CAJ | 학술논문

背景:解剖测量是临床医学的基础,可为临床影像学诊断与外科手术提供依据与参考.利用三维CT血管成像技术进行相关解剖测量具有明显的技术优势与很好的应用前景. 目的:应用64排螺旋CT血管成像对颈动脉分叉部的形态结构进行测量,为相关研究提供解剖基础.方法:查阅2008年6月至2010年6月于厦门大学附属中山医院影像科行头颈部64排螺旋CT血管成像受检者的扫描图像,随机选取颈动脉分叉部无明显病变者92例.其中男45例,女47例;≤40岁者40例,>40岁者52例.利用其断面图像进行三维成像处理,获得满意的三维图像后,对颈动脉分叉部相关结构进行解剖学测量. 结果与结论:三维图像可清晰显示颈动脉分叉部结构,实现其结构的单独和多结构、多方向观察及测量.测量结果显示受试者颈动脉分叉角为(43.5±12.3)°,颈总动脉远端内径(6.83±0.65) mm,颈内动脉膨大区近端内径(7.25±1.04) mm,颈内动脉膨大区最大内径(8.15±1.35) mm,颈内动脉膨大区远端内径(5.03±0.55) mm,颈外动脉内径(4.22±0.60) mm.与≤40岁组比较,>40岁组颈动脉分叉角度、颈内动脉膨大区近端内径、颈内动脉膨大区最大内径、颈内动脉膨大区远端内径均明显粗大,颈外动脉内径明显细小(P<0.05),而颈总动脉内径差异无显著性意义(P>0.05).与男性组比较,女性组颈动脉分叉部各测量指标均显著细小(P <0.05).左、右侧组测量值比较,除颈动脉分叉角左侧明显大于右侧外,其他测量指标差异均无显著性意义(P>0.05).三维CT可客观、准确测量颈动脉分叉部相关解剖值,具有个体化特征,可为相关应用解剖、疾病诊断及介入或手术治疗提供客观依据.
배경:해부측량시림상의학적기출,가위림상영상학진단여외과수술제공의거여삼고.이용삼유CT혈관성상기술진행상관해부측량구유명현적기술우세여흔호적응용전경. 목적:응용64배라선CT혈관성상대경동맥분차부적형태결구진행측량,위상관연구제공해부기출.방법:사열2008년6월지2010년6월우하문대학부속중산의원영상과행두경부64배라선CT혈관성상수검자적소묘도상,수궤선취경동맥분차부무명현병변자92례.기중남45례,녀47례;≤40세자40례,>40세자52례.이용기단면도상진행삼유성상처리,획득만의적삼유도상후,대경동맥분차부상관결구진행해부학측량. 결과여결론:삼유도상가청석현시경동맥분차부결구,실현기결구적단독화다결구、다방향관찰급측량.측량결과현시수시자경동맥분차각위(43.5±12.3)°,경총동맥원단내경(6.83±0.65) mm,경내동맥팽대구근단내경(7.25±1.04) mm,경내동맥팽대구최대내경(8.15±1.35) mm,경내동맥팽대구원단내경(5.03±0.55) mm,경외동맥내경(4.22±0.60) mm.여≤40세조비교,>40세조경동맥분차각도、경내동맥팽대구근단내경、경내동맥팽대구최대내경、경내동맥팽대구원단내경균명현조대,경외동맥내경명현세소(P<0.05),이경총동맥내경차이무현저성의의(P>0.05).여남성조비교,녀성조경동맥분차부각측량지표균현저세소(P <0.05).좌、우측조측량치비교,제경동맥분차각좌측명현대우우측외,기타측량지표차이균무현저성의의(P>0.05).삼유CT가객관、준학측량경동맥분차부상관해부치,구유개체화특정,가위상관응용해부、질병진단급개입혹수술치료제공객관의거.
@@@@BACKGROUND:Anatomic measurement is the basis of clinical medicines. It can provide basis and reference for clinical diagnosis and surgical operation. The anatomical measurement with 64-spiral CT angiography has the obvious technical superiority and good application prospect. @@@@OBJECTIVE:To measure the anatomical structure of the carotid artery bifurcation with 64-spiral CT angiography, and to provide anatomic basis for relevant researches. @@@@METHODS:A total of 92 subjects, who underwent 64-spiral CT angiography in head and neck without any pathology of carotid artery bifurcation from June 2008 to June 2010, were selected from Department of Radiology, Zhongshan Hospital Xiamen University. There were 40 male cases (≤40 years old) and 52 female cases (>40 years old). The cross-sectional images were processed with three-dimensional imaging to obtain the three-dimensional image and to measure the anatomical structure of the carotid artery bifurcation. @@@@RESULTS AND CONCLUSION:The three-dimensional images could clearly display the structure of carotid artery bifurcation and could achieve the mono-or multi-structure and multi-directional observation of structure. The measurement results showed the carotid artery bifurcation angle was (43.5±12.3)°, the distal inner diameter of the common carotid artery was (6.83±0.65) mm, the proximal inner diameter of the internal carotid artery enlargement area was (7.25±1.04) mm, the width of the internal carotid artery enlargement area was (8.15±1.35) mm, the distal inner diameter of the internal carotid artery enlargement area was (5.03±0.55) mm, and the inner diameter of the external carotid artery was (4.22±0.60) mm. Compared with the ≤ 40 years old group, the carotid artery bifurcation angle, proximal inner diameter of the internal carotid artery enlargement area, width of the internal carotid artery enlargement area and the distal inner diameter of the internal carotid artery enlargement area in the>40 years old group were increased significantly, while the inner diameter of the external carotid artery was smal (P<0.05), and there was no significant difference in inner diameter of common carotid artery between two groups (P>0.05). Compared with the male group, the measurement indexes of carotid artery bifurcation in the female group were significantly smal er (P<0.05). The carotid artery bifurcation angle on the left side was bigger than that on the right side, and there were no significant differences in the other measurement indexes of carotid artery bifurcation between left and right group (P>0.05). Three-dimensional CT image can objectively and accurately measure the anatomical values of carotid artery bifurcation. It has individual characteristics that can provide the objective basis for applied anatomy, disease diagnosis and surgery treatment.