大脑中动脉M1段的显微解剖研究及临床意义
发布时间：2018-10-30 14:26
【摘要】： 目的:研究大脑中动脉M1段的显微解剖结构、M1分叉部的体表投影及不同头位下M1分叉部与侧裂浅表静脉的关系,为经侧裂入路手术提供参考数据及空间量化概念。 方法:在30侧(15例)用福尔马林溶液固定的湿性成人头颅标本上,用红色乳胶灌注双侧颈内动脉和椎动脉,分别左右翼点入路开颅,在显微镜下对大脑中动脉M1段进行显微解剖,分别测量M1中点水平至蝶池前壁距离,M1段的长度和直径,M1段中央支和皮质支的支数及分支类型,观察M1段的变异情况。在标本上确定坐标轴,即以眶下缘至外耳门上缘的水平线为X轴、通过外耳门前缘并与X轴垂直的线为Y轴(X轴上方为正,下方为负;Y轴前方为正,后方为负),测量M1分叉部在此坐标系投影的数值。观测不同头位下M1分叉部和侧裂浅表静脉的关系,并测量M1分叉部与侧裂浅表静脉之间的垂直距离。所得数据用SPSS16.0软件进行统计分析。 结果:大脑中动脉M1段位于蝶池中,大部份低于碟骨嵴的水平,部份平于碟骨嵴,M1段中点水平至池的前壁距离左侧:3.94士0.36mm,右侧:3.91士0.23mm,M1段长度左侧:18.30士3.06mm,右侧:18.01士2.44mm,直径左侧:3.60士0.49mm,右侧:3.57士0.50mm。M1段发出的分支分为中央支和皮质支,中央支支数左侧:8.27士2.49支,右侧:7.67士2.35支,共发出21支皮质支,其中颞极动脉为12支(占57.14%),颞前动脉为5支(占23.81%),额眶动脉和额前动脉各2支(各占9.52%),M1段双干型26例(占86.67%),三干型4例(占13.33%),未发现单干型,1例M1段存在变异为复型大脑中动脉,占3.33%,未发现副大脑中动脉。M1分叉部投影为左侧X值:26.56士3.03mm、Y值:46.71士4.24mm,右侧X值:27.03士2.92mm、Y值:45.48士4.20mm。尸头向对侧旋转30°时,M1分叉部均在侧裂浅表静脉的额侧,旋转60°时左侧4例,右侧5例M1分叉部位于侧裂浅表静脉的额侧,其余均在侧裂浅表静脉的下方。M1分叉部与侧裂浅表静脉之间的垂直距离左侧:14.60士2.27mm,右侧:15.03士2.36mm。 结论:1大脑中动脉M1段在蝶池的近后壁处行走,M1中点水平至蝶池前壁的距离为左侧:3.94士0.36mm,右侧:3.91士0.23mm,M1段分支类型多变,因此在分离蝶池时应尽量靠近池腔的前壁,术中应仔细观察避免损伤。2 M1段真正分叉总在岛阈的最高处,在以X=25.0mm、Y=45.0mm为圆心,10mm为半径画成圆的范围内共有M1分叉部的投影27例,占90.00%。3 M1分叉部与侧裂浅表静脉之间的关系和头位密切相关,尸头向对侧旋转30°时,M1分叉部均在侧裂浅表静脉的额侧,旋转60°时9例M1分叉部位于侧裂浅表静脉的额侧,21例在侧裂浅表静脉的下方。
[Abstract]:Objective: to study the microanatomical structure of M1 segment of middle cerebral artery, the surface projection of M1 bifurcation and the relationship between M1 bifurcation and superficial vein of lateral fissure under different head positions, so as to provide reference data and spatial quantification concept for translateral fissure approach. Methods: in 30 cases (15 cases) of wet adult skull fixed with formalin solution, the bilateral internal carotid artery and vertebral artery were infused with red latex, and the left and right pterygoid point approach was used to open the craniotomy, respectively. The M1 segment of the middle cerebral artery was dissected under microscope. The distance from the midpoint of M1 to the anterior wall of sphenoid cistern, the length and diameter of M1 segment, the number and type of branches of the central and cortical branches of M1 segment were measured, and the variation of M1 segment was observed. The coordinate axis is determined on the specimen, that is, the horizontal line from the lower orbital margin to the superior edge of the outer ear door is the X axis, and the line passing through the anterior edge of the outer ear door and perpendicular to the X axis is the Y axis (positive above the X axis and negative below the X axis). The Y axis is positive in front and negative in the rear). The value of M1 bifurcation projection in this coordinate system is measured. The relationship between M1 bifurcation and superficial vein of lateral fissure was observed under different head positions, and the vertical distance between M1 bifurcation and superficial vein of lateral fissure was measured. The data were analyzed by SPSS16.0 software. Results: the M1 segment of the middle cerebral artery was located in the sphenoid cistern, most of which was lower than the level of the disc crest. The distance from the middle point of the M1 segment to the anterior wall of the cistern was 3.94 卤0.36 mm on the left side, and 3.91 卤0.23 mm on the right side. The left side of M1 segment: 18.30 卤3.06 mm, the right side 18.01 卤2.44 mm, the left side 3.60 卤0.49 mm in diameter, the right side: 3.57 卤3.57 卤0.50mm.M1, the branches are divided into central branch and cortical branch. The number of central branches was 8.27 卤2.49 on the left and 7.67 卤2.35 on the right. 