经后纵裂-胼胝体入路治疗丘脑后部肿瘤的MRI解剖学研究
Simulation of the surgery of posterior transcallosal approach to posterior thalamus on MRI
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 measure anatomical data for posterior transcallosal approach in dealing with tumors in posterior thalamus for normalization and optimization of the surgical approach. Methods One hundred and twenty midline sagittal T2-weighted magnetic resonance images (children group, 25 cases; adult group, 95 cases) were obtained. Taking lambda as a reference point, surgical schemes 1 and 2 were established. Two surgical plans of the posterior transcallosal approach to posterior thalamus on the images were simulated and the data of the related anatomical structures were obtained. Results (1)Data obtained from the scheme 1 and 2 showed that the skull window was located as follows: in children group, the skull window of scheme 1 was located before lambda (≤29.89±4.36 mm),while after lambda (≤37.04±3.22 mm); in adult group, the skull window of scheme 1 was located before lambda (≤31.20±7.36 mm),while after lambda (≤43.05±10.36 mm).In children group, the skull window of scheme 2 was located after lambda (≤37.04±3.22 mm); in adult group, the skull window of scheme 2 was located after lambda (≤43.05±10.36 mm). (2) The average length between lambda and posterior thalamus in children was (82.71±3.92) mm, while in adult group was (87.42±9.24) mm. The surgical angle of scheme 1 was shown as follows: in children group was less than (44.56±4.15)°, while in adult was less than (55.02±7.42)°. The surgical angle of scheme 2 was shown as follows: in children group was less than (24.28±3.25)°, while in adult was less than (31.33±8.25)°. Conclusions The sufficient evaluation of MRI is helpful to master the approach. Furthermore, to select, optimize the surgical approach and increase the clinical curative effects.
核磁共振成像 / 丘脑后部 / 经后纵裂-胼胝体入路 / 手术入路
Magnetic resonance imaging / Posterior thalamus / Posterior transcallosal approach / Surgical approach
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