中央后回逐渐增厚,到经中脑中部层面,中央前回的髓突方向为12点～2点位;中央后回的髓突方向为2点～5点位。中央前回的髓突较前一层面缩小,而中央后回的髓突则比前一层面明显增大。
(2)在额上、中、下回全部出现的横断面上,由额叶髓质向前内发出的髓突(11～12点位)为额上回髓突,向前外发出的髓突(1～2点位)为额中回髓突 向
Objective: In order to provide reliable morphological basis and new way for imaging study of brain function and the early diagnosis and treatment of small local disease, a new method of gyri localization on CT and MRI films was discussed using; the clock localization method.Material and methods: Choosing 5 normal cadaver heads to scan in Gessgna MR(?)Tesla MRI machine. The scanning base line is perpendicular to CM base line and 6mm slice thickness, then the brain slice was cut in correspondence with MRI scan. Choosing 30 normal cadaver heads to scan in SCT-4800TF CT machine according to CM base ine and 10mm slice thickness, then the brain slice was cut in correspondence with CT scan. The brain was obtained from the scanned cadaver heads, chen painring different water co ors on the major gyri and fasten it with 20% glutin. To cut the brain slice in corr espondence with MRI scan and CT scan with the brain knife on slice frame. Observing the medullary pattern and direction by the comparison of the MRI and CT images with serial sections of the brains, a new method of gyri localization on CT and MF I flms was discussed using the clock localization method.Result: Through our studying, the rules of localizing gyrus through the pattem of medullary branches on the transverse and coronal plane are described as follows.:(1). On cross section, because Sulcus of brain are clear on the CT film of cerebrum coping and cerebral medullary substance does not appear, gyri is Localized by sulcus. On the. middle department of cerebral hemisphere central sulcus is on 3 clock of dial plare, preoentral gyrus is anterior to central sulcus and postcentral gyrvs is posterior tc that. They are all high density. Medullary branch of precentral gyrus is on 1-2 clock of dial plare and postcentrai gyrus is on 2~3 clock of dial plate from this section. On coronal secien. medullary branch of precentral gyrus and postcentrai gyrus are observed or. the head of caudate nucleus lentiform nucleus\ anterior branch of internal capsule plane and
引文
1 Satoru Iwasaki, Hiroyuki Nakagawa, Akio Fukusumi, etal. Identification of pre-and post-central gyri on CT and MRI on the basis of the medullary pattern of cereoral white matter. Radiology, 1991, 179: 207-213
2 Nadich TP, Valavanis AG, Kubik S. Accurate anatomic localization of the major gyri and sulci along the low and mid convexity by sagittal MRI. Riv Neuroradiol, 1992, 5: 299-307
3 Nadich TP, Invited lecture. MRI imaging of brair. surface anatomy. Neuroradiology, 1991, 33 (Suppl): s95-s99
4 Thons P, Naidich, Anton G, et al. Anatomic relationships along the low-middle convexity:part 1—Normal specimens and MRI. Neurosurgery, Vol. 36, No. 3, March 1995
5 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
6 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
7 刘丰春.端脑髓质不对称性研究.解剖学杂志,1998,21(3):193-195
