人脑桥静脉的显微解剖学、影像学观察及其相关性研究

发布时间：2017-12-31 09:42

本文关键词：人脑桥静脉的显微解剖学、影像学观察及其相关性研究　出处：《安徽医科大学》2006年硕士论文　论文类型：学位论文

【摘要】：目的观察人脑桥静脉在显微解剖、DSA和CTV影像图的形态学特征，分析显微解剖与影像观察结果间的关联，为显微神经外科手术入路方案的制定、脑静脉系统疾病准确及时的诊断和脑静脉系统疾病发病机制的探讨提供形态学依据。方法 ①将30例(60侧)成人脑标本的桥静脉分为上矢状窦组、小脑幕上组、蝶骨组和颅后窝组4组进行显微解剖观测；②对12例新鲜胎儿和幼儿的脑静脉铸型标本进行观察；③分别选择36例和15例经临床证实无脑静脉血管病变或损伤病人的全脑血管数字减影血管造影(DSA)系列图像的静脉相和全脑血管CT静脉造影(CTV)图像，进行分组观测。结果 1、上矢状窦组桥静脉：①上矢状窦前部有一缺乏桥静脉注入段，显微解剖、DSA和CTV观测此段长度分别为49.16±20.34mm、48.2±18.4mm和57.5±16.2mm；此组桥静脉分布于缺乏段的前方和后方，此段的后端可作为血管影像图的冠状缝标志；②显微解剖发现，，桥静脉以单干直接或间接经上矢状窦旁硬脑膜窦注入上矢状窦，此硬脑膜窦扁平，形状不规则；上矢状窦后段，桥静脉常走行在外侧陷窝的下方；DSA和CTV观察发现，桥静脉注入处常显示不清；③96.4％的桥静脉自后向前注入上矢状窦；④DSA和CTV观察桥静脉灵敏度分别为79.5％和62.5％。2、小脑幕上组桥静脉①分为横窦组、小脑幕组、岩部组和横窦上组4组；②桥静脉注入处的形态分为单干型、多干型和烛台型；③显微解剖发现桥静脉均来自颞枕叶的底面和外侧面，DSA和CTV分别有34％和23％来自颞枕叶底面的桥静脉；④DSA和CTV观察桥静脉灵敏度均为39.7％；⑤Labbé静脉存在于所有60侧大脑半球中，DSA和CTV分别有1侧和2侧半球的LV缺如；显微解剖、DSA和CTV观察分别有80.0％、73.5％和80.0％的LV属于横窦组。3、蝶骨组桥静脉①大脑中浅静脉(SMCV)表现为缺如、单干、双干或三干，显微解剖、DSA和CTV发现缺如的SMCV分别为1.7％、7.0％和30.0％；②显微解剖观察SMCV注入海绵窦、蝶顶窦、岩上窦、蝶岩窦和岩鳞窦，DSA注入海绵窦或蝶顶窦，蝶岩窦，CTV注入海绵窦、蝶顶窦、岩上窦、
[Abstract]:Objective to observe the morphologic features of cerebral bridging vein in microanatomical anatomy and CTV images, and to analyze the correlation between microanatomy and image observation results, so as to make the scheme of microsurgical approach. The accurate and timely diagnosis of cerebral venous diseases and the study of the pathogenesis of cerebral venous system diseases provided morphological basis. Methods 1 the pontine veins of 30 adult brain specimens were divided into superior sagittal sinus group. The microanatomy was observed in the supratentorial group, sphenoid bone group and posterior fossa group. (2) the cerebral vein cast specimens of 12 fresh fetuses and young children were observed. 3The venous phase and CT venography of all cerebral vessels in 36 patients and 15 patients with clinically proven anencephalic venous lesion or injury were selected respectively (. CTV) image. Results 1. In the superior sagittal sinus group, there was a lack of bridged vein injection in the anterior part of the superior sagittal sinus. The lengths of DSA and CTV were 49.16 卤20.34mm and 57.5 卤16.2 mm, respectively. The graft veins in this group were located in the front and rear of the absence segment, and the posterior end of the segment could be used as a coronal suture marker of the angiogram. 2Microanatomy showed that the superior sagittal sinus was injected directly or indirectly into the superior sagittal sinus through the superior sagittal sinus by a single trunk. The dural sinus was flat and irregular in shape. In the posterior segment of the superior sagittal sinus, the bridge vein often runs below the lateral lacuna; DSA and CTV observation showed that the location of bridge vein injection was often unclear. 396.4% of the bridging veins were injected forward into the superior sagittal sinus; 4the sensitivity of CTV and DSA were 79.5% and 62.5 respectively. The supratentorial pontine vein 1 was divided into 4 groups: transverse sinus group, tentorial cerebellar group, petrosal group and supratransverse sinus group. (2) the shape of the graft vein was divided into single trunk type, multiple trunk type and candlestick type. 3The results of microanatomy showed that 34% and 23% of the bridging veins came from the lower and lateral sides of the temporal and occipital lobes, respectively, and 34% and 23% from the bottom of the temporal and occipital lobe, respectively. 4the sensitivity of DSA and CTV in observing the bridging vein was 39.7; (5) in all the 60 cerebral hemispheres, the LV was absent in 1 and 2 hemispheres of CTV and DSA in all 60 cerebral hemispheres. 73.5% of LV and 80.0% of LV were found in transverse sinus group, and the sphenoid bone group showed the absence of SMCV-1 in the pontine vein 1, and the superficial cerebral vein in the sphenoid bone group (83.5% and 80.0%%, respectively). In single trunk, double trunk or third trunk, SMCV was found to be 1. 7% and 30. 0% in microanatomical dissection and CTV, respectively. (2) SMCV was injected into cavernous sinus, sphenoid parietal sinus, superior petrosal sinus, sphenolus sinus and petrosal sinus into cavernous sinus or sphenoid parietal sinus, and sphenoid sinus into cavernous sinus, sphenoid parietal sinus and superior petrosal sinus.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R322

【参考文献】