成人CT血管成像横窦体表定位研究及其意义
盛 波, 吕富荣, 肖智博, 欧阳羽, 吕发金, 邓金木, 刘 楠
中国临床解剖学杂志 ›› 2011, Vol. 29 ›› Issue (2) : 184-187.
成人CT血管成像横窦体表定位研究及其意义
Surface location of the transverse sinus by computed tomographic angiography and its clinic significance
目的 利于64排螺旋CT确定横窦和乙状窦的体表定位，评价采用上项线和颧弓-枕外隆突连线作为横窦标志的准确性，为横窦区入路相关手术的骨窗定位提供解剖学基础。 方法 回顾性重建100例进行过64排螺旋CT头部CTA检查患者的横窦和乙状窦影像，对比观察体表骨性标志与静脉窦的位置关系，确定横窦的体表定位。 结果 星点主要位于横窦和乙状窦连接部的横窦侧；星点位于横窦和乙状窦连接部前上方占4%，星点恰好位于连接部占81%，星点位于连接部后下方占15%。颧弓-枕外隆突连线和上项线走行不完全一致，它们与横窦的关系多样；上项线与横窦走行不一致；颧弓-枕外隆突连线可作近段横窦的定位标志，但是随着它们向外移行，颧弓-枕外隆突连线则主要位于横窦下方，并且它们的距离越来越远。 结论 上项线不能代表颧弓-枕外隆突连线的走行，同时它们都不是定位横窦的可靠标志，64排螺旋CT的头部减影CTA检查可作为常规术前检查来明确个体解剖资料从而定位横窦和乙状窦，以便指导横窦区相关手术入路设计。
Objective To evaluate the anatomical relationship of transverse-sigmoid sinuses and surgical landmarks for clinic surgery by computed tomographic angiography with 64-row CT, and to determine the reliability of the superior nuchal line (SNL) and the line drawn from the zygoma root to the inion for the posterolateral approaches as the surgical landmark. Methods The images of transverse-sigmoid sinuses from 100 cases were collected adopting CT angiography and further three-dimensional reconstructed to determine the location of the transverse-sigmoid sinuses. Results The main asterion located at the transverse-sigmoid sinuses transition (TSST), and closed to transverse sinuses. Regarding its position from the TSST, it was at the transition point for most cases (81%), at the lower part of transition about 15%, and at the upper part about 4%. It was disaccord to the course of SNL and the line drawn from the zygoma root to the inion, furthermore, their relationship with the transverse sinus was varied. Transverse sinus and SNL was inconsistent. The line from the zygoma root to the inion can be used as a sign of proximal transverse sinus, but with their outward migration, the line passed below the transverse sinus and gradually away from it. Conclusions SNL is different from the line from the zygoma root to the inion, and cannot be taken as a strictly reliable landmark for locating transverse sinuses. Subtraction CT angiography is a reliable method in the localization of the transverse-sigmoid sinuses for surgical craniotomies.
Transverse sinus / Superior nuchal line / Anatomy / Computed tomographic angiography(CTA)
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