8 Ebeling U, Steinmetz H, Huang Y, etal. Topography and identification of the inferior precentral sulcus in MRI imaging. AJNR Am J Neuroradiol, 1989, 10: 937-942
9 S(?)eirmetz H, Furst G, Freund H-J. Variation of perisylvian and calcarine anatomic landmarks within stereotaxic proportional coordinates. AJNR An J Neuroradiol, 1990, 11: 1123-1130
10 Sobel DF, Gallen CC, Schwartz BJ, etal. Locating the central sulcus: Comparison of MFI anatomic and magnetoencephalographic function methods. AJNR, Am J Neuroradiol, 1993, 14: 915-925
11 刘树伟.李传富,丁娟,等.大脑沟回在冠状面上定位的初步探讨.解剖学报,1998,29,增刊:50-53
12 刘树伟.我国断层影像解剖学的发展现状与前景展望.中国断层影像解剖学杂志,2000,4(1):1-8
13 Nadich TP, Brighrbill TC. The intraparietal sulcus: A landmark for localization of pathology on axial CT scan. Int J Neuroriadiol, 1996, 1: 3
14 丁娟,刘树伟.成人大脑沟回在断面上的定位.中国断层影像解剖学杂志,1999,3(1):68-72
15 Shoichiro Otake, Daigo Yamana, Hirokazu Mizutani, etal. Reference lines for oblique ax(?)a(?) MRI imaging of the brain. Radiology, 1996, 198: 906-907
16 Co(?)fey CE, Wilkinson WE, Parashos IA, etal. Quantitative cerebral anatomy of the ag(?)ng human brain: a crass-sectional study using MRI. Neurology, 1992, 42: 527-535
17 Steirme(?)z H, Huang Y. Two-dimensional mapping of brain surface anatomy J. (?)JNR, 1991, 12: 997-1000
18 Nadich TF. Brighrhill TC. Systems for localizing frontal-parietal gyri and sul(?)i on ax(?)al O(?) and MRI. Int J Neuroradiol, 1996, 2: 313
19 Daniel K.Kido, Marjorie Lemay, Andrew W. Levinson, etal. Computer tomographic localization of theprecentralgyrus. Radiology, 1998, 135: 373-377
20 沈宗文,林祥通,刘永昌,等.脑SPECT横位图像的皮质机能定位和动脉配布.临床医学影像杂志,1994,5(4):204
21 沈宗文,林祥通,刘永昌,等.脑矢状SPECT图像与脑矢状位断面标本对照观察.临床医学影像杂志,1997,8(2):116-118
22 沈宗文,林祥通,刘永昌,等.脑冠状SPECT图像的皮质机能定位和大脑动脉的血流配布.临床医学影像杂志,1995,6(3):149-154
23 沈宗文,滑炎卿,戴正寿,等.脑MRI图像的皮质机能定位和大脑动脉的血流配布.临床医学影像杂志,1993,4(4):199-203
24 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):100-102
25 三跃,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
26 (?)oe(?)ing L, Steinmetz H. Anatomy of the parietal lobe: mapping the individual partern. J. Acta Neurochir Wien, 1995, 136(1～2) :8-11
27 崔志潭,陈仲欣,黄璇英.国人大脑半球脑沟的形态.解剖学报,1980,11(2):182-193
28 耿道颖,沈天真,等.大脑凸面脑沟的CT和MRI定位体系的临床应用价值初探.国外医学/临床放射学杂志,1997,20(6):331-333
29 李振平,丁娟,刘树伟,等.成人大脑沟回MRI矢状图像上的定位研究.解剖学报,1998,29,增刊:46-49
30 王晓明,陈丽英,杨洪涛,等.新生儿和婴儿正常脑发育MRI研究(关于髓鞘形成).中华放射学杂志,1996,30(10):654-658
31 Tsuch(?)ya K, Mizutani Y, Hachiya J. Surface anatomy MRI scanning of the brain using HASTE sequences. AJR, 1996, 167: 1585-1587
32 Malcolm Battin, Elia F Maalouf, Serena Counsell, etal. Magnetic resonance imaging of the brain of premature infants. The lancet, 1997, Vol 349, June 14
33 Topogyaphy of the cortical motor hand area: prospective study with functional MRI
2 Nadich TP, Valavanis AG, Kubik S. Accurate anatomic localization of the major gyri and sulci along the low and mid convexity by sagittal MRI. Riv Neuroradiol, 1992, 5: 299-307
3 Nadich TP, Invited lecture. MRI imaging of brair. surface anatomy. Neuroradiology, 1991, 33 (Suppl): s95-s99
