大脑中动脉M1段的显微解剖与血管造影对照观测及临床意义
韩晓红, 李晓鹏, 李培, 付升旗, 范锡印, 牛杰
中国临床解剖学杂志 ›› 2013, Vol. 31 ›› Issue (2) : 154-157.
大脑中动脉M1段的显微解剖与血管造影对照观测及临床意义
Microanatomy and angiography control observation of M1 segment of middle cerebral artery and its clinical significance
目的 为选择血管支架的类型和放置部位提供解剖学基础。 方法 （1）选取头部标本20例，经双侧翼点入路解剖观测大脑中动脉M1段及其分支、穿支血管。（2）选取无病变的全脑血管造影像100例，观测大脑中动脉M1段的走行及其穿支的开口部位。 结果 大脑中动脉M1段的长度和外径分别为(13.14±3.62) mm、(3.41±0.38) mm，血管造影长度和直径分别为(10.65±5.61) mm、(2.30±0.35) mm，显微解剖与血管造影有显著性差异（P<0.05）。大脑中动脉M1段中央支的内侧群动脉发自大脑中动脉M1段的上壁和内侧壁，较细小；外侧群动脉发自大脑中动脉M1段分叉处动脉干的上壁和内侧壁，较粗、长。男、女性大脑中动脉M1段血管造影的长度、直径有显著性差异（P<0.05），男性较女性的大脑中动脉M1段长，直径粗。 结论 大脑中动脉M1段的显微解剖与血管造影对照观测对选择血管支架的类型和放置部位，避免血管支架阻塞中央支开口处，防止术后中央支供应区域缺血等具有重要的临床意义。
Objective To provide anatomical basis for selecting the type of intravascular stent and site for placing it. Methods (1)20 head specimens were selected and measured at the M1 segment of the middle cerebral artery, its branches and perforators through the left and right pterion approach, respectively. (2)100 angiography images of brains with no obvious diseases were selected, the course of the M1 segment of the middle cerebral artery and the openings of its perforators were observed. Results The length and caliber of the MI segment of middle cerebral artery was (13.14±3.62)mm and (3.41±0.38)mm through measurement in specimens, respectively, and was (10.65±5.61)mm, (2.30±0.35)mm through measurement in angiography, respectively. There was significant difference in length and diameter between microanatomic measurement and angiographic measurement (P<0.05). Minute medial group of central branches originated from the superior and medial aspects of the the M1 segment of middle cerebral artery, whereas sizable lateral group of central branches originated from the superior and medial aspects of the arterial at its bifurcation. There was significant difference in length and diameter between angiography of the M1 segment of the middle cerebral artery in male and female (P<0.05); the M1 segment of the middle cerebral artery in male was longer and larger in diameter than that in female. Conclusion This study can provide guidance for selecting the type and placing site of intravascular stent, avoiding obstruction the openings of central branches and thus preventing postoperative ischemia of the vascularized area of central branches.
Middle cerebral artery / Microanatomy / Angiography / Control observation
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