横窦与颅外骨性标志线位置关系的CT重建图像及其临床意义

目的: 采用枕外隆凸和乳突最低点连线作为标志线定位横窦在颅骨表面的体表投影,为小脑幕上下手术入路时避免横窦损伤提供形态学基础。方法: 对80名志愿者进行CT扫描,采用CT重建技术构建颅骨3D模型以进行结构标记和测量,以枕外隆凸最高点(A)与乳突最低点(B)连线作为标志线描绘横窦沟至该标志线的距离和横窦沟宽度。结果: 横窦沟中部标志点J处横窦沟宽度d右边测量值大于左边(t=5.232,P<0.05);横窦沟标志点至连线AB的测量指标h1、h2、h3、h4、h5、s1、s2、BE、BD、BJ和BI的左右测量值比较差异无统计学意义(P>0.05);横窦沟标志点至连线AB的测量指标h1、h2、h3、h4、h5、s1、s2、d、BE、BD、BJ和BI的男女测量值比较差异无统计学意义(P>0.05)。结论: 采用CT重建图像在二维平面上可精确地获得横窦沟在颅骨表面的体表投影数据,该方法简单、便捷、实用,且术中易于操作,对术中开颅保护横窦具有指导意义。

CT reconstruction images of positional relationship between transverse sinus and connecting line of bone landmarks and its clinical significance

Objective: To locate the surface projection of transverse sinus on the skull using the connecting line between inion and low point of mastoid,and to provide the morphological foundation for infratentorial-supracerebellar approaches and other related approaches and to protect the transverse sinus. Methods: Eighty adult cases were scanned with thin-section CT.The skull 3D model was rebuilt by CT reconstruction technology for the marking of structures and measurements.The connecting line between the inion(A) and the low point of mastoid (B) was chosen as the marker line,and the morphological parameters of distances and projection from the groove of the transverse sinus to the connecting line were measured. Results: The width of marker point J in middle of transverse sinus on the right hemisphere was bigger than that on the left hemiphere (t=5.232,P<0.05);there were no statistical differences in the measurement values of h1,h2,h3,h4,h5,s1,s2,BE,BD,BJ, and BI from the marker points of groove of transverse sinus to the connecting line AB between two cerebral hemispheres(P>0.05);there were no statistical differences in the measurement values of h1,h2,h3,h4,h5,s1,s2,BE,BD,BJ,and BI from the marker points of groove of transverse sinus to the connecting line AB between genders (P>0.05). Conclusion: The surface projection of transverse sinus is obtained accurately with CT reconstruction image.The method is simple and accessible which can guide to protect transverse sinus during the operation.