骨性鼻泪管横截面断层解剖学与影像解剖学的比较
골성비루관횡절면단층해부학여영상해부학적비교
Sectional anatomy characteristics versus image anatomy of bone nasolacrimal duct
  • 万方数据
    中国组织工程研究与临床康复 중국조직공정연구여림상강복
    JOURNAL OF CLINICAL REHABILITATIVE TISSUE ENGINEERING RESEARCH
    2007年 27期 5440-5443 ,共4页

    李鑫%刘卫华%马大军%王伦安%刘亚国%谢拥军%米永杰%李健

    리흠%류위화%마대군%왕륜안%류아국%사옹군%미영걸%리건

    骨性鼻泪管%横截面%断层解剖学%影像解剖学 骨性鼻淚管%橫截麵%斷層解剖學%影像解剖學
    골성비루관%횡절면%단층해부학%영상해부학
    背景:目前研究集中于鼻泪管的局部解剖和影像解剖方面,而在干性颅骨标本上进行较系统的骨性鼻泪管横截面断层解剖学与影像解剖学对照研究尚较缺乏.目的:探讨骨性鼻泪管横截面断层解剖学与影像解剖学特点,为相关鼻内镜鼻泪管手术提供依据.设计:标本自身对照试验.单位:成都医学院教学保障处.材料:实验于2005-09/2006-09在成都医学院人体解剖学教研室局部解剖实验室完成.随机选取国人成人完整无损干性颅骨34例(68侧),其中男性34侧,女性34侧.方法:①使用SHIMADZU型CT机以头颅CT的常规扫描基线OM线为轴位扫描基线,对标本进行水平位扫描.人为将骨性鼻泪管分为3等分(上1/3段、中1/3段、下1/3段),每一等分的测量结果取其包括相应层面相应数据的平均值.②按影像扫描基线在颅骨标本上做好标记.使用切片刀沿CT的水平位扫描基线行横断面断层切片,分别测量骨性鼻泪管的相关测量指标,并与影像学的结果相对照.主要观察指标:①骨性鼻泪管上口、上1/3段、中1/3段、下1/3段、下口的前后径和左右径.②骨性鼻泪管上口、上1/3段、中1/3段、下1/3段、下口的内骨壁和后骨壁厚度.③骨性鼻泪管下口的位置和形态.④骨性鼻泪管相应指标的CT影像测量结果与横截面解剖测量结果的对照.结果:①骨性鼻泪管横截面前后径及左右径:骨性鼻泪管上口明显狭窄;下口的大小变异较大;管径由上至下逐渐增大;前后径大于左右径;骨性鼻泪管上口内径、下1/3段内径,男女之间比较,差异有显著性意义(t=2.458,2.227,P＜0.05).骨性鼻泪管上1/3段内径、中1/3段内径、下口内径,男女之间比较,差别无显著性意义(P＞0.05).②骨性鼻泪管横截面的内骨壁和后骨壁:骨性鼻泪管内骨壁的厚度为(0.87±0.23)mm,后骨壁的厚度为(0.21±0.19)mm,内骨壁的厚度和后骨壁的厚度之间比较,差异有显著性意义(t=2.547,P＜0.05);骨性鼻泪管上口、上1/3段、中1/3段、下1/3段、下口的内骨壁厚度以及相应位置的后骨壁厚度,男女之间比较,差异均无显著性意义(P＞0.05).③鼻泪管下口的位置、开口的形态变异较大.骨性鼻泪管相应指标的CT影像测量结果与横截面解剖测量结果一致.结论:熟悉骨性鼻泪管的正常横截面解剖及影像解剖有助于鼻泪管相关手术的顺利进行和减少并发症.
    배경:목전연구집중우비루관적국부해부화영상해부방면,이재간성로골표본상진행교계통적골성비루관횡절면단층해부학여영상해부학대조연구상교결핍.목적:탐토골성비루관횡절면단층해부학여영상해부학특점,위상관비내경비루관수술제공의거.설계:표본자신대조시험.단위:성도의학원교학보장처.재료:실험우2005-09/2006-09재성도의학원인체해부학교연실국부해부실험실완성.수궤선취국인성인완정무손간성로골34례(68측),기중남성34측,녀성34측.방법:①사용SHIMADZU형CT궤이두로CT적상규소묘기선OM선위축위소묘기선,대표본진행수평위소묘.인위장골성비루관분위3등분(상1/3단、중1/3단、하1/3단),매일등분적측량결과취기포괄상응층면상응수거적평균치.②안영상소묘기선재로골표본상주호표기.사용절편도연CT적수평위소묘기선행횡단면단층절편,분별측량골성비루관적상관측량지표,병여영상학적결과상대조.주요관찰지표:①골성비루관상구、상1/3단、중1/3단、하1/3단、하구적전후경화좌우경.②골성비루관상구、상1/3단、중1/3단、하1/3단、하구적내골벽화후골벽후도.③골성비루관하구적위치화형태.④골성비루관상응지표적CT영상측량결과여횡절면해부측량결과적대조.결과:①골성비루관횡절면전후경급좌우경:골성비루관상구명현협착;하구적대소변이교대;관경유상지하축점증대;전후경대우좌우경;골성비루관상구내경、하1/3단내경,남녀지간비교,차이유현저성의의(t=2.458,2.227,P＜0.05).골성비루관상1/3단내경、중1/3단내경、하구내경,남녀지간비교,차별무현저성의의(P＞0.05).②골성비루관횡절면적내골벽화후골벽:골성비루관내골벽적후도위(0.87±0.23)mm,후골벽적후도위(0.21±0.19)mm,내골벽적후도화후골벽적후도지간비교,차이유현저성의의(t=2.547,P＜0.05);골성비루관상구、상1/3단、중1/3단、하1/3단、하구적내골벽후도이급상응위치적후골벽후도,남녀지간비교,차이균무현저성의의(P＞0.05).③비루관하구적위치、개구적형태변이교대.골성비루관상응지표적CT영상측량결과여횡절면해부측량결과일치.결론:숙실골성비루관적정상횡절면해부급영상해부유조우비루관상관수술적순리진행화감소병발증.
    BACKGROUND: Researches are recently focus on topography and image dissection of nasolacrimal duct, but it is lack of systemically contrast researches between sectional anatomy and image anatomy on bone nasolacrimal duct by using dry cranium samples.OBJ ECTIVE: To investigate the characteristics of sectional anatomy and image anatomy on bone nasolacrimal duct and provide evidences for related operations of nasolacrimal duct.DESrGN: Self controlled study.SETTING: Office of Teaching Supplies, Chengdu Medical College.MATERIALS: The experiment was carried out in the Topography Laboratory, Department of Human Anatomy, Chengdu Medical College from September 2005 to September 