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目的利于MRI测量经后纵裂-胼胝体入路处理丘脑后部肿瘤解剖学数据,以助于规范和优化该手术入路。方法选取120例无颅内异常的头颅MRI正中矢状位头颅核磁共振T2加权序列(少儿组25例,成人组95例),以人字点为参考点,分别设手术方案一和方案二,并在正中矢状位头颅MRI上模拟经后纵裂-胼胝体入路到达丘脑后部的两种手术路径,测量与该入路相关的解剖结构。结果 (1)方案一与方案二所得的骨窗位置分别为(少儿组人字点前≤29.89±4.36 mm,人字点后≤37.04±3.22 mm;成人组为人字点前≤(31.20±7.36)mm,人字点后≤43.05±10.36 mm),(少儿组人字点后37.04±3.22 mm;成人组人字点后43.05±10.36 mm)。(2)测量人字点至丘脑后部长度的平均值少儿组为(82.71±3.92)mm,成人组为(87.42±9.24)mm。(3)方案一与方案二所得手术视角分别为(少儿组≤44.56°±4.15°,成人组≤55.02°±7.42°),(少儿组为24.28°±3.25°,成人组为31.33°±8.25°)。结论充分的MRI评估有助于更好的掌握该入路,利于选择及优化该手术入路,提高手术效果。
Objective To facilitate the measurement and optimization of the surgical approach by MRI-based posterior longitudinal-corpus callosal approach to the posterior thalamic tumor anatomy. Methods 120 cases of non-intracranial MRI skull MRI MRI middle weighted sagittal T2-weighted sequence (25 cases of children, 95 cases of adult group), the acupoints as a reference point, respectively, a surgical program and program two, The two sagittal routes to the posterior thalamus through the posterior longitudinal-corpus callosum were simulated on the median sagittal MRI, and the anatomical structures associated with the approach were measured. Results (1) The location of the bone-window in program 1 and 2 were (29.89 ± 4.36 mm in front of children’s pedigree, ≤37.04 ± 3.22 mm in pedigree, and 31.20 ± 7.36 ) mm, ≤43.05 ± 10.36 mm after acupuncture point), (37.04 ± 3.22 mm after pedigree point in children group and 43.05 ± 10.36 mm after acupuncture point in adult group). (2) The average length of the Mabul point to the posterior thalamus was (82.71 ± 3.92) mm in the pediatric group and (87.42 ± 9.24) mm in the adult group. (3) The surgical perspectives of program I and program II were (children≤44.56 ° ± 4.15 °, adults≤55.02 ° ± 7.42 °), children (24.28 ° ± 3.25 °, adults 31.33 ° ± 8.25 °). Conclusion Adequate MRI evaluation can help better understand the approach, which will help to select and optimize the surgical approach and improve the surgical outcome.