4 Thons P, Naidich, Anton G, et al. Anatomic relationships along the low-middle convexity:part 1—Normal specimens and MRI. Neurosurgery, Vol. 36, No. 3, March 1995
5 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
6 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
7 刘丰春.端脑髓质不对称性研究.解剖学杂志,1998,21(3):193-195
8 Ebeling U, Steinmetz H, Huang Y, etal. Topography and identification of the inferior precentral sulcus in MRI imaging. AJNR Am J Neuroradiol, 1989, 10: 937-942
9 S(?)eirmetz H, Furst G, Freund H-J. Variation of perisylvian and calcarine anatomic landmarks within stereotaxic proportional coordinates. AJNR An J Neuroradiol, 1990, 11: 1123-1130
10 Sobel DF, Gallen CC, Schwartz BJ, etal. Locating the central sulcus: Comparison of MFI anatomic and magnetoencephalographic function methods. AJNR, Am J Neuroradiol, 1993, 14: 915-925
11 刘树伟.李传富,丁娟,等.大脑沟回在冠状面上定位的初步探讨.解剖学报,1998,29,增刊:50-53
12 刘树伟.我国断层影像解剖学的发展现状与前景展望.中国断层影像解剖学杂志,2000,4(1):1-8
13 Nadich TP, Brighrbill TC. The intraparietal sulcus: A landmark for localization of pathology on axial CT scan. Int J Neuroriadiol, 1996, 1: 3
14 丁娟,刘树伟.成人大脑沟回在断面上的定位.中国断层影像解剖学杂志,1999,3(1):68-72
15 Shoichiro Otake, Daigo Yamana, Hirokazu Mizutani, etal. Reference lines for oblique ax(?)a(?) MRI imaging of the brain. Radiology, 1996, 198: 906-907
16 Co(?)fey CE, Wilkinson WE, Parashos IA, etal. Quantitative cerebral anatomy of the ag(?)ng human brain: a crass-sectional study using MRI. Neurology, 1992, 42: 527-535
17 Steirme(?)z H, Huang Y. Two-dimensional mapping of brain surface anatomy J. (?)JNR, 1991, 12: 997-1000
18 Nadich TF. Brighrhill TC. Systems for localizing frontal-parietal gyri and sul(?)i on ax(?)al O(?) and MRI. Int J Neuroradiol, 1996, 2: 313
19 Daniel K.Kido, Marjorie Lemay, Andrew W. Levinson, etal. Computer tomographic localization of theprecentralgyrus. Radiology, 1998, 135: 373-377
20 沈宗文,林祥通,刘永昌,等.脑SPECT横位图像的皮质机能定位和动脉配布.临床医学影像杂志,1994,5(4):204
21 沈宗文,林祥通,刘永昌,等.脑矢状SPECT图像与脑矢状位断面标本对照观察.临床医学影像杂志,1997,8(2):116-118
22 沈宗文,林祥通,刘永昌,等.脑冠状SPECT图像的皮质机能定位和大脑动脉的血流配布.临床医学影像杂志,1995,6(3):149-154
23 沈宗文,滑炎卿,戴正寿,等.脑MRI图像的皮质机能定位和大脑动脉的血流配布.临床医学影像杂志,1993,4(4):199-203
24 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):100-102
25 三跃,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
26 (?)oe(?)ing L, Steinmetz H. Anatomy of the parietal lobe: mapping the individual partern. J. Acta Neurochir Wien, 1995, 136(1～2) :8-11
27 崔志潭,陈仲欣,黄璇英.国人大脑半球脑沟的形态.解剖学报,1980,11(2):182-193
28 耿道颖,沈天真,等.大脑凸面脑沟的CT和MRI定位体系的临床应用价值初探.国外医学/临床放射学杂志,1997,20(6):331-333
29 李振平,丁娟,刘树伟,等.成人大脑沟回MRI矢状图像上的定位研究.解剖学报,1998,29,增刊:46-49
30 王晓明,陈丽英,杨洪涛,等.新生儿和婴儿正常脑发育MRI研究(关于髓鞘形成).中华放射学杂志,1996,30(10):654-658
31 Tsuch(?)ya K, Mizutani Y, Hachiya J. Surface anatomy MRI scanning of the brain using HASTE sequences. AJR, 1996, 167: 1585-1587
32 Malcolm Battin, Elia F Maalouf, Serena Counsell, etal. Magnetic resonance imaging of the brain of premature infants. The lancet, 1997, Vol 349, June 14
33 Topogyaphy of the cortical motor hand area: prospective study with functional MRI