CAJ | 학술논문

目的在CT血管造影(CTA)三维重建图像上观察Corona Mortis动脉的存在率及位置,以期为骨盆、髋臼骨折的手术入路提供解剖学基础.方法回顾性分析2010年12月至2012年5月期间行腹主动脉CTA检查的80例(160个半骨盆)患者资料,男34例,女46例；年龄19 ～ 84岁,平均47.2岁.利用Mimics 10.01软件对患者骨盆CTA.dicom格式原始数据进行三维重建,在三维图像上观察Corona Mortis动脉,记录该血管的支数及起源,并测量该血管与耻骨联合的距离.比较左右两侧半骨盆、男女性及年龄≤50岁组与年龄＞ 50岁组之间Corona Mortis动脉存在率的差异. 结果共发现29条Corona Mortis动脉,存在率为18.1％ (29/160).左侧和右侧Corona Mortis动脉存在率分别为17.5％ (14/80)、18.8％ (15/80);男性与女性Corona Mortis动脉存在率分别为19.1％ (13/68)、17.4％ (16/92),年龄≤50岁组与年龄＞50岁组Corona Mortis动脉存在率分别为14.3％ (14/98)、24.2％ (15/62),以上组别之间比较差异均无统计学意义(P＞0.05).Corona Mortis动脉经过耻骨上支的交点至耻骨联合上边缘的距离平均为(53.70 ±4.00) mm. 结论 CTA三维重建可清晰观察到Corona Mortis动脉.采用髂腹股沟入路和Stoppa入路行骨盆髋臼骨折手术前建议先行腹主动脉CTA检查,以明确是否存在该血管.术中剥离至距离耻骨联合上边缘(53.70±4.00) mm处的耻骨上支表面时,应高度警惕该变异血管的存在.
목적 재CT혈관조영(CTA)삼유중건도상상관찰Corona Mortis동맥적존재솔급위치,이기위골분、관구골절적수술입로제공해부학기출.방법 회고성분석2010년12월지2012년5월기간행복주동맥CTA검사적80례(160개반골분)환자자료,남34례,녀46례；년령19 ～ 84세,평균47.2세.이용Mimics 10.01연건대환자골분CTA.dicom격식원시수거진행삼유중건,재삼유도상상관찰Corona Mortis동맥,기록해혈관적지수급기원,병측량해혈관여치골연합적거리.비교좌우량측반골분、남녀성급년령≤50세조여년령＞ 50세조지간Corona Mortis동맥존재솔적차이. 결과 공발현29조Corona Mortis동맥,존재솔위18.1％ (29/160).좌측화우측Corona Mortis동맥존재솔분별위17.5％ (14/80)、18.8％ (15/80);남성여녀성Corona Mortis동맥존재솔분별위19.1％ (13/68)、17.4％ (16/92),년령≤50세조여년령＞50세조Corona Mortis동맥존재솔분별위14.3％ (14/98)、24.2％ (15/62),이상조별지간비교차이균무통계학의의(P＞0.05).Corona Mortis동맥경과치골상지적교점지치골연합상변연적거리평균위(53.70 ±4.00) mm. 결론 CTA삼유중건가청석관찰도Corona Mortis동맥.채용가복고구입로화Stoppa입로행골분관구골절수술전건의선행복주동맥CTA검사,이명학시부존재해혈관.술중박리지거리치골연합상변연(53.70±4.00) mm처적치골상지표면시,응고도경척해변이혈관적존재.
Objective To investigate the incidence and location of the corona mortis artery by means of three dimensional (3D) reconstruction of computerized tomography angiography (CTA) as well as the clinical significance of the knowledge in the treatment of pelvic and acetabular fractures via ilioinguinal and Stoppa approaches.Methods Radiological and clinical data from 80 patients (160 hemi-pelvises) undergoing aorta abdominalis CTA between Deeember 2010 and May 2012 were collected.This study involved 34 males and 46 females,aged from 19 to 84 years (average,47.2 years).The.dicom format CTA data were used for 3D reconstruction using the Mimics software.The incidence and origin of the corona mortis artery crossing the superior pubic ramus into the obturator foramen were observed and the distances between the corona mortis artery and the pubic symphysis were measured on the 3D reconstruction images.The incidences were compared between hemi-pelvises,genders and age groups of ≤50 and ＞ 50 years.Results In the 160 hemi-pelvises,altogether 29 corona mortis arteries were detected,giving a total incidence of 18.1％ (29/160).Of them,14(14/80,17.5％) were found on the left side and 15 (15/80,18.8％) on the right; 16(16/92,17.4％) in the female patients and 13 (13/68,19.1％) in the male patients; 14 (14/98,14.3％) in the ≤50 age group and 15(15/62,24.2％) in the ＞ 50 age group.There were no significant differences regarding the incidence between hemi-pelvises,genders or age groups (P ＞ 0.05).The distances between the corona mortis artery and the pubic symphysis averaged 53.70 ±4.00 mm.Conclusions Since CTA 3D reconstruction images can clearly demonstrate the corona mortis artery,abdominal aorta CTA should be recommended before operative treatment of pelvic and acetabular fractures via the ilioinguinal and Stoppa approaches to make sure that no operative accident will occur due to presence of the corona mortis artery.We should be alert to this artery variation when stripping the suprapubic area 53.70 ± 4.00 mm to the edge of the pubic symphysis.