CAJ | 학술논문

颅内动脉瘤%前床突切除术%颈内动脉%颈内动脉虹吸部%体层摄影术,螺旋计算机%脑血管造影术%计算机模拟%图像处理,计算机辅助顱內動脈瘤%前床突切除術%頸內動脈%頸內動脈虹吸部%體層攝影術,螺鏇計算機%腦血管造影術%計算機模擬%圖像處理,計算機輔助
로내동맥류%전상돌절제술%경내동맥%경내동맥홍흡부%체층섭영술,라선계산궤%뇌혈관조영술%계산궤모의%도상처리,계산궤보조
Intracranial aneurysm%Resection of anterior clinoid process%Carotid artery,internal%Siphon internal carotid artery%Tomography,spiral computed%Cerebral angiography%Computer simulation%Image processing,computer-assisted

目的：应用多层螺旋CT（MSCT）在活体个性化模拟前床突切除术扩大颈内动脉虹吸部的暴露范围，提高该区肿瘤切除率，保证手术效果。资料与方法对100例受检者（200侧）在MSCT三维重建图像上模拟眶上锁孔手术入路进行观察，并测量前床突去除前后大脑前中动脉分叉处距所观察到的颈内动脉虹吸部最近心点的曲线距离（暴露长度）。结果100例（200侧）在影像上模拟眶上锁孔手术入路测量前床突去除前后左侧暴露长度分别为（14.3±3.9）mm、（30.5±4.2）mm，右侧分别为（15.9±3.8）mm、（31.8±3.9）mm，差异均有统计学意义（t=45.278、40.513, P<0.001）；前床突去除前后左、右侧暴露长度分别增加（16.3±3.6）mm、（15.8±3.9）mm，差异无统计学意义（t=0.251, P>0.05）。结论 MSCT活体个性化模拟眶上锁孔入路前床突切除术可以有效增加颈内动脉的暴露长度，并扩大鞍区的暴露范围，为该区肿瘤切除及治疗方案的选择提供可靠的影像学信息。
목적：응용다층라선CT（MSCT）재활체개성화모의전상돌절제술확대경내동맥홍흡부적폭로범위，제고해구종류절제솔，보증수술효과。자료여방법대100례수검자（200측）재MSCT삼유중건도상상모의광상쇄공수술입로진행관찰，병측량전상돌거제전후대뇌전중동맥분차처거소관찰도적경내동맥홍흡부최근심점적곡선거리（폭로장도）。결과100례（200측）재영상상모의광상쇄공수술입로측량전상돌거제전후좌측폭로장도분별위（14.3±3.9）mm、（30.5±4.2）mm，우측분별위（15.9±3.8）mm、（31.8±3.9）mm，차이균유통계학의의（t=45.278、40.513, P<0.001）；전상돌거제전후좌、우측폭로장도분별증가（16.3±3.6）mm、（15.8±3.9）mm，차이무통계학의의（t=0.251, P>0.05）。결론 MSCT활체개성화모의광상쇄공입로전상돌절제술가이유효증가경내동맥적폭로장도，병확대안구적폭로범위，위해구종류절제급치료방안적선택제공가고적영상학신식。
Purpose To study the exposure extent of internal carotid artery siphon (ICAS) before and after removing anterior clinoid process (ACP) using multislice spiral CT (MSCT) simulation, and to improve the tumor resection rate and ensure the operation effect. Materials and Methods MSCT three-dimensional images reconstruction simulating supraorbital keyhole approach of 100 patients (200 sides) were observed, the distance between the crotch of anterior cerebral artery and middle cerebral artery and ICAS before and after removing ACP (exposure extent) was measured. Results In 100 patients (200 sides ACP), the exposure extent before and after removing ACP were (14.3±3.9) mm and (30.5±4.2) mm, respectively on the left side with statistical difference (t=45.278, P<0.001), and were (15.9±3.8) mm and (31.8±3.9) mm, respectively on the right side with statistical difference (t=40.513, P<0.001). The exposure extent increased (16.3±3.6) mm and (15.8±3.9) mm, respectively on the left and right side with no statistical difference (t=0.251, P>0.05). Conclusion MSCT simulating supraorbital keyhole approach in removing ACP can effectively increase the exposure length of ICA, and enlarge the exposure extent of sella region, thus provide reliable imaging information for removing tumor and selecting surgical project in this region.