21 branches of cortex were produced, including 12 of the temporal polar artery (57.14%) and 5 of the anterior temporal artery (23.81%). There were two branches of frontoorbital artery and anterior frontal artery (9.52% each), 26 cases (86.67%) of double trunk type in M1 segment and 4 cases (13.33%) of third trunk type. The accessory middle cerebral artery (M1) was projected to the left side X value: 26.56 卤3.03mm Y value: 46.71 卤4.24mm, right side X value: 27.03 卤2.92mm Y value: 45.48 卤4.20mm. When the head rotated to the opposite side 30 掳, the M1 bifurcation was located on the frontal side of the superficial vein of the lateral fissure, 4 cases on the left side at 60 掳rotation, and 5 cases on the frontal side of the superficial vein of the lateral fissure on the right side. The rest were below the superficial veins of the lateral fissure. The vertical distance between M1 bifurcation and superficial veins was 14.60 卤2.27 mm on the left side and 15.03 卤2.36 mm on the right side. Conclusion: 1 the M1 segment of the middle cerebral artery walks near the posterior wall of the sphenoid cistern. The distance from the midpoint of M1 to the anterior wall of the sphenoid cistern is 3.94 卤0.36 mm on the left side and 3.91 卤0.23 mm on the right side. Therefore, the sphenoid cistern should be separated as close as possible to the anterior wall of the cistern cavity, and the injury should be carefully observed during the operation. 2 the true bifurcation of M1 segment is always at the highest point of the island threshold, and the center of the sphenoid cistern is 45.0mm. There were 27 cases of M1 bifurcation projection within the radius of 10mm, accounting for 90.00.3 cases. The relationship between M1 bifurcation part and superficial vein of lateral fissure was closely related to the head position. When the head of the corpse rotated to the opposite side 30 掳, there was a close relationship between the projection of M1 bifurcation part and the superficial vein of lateral fissure. The M1 bifurcation was located on the frontal side of the superficial vein of the lateral fissure. In the 60 掳rotation, the M1 bifurcation was located on the frontal side of the superficial vein of the lateral fissure and 21 cases under the superficial vein of the lateral fissure.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R651;R322
本文编号：2300259
[Abstract]:Objective: to study the microanatomical structure of M1 segment of middle cerebral artery, the surface projection of M1 bifurcation and the relationship between M1 bifurcation and superficial vein of lateral fissure under different head positions, so as to provide reference data and spatial quantification concept for translateral fissure approach. Methods: in 30 cases (15 cases) of wet adult skull fixed with formalin solution, the bilateral internal carotid artery and vertebral artery were infused with red latex, and the left and right pterygoid point approach was used to open the craniotomy, respectively. The M1 segment of the middle cerebral artery was dissected under microscope. The distance from the midpoint of M1 to the anterior wall of sphenoid cistern, the length and diameter of M1 segment, the number and type of branches of the central and cortical branches of M1 segment were measured, and the variation of M1 segment was observed. The coordinate axis is determined on the specimen, that is, the horizontal line from the lower orbital margin to the superior edge of the outer ear door is the X axis, and the line passing through the anterior