CAJ | 학술논문

目的为临床选择颅内血管支架的类型和放置部位提供解剖学基础.方法选取尸头标本20具,经双侧翼点入路显微解剖观测大脑前动脉A1段及其穿支血管.选取无病变的全脑DSA 100例,观测大脑前动脉A1段的走行及其穿支的开口部位.结果显微解剖大脑前动脉A1段的长度和直径分别为(13.55±1.43) mm、(2.43±0.37) mm,DSA血管造影的长度和直径分别为(13.42±1.57) mm、(2.28 ±0.40) mm,显微解剖与DSA血管造影直径的差异有统计学意义(P＜0.05).大脑前动脉A1段的穿支发自其后上壁,近侧段穿支数目(2.55±0.39)支,中间段(0.52±0.46)支,远侧段(1.12±0.11)支,近侧、中间、远侧段的穿支数目的差异均有统计学意义(P值均＜0.05).男性较女性的大脑前动脉A1段长、直径粗,两者差异均有统计学意义(P值均＜0.05).结论大脑前动脉A1段的显微解剖与数字减影血管造影对照观测对临床选择颅内血管支架的类型和放置部位,避免血管支架阻塞穿支开口处,防止术后穿支供应区域缺血等具有重要的临床意义.
목적 위림상선택로내혈관지가적류형화방치부위제공해부학기출.방법 선취시두표본20구,경쌍측익점입로현미해부관측대뇌전동맥A1단급기천지혈관.선취무병변적전뇌DSA 100례,관측대뇌전동맥A1단적주행급기천지적개구부위.결과 현미해부대뇌전동맥A1단적장도화직경분별위(13.55±1.43) mm、(2.43±0.37) mm,DSA혈관조영적장도화직경분별위(13.42±1.57) mm、(2.28 ±0.40) mm,현미해부여DSA혈관조영직경적차이유통계학의의(P＜0.05).대뇌전동맥A1단적천지발자기후상벽,근측단천지수목(2.55±0.39)지,중간단(0.52±0.46)지,원측단(1.12±0.11)지,근측、중간、원측단적천지수목적차이균유통계학의의(P치균＜0.05).남성교녀성적대뇌전동맥A1단장、직경조,량자차이균유통계학의의(P치균＜0.05).결론 대뇌전동맥A1단적현미해부여수자감영혈관조영대조관측대림상선택로내혈관지가적류형화방치부위,피면혈관지가조새천지개구처,방지술후천지공응구역결혈등구유중요적림상의의.
Objective To provide anatomical basis for selecting the types and placing parts of vascular stent.Methods Twenty head specimens were selected and the A1 segment of anterior cerebral artery and its perforators were measured by the pterion approach.One hundred digital subtraction angiography(DSA) images with no diseases of whole brain were selected,the course of the A1 segment of anterior cerebral artery and the opening parts of its perforators were observed.Results The length and external diameter of the microanatomy were (13.55 ± 1.43) mm and (2.43 ± 0.37) mm,respectively.The length and diameter of the DSA angiography of the A1 segment of anterior cerebral artery were (13.42 ± 1.57) mm and (2.28 ±0.40) mm respectively.There were significant differences in the diameter between the microanatomy and DSA angiography (P ＜ 0.05).The perforators of the A1 segment of anterior cerebral artery originated from its posterior and superior wall,the branches of the proximal,middle and distal segment were 2.55 ±0.39,0.52 ±0.46,and 1.12 ±0.10,respectively.There were significant differences in the perforators among the proximal,middle and distal segment (all P values ＜ 0.05).The male A1 segment of anterior cerebral artery was longer than that of the female,there were significant differences in length and diameter respectively (all P values ＜ 0.05).Conclusions Microanatomy and digital subtraction angiography comparative observation of the A1 segment of anterior cerebral artery has an important clinical significance for selecting the types and placing parts of vascular stent,avoiding obstruction the opening parts of perforators,preventing postoperative ischemia of the supply area of perforators.