CAJ | 학술논문

目的探讨大脑深静脉系统的解剖特点及代偿功能,为临床提供参考.方法对常规CT和/或MRI检查已排除累及静脉系统疾病的60例受检者分别进行脑CT静脉血管成像(CTV)、磁共振静脉血管成像(MRV)、数字减影血管造影(DSA)检查,对大脑深静脉和静脉窦的显示、构成、走形、引流情况进行统计分析,并测量相关数据.结果 ①两侧大脑内静脉无明显差异,大多呈相互平行的关系,但并非恒定,由前向后的走行过程中存在变异(前部呈上下位,向后渐移行呈平行关系),其间未见吻合支,最终均汇入Galen静脉.②基底静脉系变异较多,90％(104侧)汇入大脑大静脉；10％(12侧)汇入大脑内静脉的末端.③Galen均表现为单干型,变异较少,走行较直,根据MRV图像可分为5种类型:Ⅰ型,由左右大脑内静脉和左右基底静脉构成；Ⅱ型,由左右大脑内静脉和单支基底静脉构成；Ⅲ型,由左右大脑内静脉构成；Ⅳ型,由单支大脑内静脉和左右基底静脉构成；V型,由单支大脑内静脉和单支基底静脉构成.④按照上矢状窦、直窦和双侧横窦的吻合关系以及横窦引流优势,可将窦汇区的解剖形态根据CTV图像分为4型,横窦引流优势表现为右侧为主38例,左侧为主10例,基本相等12例.结论大脑深静脉系统的解剖结构复杂且变异较多,CTV、MRV、DSA是显示大脑深静脉系统及静脉窦的有效方法,各有优劣,有助于判断代偿通道,对于临床诊断和手术过程具有重要意义.
목적 탐토대뇌심정맥계통적해부특점급대상공능,위림상제공삼고.방법 대상규CT화/혹MRI검사이배제루급정맥계통질병적60례수검자분별진행뇌CT정맥혈관성상(CTV)、자공진정맥혈관성상(MRV)、수자감영혈관조영(DSA)검사,대대뇌심정맥화정맥두적현시、구성、주형、인류정황진행통계분석,병측량상관수거.결과 ①량측대뇌내정맥무명현차이,대다정상호평행적관계,단병비항정,유전향후적주행과정중존재변이(전부정상하위,향후점이행정평행관계),기간미견문합지,최종균회입Galen정맥.②기저정맥계변이교다,90％(104측)회입대뇌대정맥；10％(12측)회입대뇌내정맥적말단.③Galen균표현위단간형,변이교소,주행교직,근거MRV도상가분위5충류형:Ⅰ형,유좌우대뇌내정맥화좌우기저정맥구성；Ⅱ형,유좌우대뇌내정맥화단지기저정맥구성；Ⅲ형,유좌우대뇌내정맥구성；Ⅳ형,유단지대뇌내정맥화좌우기저정맥구성；V형,유단지대뇌내정맥화단지기저정맥구성.④안조상시상두、직두화쌍측횡두적문합관계이급횡두인류우세,가장두회구적해부형태근거CTV도상분위4형,횡두인류우세표현위우측위주38례,좌측위주10례,기본상등12례.결론 대뇌심정맥계통적해부결구복잡차변이교다,CTV、MRV、DSA시현시대뇌심정맥계통급정맥두적유효방법,각유우렬,유조우판단대상통도,대우림상진단화수술과정구유중요의의.
Objective To observe the deep cerebral veins and venous sinus,including the anatomic forms,shapes and drainage pathways by using computed toinography venography (CTV),magnetic resonance venography (MRV) and digital subtraction angiography(DSA),in order to explore the anatomic features and the compensatory function of the deep cerebral venous system.Methods To observe imaging data of brain CTV,MRV,DSA respectively in 60 cases excluded with venous system diseases by computed tomography(CT) or magnetic resonance imaging (MRI) examination.To analyze the data of displaying,composition,shape,drainage condition about the deep cerebral veins and venous sinus,and measure the related data.Results ①According to imaging data,the internal cerebral veins could be divided into five types.Both sides of the internal cerebral veins were mostly parallel to each other.There were some variabilities in the running process from front to back.There were not any anastomotic veins between two sides of the internal cerebral veins,and the internal cerebral veins were flowing into the Galen vein ultimately.②The Rosenthal's veins showed a 90％ (104 sides)flow into the vein of Galen and 10％ (12 sides)flow into the end of the internal cerebral veins.③All of the Galen veins showed a single vein,little of them have variation,their shapes are straight.According to the MRV images,they can be divided into five types.④According to CTV image the torcular's anatomy morphology can be divided into 4 type:straight sinus,two sides of transverse sinus,as well as the transverse sinus drainage dominance.Conclusions There are complex anatomical structures and lots of variabilities in the deep cerebral venous system.CTV,MRV,DSA examinations are efficient methods to show the deep cerebral venous system and venous sinus.