edge of the outer ear door and perpendicular to the X axis is the Y axis (positive above the X axis and negative below the X axis). The Y axis is positive in front and negative in the rear). The value of M1 bifurcation projection in this coordinate system is measured. The relationship between M1 bifurcation and superficial vein of lateral fissure was observed under different head positions, and the vertical distance between M1 bifurcation and superficial vein of lateral fissure was measured. The data were analyzed by SPSS16.0 software. Results: the M1 segment of the middle cerebral artery was located in the sphenoid cistern, most of which was lower than the level of the disc crest. The distance from the middle point of the M1 segment to the anterior wall of the cistern was 3.94 卤0.36 mm on the left side, and 3.91 卤0.23 mm on the right side. The left side of M1 segment: 18.30 卤3.06 mm, the right side 18.01 卤2.44 mm, the left side 3.60 卤0.49 mm in diameter, the right side: 3.57 卤3.57 卤0.50mm.M1, the branches are divided into central branch and cortical branch. The number of central branches was 8.27 卤2.49 on the left and 7.67 卤2.35 on the right. 21 branches of cortex were produced, including 12 of the temporal polar artery (57.14%) and 5 of the anterior temporal artery (23.81%). There were two branches of frontoorbital artery and anterior frontal artery (9.52% each), 26 cases (86.67%) of double trunk type in M1 segment and 4 cases (13.33%) of third trunk type. The accessory middle cerebral artery (M1) was projected to the left side X value: 26.56 卤3.03mm Y value: 46.71 卤4.24mm, right side X value: 27.03 卤2.92mm Y value: 45.48 卤4.20mm. When the head rotated to the opposite side 30 掳, the M1 bifurcation was located on the frontal side of the superficial vein of the lateral fissure, 4 cases on the left side at 60 掳rotation, and 5 cases on the frontal side of the superficial vein of the lateral fissure on the right side. The rest were below the superficial veins of the lateral fissure. The vertical distance between M1 bifurcation and superficial veins was 14.60 卤2.27 mm on the left side and 15.03 卤2.36 mm on the right side. Conclusion: 1 the M1 segment of the middle cerebral artery walks near the posterior wall of the sphenoid cistern. The distance from the midpoint of M1 to the anterior wall of the sphenoid cistern is 3.94 卤0.36 mm on the left side and 3.91 卤0.23 mm on the right side. Therefore, the sphenoid cistern should be separated as close as possible to the anterior wall of the cistern cavity, and the injury should be carefully observed during the operation. 2 the true bifurcation of M1 segment is always at the highest point of the island threshold, and the center of the sphenoid cistern is 45.0mm. There were 27 cases of M1 bifurcation projection within the radius of 10mm, accounting for 90.00.3 cases. The relationship between M1 bifurcation part and superficial vein of lateral fissure was closely related to the head position. When the head of the corpse rotated to the opposite side 30 掳, there was a close relationship between the projection of M1 bifurcation part and the superficial vein of lateral fissure. The M1 bifurcation was located on the frontal side of the superficial vein of the lateral fissure. In the 60 掳rotation, the M1 bifurcation was located on the frontal side of the superficial vein of the lateral fissure and 21 cases under the superficial vein of the lateral fissure.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R651;R322
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