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目的:探讨颈静脉孔区正常解剖结构特点及影像学表现,为该区疾病诊断、手术治疗提供解剖学与影像学依据。方法:取10个成人头颅标本(20侧颈静脉孔)通过采用Fisch颞下窝手术入路进行解剖和观察,测量相关解剖学数据;采用MSCT与MR对10名健康自愿者进行头颅扫描,获取MSCT与MR影像表现,将测得数据进行统计学分析。结果:在20侧颈静脉孔中,有18侧(90%)的舌咽神经和迷走神经之间存在纤维性硬膜,颞突比较恒定,枕突少见,3侧(15%)有完整骨桥;舌咽神经、迷走神经、副神经都有很多根丝,迷走神经根丝可多达13条;右侧颈静脉球高度高于左侧,P<0.05。MSCT颅底层面可清晰显示颈静脉孔大小、形态及其内颞突、枕突、骨桥等骨性结构;MR3D-TOF法可显示颈内动脉、基底动脉、大脑后动脉等血管影像。结论:颈静脉孔区解剖结构复杂,通过颈静脉孔区的解剖学和影像学研究,能够为颈静脉孔区骨质消磨术和该区血管病变手术提供客观依据,从而降低该区手术对神经、血管的损伤,提高手术疗效。
Objective: To explore the normal anatomic structure and imaging findings of jugular foramen area, and to provide anatomic and imaging evidences for the diagnosis and surgical treatment of this area. Methods: Ten adult skull specimens (20 lateral jugular foramen) were dissected and observed by means of Fisch infratemporal fossa approach and related anatomical data were measured. Ten healthy volunteers were scanned by MSCT and MR, MSCT and MR imaging performance, the measured data for statistical analysis. RESULTS: There were fibrous dura between the glossopharyngeal nerve and the vagus nerve in 18 sides (90%) in 20 jugular foramen. The temporal bursa was relatively constant and the occipital processes were uncommon. There were complete osteopontras in 3 sides (15%), ; Glossopharyngeal nerve, vagus nerve, accessory nerve have a lot of root filament, vagus nerve root wire up to 13; right jugular bulb height is higher than the left, P <0.05. MSCT skull base level can clearly show the jugular foramen size, shape and its internal temporal processes, occipital process, bone bridge and other bony structures; MR3D-TOF method can display the internal carotid artery, basilar artery, posterior cerebral artery and other vascular images. Conclusion: The anatomical structure of jugular foramen region is complex. The anatomical and imaging studies of the jugular foramen region provide an objective basis for osteocalis in the jugular foramen region and vascular surgery in this region, and thus reduce the risk of nerve injury , Vascular damage, improve surgical outcomes.