颈内动静脉与颅底骨三维空间关系

目的 :显示对比正常侧和病变侧颈内动静脉与周围骨结构的解剖关系 ,以完善术前准备。方法 :10例颌颈部肿瘤患者 ,术前行颈动脉三维CT血管成像 (CTA) ,同步注射造影剂 ,螺旋CT对病变区血管段进行重点薄层螺旋扫描 ,由EasyVision工作站三维重建。结果 :5例颈外动脉和颈内静脉受压狭窄 ,其中 3例出现颈总动脉、颈内动脉向内侧移位 ,另 1例左侧颈内动脉动脉瘤清晰定位。CTA能够显示病变区血管段 (包括颈总动脉、颈内动脉、颈外动脉、颈内静脉 )与下颌骨、舌骨、颈椎、颅底骨结构的三维解剖关系 ,进行旋转、放大 ,三维测量 ,多视角观察 ,无重叠干扰。结论 :对颌颈、口咽部肿瘤患者术前CTA检查 ,能够判断颈部大血管的情况及颈部巨大肿瘤造成颈内动脉移位 ,CTA可显示血管性肿瘤的三维形状和与颅底骨空间关系 ,为手术入路及术式提供参考 ,有助于降低手术风险

The three dimensional spatial relationship between the carotid artery and skull base

Objective:To compare the normal carotid artery and abnomal carotid artery inskull base via computerized topographic angiography (CTA).Methods:Contrast mediums were administrated intravenously during the three dimensional CT imaging in ten patients with tumor in mandible or neck.Three dimensional CTA imaging were reconstructed compared and analyzed on Easy Vision Workstaion.Results:Stenosis of extenal carotid artery and internal jugular artery were found in five cases.Displacement of the internal carotid artery in three of them was detected.The aneurysm in the left internal carotid artery was clearly located in another case.The images of the cervical vessels (external carotid artery,intemal carotid artery,carotid bifurcation and intemal jugular )of both sides and the skull bass were displayed in arbitrary views without disturbing superposition by cutting,rotating and 3D measurement procedures.Conclusions:Some large cervical tumor could change the position of the carotid artery.CTA was able to display the shape and localization of aneurysm and this could reduce the risk of operation.