CAJ | 학술논문

目的:探讨舌咽神经、迷走神经和副神经的走行和毗邻关系,为影像学诊断及临床开展该区手术提供形态学依据.方法:利用36例成尸头部连续横断层标本和15例成尸头部连续冠状断层标本,并与10例志愿者的3D-CISS序列MR图像进行对照,观察舌咽神经、迷走神经和副神经在颅内的走行规律及其与周围结构的位置关系.结果:舌咽、迷走和副神经由上而下从延髓的橄榄后沟发出,跨过延池,穿颈静脉孔出颅.根据走行,可分其为延髓内段、脑池段和颈静脉孔段.在脑池段,舌咽神经走行在上方,迷走神经和副神经在下方且结合紧密;在颈静脉孔段,这3对脑神经及其与颈内静脉和颈内动脉的关系是:颈内动脉位于最前方,颈内静脉位于最外侧,舌咽神经走行在前内上方,有单独的硬脊膜包绕,迷走神经和副神经位于其后外下方,形成迷走、副神经复合体.结论:在标本的连续断面和对应的MR图像上能够清楚地显示舌咽、迷走和副神经的走行和毗邻关系.
목적:탐토설인신경、미주신경화부신경적주행화비린관계,위영상학진단급림상개전해구수술제공형태학의거.방법:이용36례성시두부련속횡단층표본화15례성시두부련속관상단층표본,병여10례지원자적3D-CISS서렬MR도상진행대조,관찰설인신경、미주신경화부신경재로내적주행규률급기여주위결구적위치관계.결과:설인、미주화부신경유상이하종연수적감람후구발출,과과연지,천경정맥공출로.근거주행,가분기위연수내단、뇌지단화경정맥공단.재뇌지단,설인신경주행재상방,미주신경화부신경재하방차결합긴밀;재경정맥공단,저3대뇌신경급기여경내정맥화경내동맥적관계시:경내동맥위우최전방,경내정맥위우최외측,설인신경주행재전내상방,유단독적경척막포요,미주신경화부신경위우기후외하방,형성미주、부신경복합체.결론:재표본적련속단면화대응적MR도상상능구청초지현시설인、미주화부신경적주행화비린관계.
@@@@ Objective:To explore the course and adjacent structures of glossopharyngeal , vagus and ac-cessory nerves in order to provide intimate morphological data for clinical image diagnosis and surgical opera -tions of the diseases in this region .Methods:Serial transverse sections of 36 Chinese adult head specimen and serial coronal sections of 15 head specimen were obtained to investigate the course and adjacent structures rela -tionship of the glossopharyngeal , vagus and accessory nerves in the cranial cavity with the corresponding 3D-CISS MR images.Results:The glossopharyngeal, vagus and accessory nerves originated from the retroolivary sulcus of medulla oblongata , crossed the medulla oblongata cistern and passed through the jugular foramen to the out of cranium.According to their course, the three cranial nerves could be divided into inter -medullar oblongata segment, cistern segment and jugular foramen segment .In the cistern segment, the glossopharyngeal nerve ran upside, the vagus nerve and accessory nerve ran downside and combined together tightly .In the jugu-lar foramen segment, the relationship between the three cranial nerves and vessels were as follows :the internal carotid artery lied in the most anterior part , the internal carotid vein lay extreme -lateral, the glossopharyngeal nerve ran cross the anteromedial superior part with a sole spinal dura mater covered , the vagus nerve and acces-sory nerve combined together to form a complex and ran posterolateral inferior to it .Conclusions:Combining se-rial sections with 3D-CISS MR images offers a better understanding of the course and adjacent structures of glossopharyngeal, vagus and accessory nerves , especially the identification of key structures .