CAJ | 학술논문

目的利用虚拟现实技术(VR)观测上矢状窦(SSS)及桥静脉(BrV)的形态特征,并探讨其临床意义. 方法选择南京军区福州总医院神经外科自2011年10月至2013年3月收治的43例上矢状窦旁脑膜瘤(PSM)患者(PSM组)及21例无颅内静脉系统病变的三叉神经痛或面肌痉挛患者(正常组).VR环境下,观测2组患者SSS及窦旁BrV的形态特征,分析皮质静脉数量、直径在正常组双侧和SSS前、中、后1/3段间以及2组之间的差异. 结果 2组患者中,首次共观察到4例患者的SSS后部有形态变异.BrV注入SSS的方式以逆行最多,主要集中在SSS的中、后1/3段;SSS前1/3段的BrV有多种注入SSS的方式,以垂直方式最多.正常组皮质静脉的数量和直径,在SSS双侧差异无统计学意义(P＞0.05);皮质静脉数量在SSS前、中、后1/3段之间差异有统计学意义(P＜0.05),静脉直径差异无统计学意义(P＞0.05).PSM组的皮质静脉数量少于正常组,直径也小于正常组,差异均有统计学意义(P＜0.05).随着PSM的生长,SSS和皮质静脉受侵犯程逐渐加重,影响静脉回流,导致侧支静脉逐渐增多和变复杂. 结论 SSS及BrV存在一定的变异性,BrV注入SSS的方式可能与颅内静脉系统的血流动力学有关.VR技术可以清晰、立体地观察SSS和皮质静脉,解析PSM导致的静脉循环改变.
목적 이용허의현실기술(VR)관측상시상두(SSS)급교정맥(BrV)적형태특정,병탐토기림상의의. 방법 선택남경군구복주총의원신경외과자2011년10월지2013년3월수치적43례상시상두방뇌막류(PSM)환자(PSM조)급21례무로내정맥계통병변적삼차신경통혹면기경련환자(정상조).VR배경하,관측2조환자SSS급두방BrV적형태특정,분석피질정맥수량、직경재정상조쌍측화SSS전、중、후1/3단간이급2조지간적차이. 결과 2조환자중,수차공관찰도4례환자적SSS후부유형태변이.BrV주입SSS적방식이역행최다,주요집중재SSS적중、후1/3단;SSS전1/3단적BrV유다충주입SSS적방식,이수직방식최다.정상조피질정맥적수량화직경,재SSS쌍측차이무통계학의의(P＞0.05);피질정맥수량재SSS전、중、후1/3단지간차이유통계학의의(P＜0.05),정맥직경차이무통계학의의(P＞0.05).PSM조적피질정맥수량소우정상조,직경야소우정상조,차이균유통계학의의(P＜0.05).수착PSM적생장,SSS화피질정맥수침범정축점가중,영향정맥회류,도치측지정맥축점증다화변복잡. 결론 SSS급BrV존재일정적변이성,BrV주입SSS적방식가능여로내정맥계통적혈류동역학유관.VR기술가이청석、입체지관찰SSS화피질정맥,해석PSM도치적정맥순배개변.
Objective To investigate the morphological characteristics of superior sagittal sinus (SSS) and bridging vein (BrV) with virtual reality (VR) technology and their clinical significances.Methods Forty-three patients with parasagittal meningioma (PSM group) and 21 patients with trigeminal neuralgia or hemifacial spasm who had no intracranial venous system diseases (normal group),admitted to our hospital from October 2011 to March 2013,were chosen.The morphological characteristics of SSS and parasagittal BrV of patients from the 2 groups were observed,which was finished in the VR workstation.The number and diameter differences of cortical veins between the 2 groups,and bilatelal side and the first,middle and third 1/3 of SSS of normal group were analyzed.Results Among the patients from the 2 groups,4 having SSS extremity with morphological variation were observed firstly.The direction of BrV entering the SSS mainly was retrograde,which concentrated in the middle and third 1/3 of SSS.There were many directions of BrV entering the SSS in the first 1/3 of SSS,and the direction mostly was perpendicular.In normal group,there were no statistical differences of number and diameter in the bilatelal cortical veins (P＞0.05); in the first,middle and third 1/3 of SSS,there was statistical difference of cortical veins number (P＜0.05),but no difference of diameter (P＞0.05).The number and diameter of cortical veins of PSM group were under the normal group,with statistically significant difference (P＜0.05).With the growth of PSM,violations of SSS and cortical venous gradually aggravated,affecting venous return,which resulted in increase number and complication of collateral veins.Conclusions There is certain variability of SSS and related BrV.The direction of BrV entering the SSS may be associated with intracranial venous system hemodynamic.It is clear and three-dimensional to observe SSS and cortical veins in the help of VR,and to analyze the venous circulation changes caused by PSM.