2006. Non-injured dry cranium was randomly selected from 34 adults (68 sides), including 34 sides on males and 34 sides on females.METHODS: ① Based on OM line, a routine scanning base line, which was regarded as the axial scanning baseline,samples were scanned at flat level with SHIMADZU CT device. Bone nasolacrimal duct was factitiously divided into three parts, including 1/3 superior segment, 1/3 middle segment and 1/3 inferior segment. The means at each related layer were determined as the final results. ② Cranium samples were signed based on image scanning baseline, and then they were cut into sections at cross section fault along scanning baseline at flat level with section razor. In addition, related indexes of bone nasolacrimal duct were measured and compared with image results.MAIN OUTCOME MEASURES: ① Anterior, posterior, left and right diameters of superior aperture, 1/3 superior segment,1/3 middle segment, 1/3 inferior segment and inferior aperture of bone nasolacrimal duct; ② depth of internal bone wall and posterior bone wall in superior aperture, 1/3 superior segment, 1/3 middle segment, 1/3 inferior segment and inferior aperture if bone nasolacrimal duct; ③ position and form of inferior aperture of bone nasolacrimal duct; ④ comparisons of bone nasolacrimal duct between image anatomy and sectional anatomy.RESULTS: ① Anterior, posterior, left and right diameters of cross section of bone nasolacrimal duct: Superior aperture of bone nasolacrimal duct was narrow, but inferior aperture was changed obviously. Diameter was increased from top to bottom. In addition, anterior and posterior diameters were more than left and right ones. There was significant difference in internal diameter of superior aperture and 1/3 inferior segment of bone nasolacrimal duct between male and females (t =2.458, 2.227, P ＜ 0.05). However, there was no significant difference in internal diameter of 1/3 superior segment, 1/3 middle segment and inferior aperture of bone nasolacrimal duct between male and female (P ＞ 0.05). ② Depth of internal bone wall and posterior bone wall of bone nasolacrimal duct at cross section: Depths of internal bone wall and posterior bone wall of bone nasolacrimal duct were (0.87±0.23) mm and (0.21±0.19) mm, respectively. In addition, there was significant difference between them (t =2.547, P ＜ 0.05). However, there was no significant difference in depth of internal bone wall and related posterior bone wall of superior aperture, 1/3 superior segment, 1/3 middle segment, 1/3 inferior segment and inferior aperture of bone nasolacrimal duct between male and female (P ＞ 0.05). ③ Position and form of inferior aperture of bone nasolacrimal duct changed remarkably. Results of image anatomy of bone nasolacrimal duct were as the same as those of sectional anatomy.CONCLUSION: Perfection of normal sectional anatomy and image anatomy of bone nasolacrimal duct is beneficial for successfully performing related operations of nasolacrimal duct and reducing complications.
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