CAJ | 학술논문

目的：从活体影像解剖学角度观察视交叉前间隙的形态特征，获取其相关参数，为神经外科鞍区手术提供影像学依据，并为神经解剖学提供基础研究。材料与方法对165例志愿者，男87例，女78例；年龄18～80岁，平均年龄44.6岁；按年龄分青年组(18～40岁)60名，中年组(41～60岁)60名，老年组(61～80岁)45名，行视交叉区T1WI MP-RAGE序列、T2WI TSE序列扫描。采用MPR技术在正中矢状面平行于视神经重建轴面MR图像，测量视神经颅内段长度及视交叉前角角度，计算前间隙面积，比较男女之间、年龄组之间及视神经颅内段左右之间各参数的差异性。结果本研究中视神经颅内段长度为(18.3±3.3) mm；左侧为(18.2±3.1) mm，右侧为(17.3±3.3) mm；青年组、中年组、老年组视神经颅内段分别为(17.6±3.1) mm、(18.3±3.0) mm、(17.3±3.2) mm。165名志愿者中，163名视交叉前间隙大致呈三角形，2名近似梯形，其面积为(44.7±7.7) mm2；青年组、中年组、老年组前间隙面积分别为(47.1±6.5) mm2、(45.6±6.9) mm2、(43.7±7.0) mm2。视交叉前角为(72.7±7.4)°；青年组、中年组、老年组视视交叉前角分别为(69.5±7.9)°、(72.5±7.8)°、(72.3±8.0)°。所有测量参数男女之间差异均无统计学意义(P值均＞0.05)；视神经颅内段年龄组之间差异有统计学意义(P＜0.05)；视交叉前间隙面积、视交叉前角年龄组之间差异无统计学意义(P值均＞0.05)；视神经颅内段左右之间差异无统计学意义(P＞0.05)。结论 MRI及后处理技术能清晰显示视交叉前间隙的形态特征，准确测量其相关参数，建立正常人群的标准参考值，为临床诊断及手术提供基本影像学依据。
목적：종활체영상해부학각도관찰시교차전간극적형태특정，획취기상관삼수，위신경외과안구수술제공영상학의거，병위신경해부학제공기출연구。재료여방법대165례지원자，남87례，녀78례；년령18～80세，평균년령44.6세；안년령분청년조(18～40세)60명，중년조(41～60세)60명，노년조(61～80세)45명，행시교차구T1WI MP-RAGE서렬、T2WI TSE서렬소묘。채용MPR기술재정중시상면평행우시신경중건축면MR도상，측량시신경로내단장도급시교차전각각도，계산전간극면적，비교남녀지간、년령조지간급시신경로내단좌우지간각삼수적차이성。결과본연구중시신경로내단장도위(18.3±3.3) mm；좌측위(18.2±3.1) mm，우측위(17.3±3.3) mm；청년조、중년조、노년조시신경로내단분별위(17.6±3.1) mm、(18.3±3.0) mm、(17.3±3.2) mm。165명지원자중，163명시교차전간극대치정삼각형，2명근사제형，기면적위(44.7±7.7) mm2；청년조、중년조、노년조전간극면적분별위(47.1±6.5) mm2、(45.6±6.9) mm2、(43.7±7.0) mm2。시교차전각위(72.7±7.4)°；청년조、중년조、노년조시시교차전각분별위(69.5±7.9)°、(72.5±7.8)°、(72.3±8.0)°。소유측량삼수남녀지간차이균무통계학의의(P치균＞0.05)；시신경로내단년령조지간차이유통계학의의(P＜0.05)；시교차전간극면적、시교차전각년령조지간차이무통계학의의(P치균＞0.05)；시신경로내단좌우지간차이무통계학의의(P＞0.05)。결론 MRI급후처리기술능청석현시시교차전간극적형태특정，준학측량기상관삼수，건립정상인군적표준삼고치，위림상진단급수술제공기본영상학의거。
Objectives: To study and measure the prechiasmatic interspaces on the images in human beings, in order to provide imaging evidence for sellar region neurosurgery operation and basic research for neuroantomy.Materials and Methods:Totally 165 volunteers (87 males and 78 females, age 18 to 80 years, mean 44.6 years), who were divided into three groups by age, young(18—40 years), 60, middle-age (41—60 years), 60 and elderly age group (61—80 years), 45 underwent optic chiasm MR scan with T1 weighted MP-RAGE and T2 weighted TSE sequence. The reconstructed images of axial section parallel with optic nerve were obtained with MPR analysis software on midsagittal images. The length of the intracranial optic nerves and anterior horn of optic chiasma were measured, the area of prechiasmatic interspace was calculated as well. The difference between genders, ages and the left and right intracranial optic nerves were compared.Results:In our studies, mean values of the length of intracranial optic nerves were (18.3±3.3) mm, (18.2±3.1) mm for left and (17.3±3.3) mm for right, (17.6±3.1) mm, (18.3±3.0) mm, (17.3±3.2) mm in young, middle-age and elderly age group. the prechiasmatic interspace was triangular shape for163, trapezoid shape for 2 and its area was (44.7±7.7) mm2,(47.1±6.5) mm2, (45.6±6.9) mm2, (43.7±7.0) mm2 in young, middle-age and elderly age group. the anterior horn of optic chiasm was (72.7±7.4) degree, (69.5±7.9)°, (72.5±7.8)°, (72.3±8.0)° in young, middle-age and elderly age group. All the results did not show signiifcant differences between male and female (P>0.05). The length of both intracranial optic nerves had statistical signiifcance difference between age groups (P<0.05). There were no statistically signiifcant difference of the anterior horn of optic chiasm and the area of prechiasmatic interspace between age groups (P>0.05). There were no statistically signiifcant difference of intracranial optic nerves length between left and right (P>0.05).Conclusions:The characteristics of the prechiasmatic interspaces and its adjacent anatomical structures can be well shown on MR images and measure and establish reference values of parameters for clinical diagnosis and neurosurgery.