解剖学和影像学观察寰枢关节及相关结构的对比研究

目的:评价解剖学和影像学方法观察寰枢关节(AAJ)及相关结构的优缺点及应用价值。方法:对8例寰枢关节段尸体解剖标本进行解剖学和影像学对比研究,观察椎动脉寰枢段(VA-A)、第1、2脊神经(CN1,CN2)以及AAJ滑膜皱襞(SF)的解剖,测量它们的大小及位置关系值。结果:CN1出椎管后向外下走行于寰椎后弓上缘及VA下缘,CN2出椎管后走行于寰、枢椎后弓之间及VA后。SF存在于寰枢中央前关节6例,寰枢外侧关节5例。VA-A沿AAJ走行,有4个弯曲,其中第2、4个弯曲远离其骨结构。CN1、CN2到VA-A距离范围分别为0.0~2.2 mm、0.0~3.6 mm,VA2个弯曲行程远离AAJ骨结构距离范围分别为0.0~4.8 mm、2.0~7.9 mm,解剖及影像测量值统计学比较差异无统计学意义(P0.05)。结论:解剖学方法有利于观察CN和SF,影像学方法显示VA-A与AAJ清楚。两者具有互补性,得到的测量值相当,结合应用为研究该区域的复杂解剖提供了新的手段。

Comparative Study of Anatomy and Imageology in Observing Relational Structures of Atlanto-axial Joint

Objective：To evaluate the application and characteristics of anatomy and imageology in observing atlanto-axial joint（AAJ） and relational structures.Methods：AAJ segments of 8 cadaveric specimens were studied with both anatomical and imaging methods.Vertebral arteries of AAJ segment（VA-A）,the first and second cervical nerve（CN1,CN2）,and synovial fold（SF） of AAJ were observed and measured.Results：After extending from vertebral canal,CN1 goes between the posterior arch of atlas and VA-A,and CN2 passes between the posterior arch of the atlas and axis posterior to VA-A.Among the 8 cases,SF in central anterior AAJ was found the 6 cases and in articulatio atlantoaxialis lateralis in 5 cases.VA-A goes along AAJ with 4 curves,in which the second and fourth VA-A were away from the bone structure of AAJ.The distance from CN1,CN2 to VA-A and that from the second,fourth curve of VA-A to AAJ is 0.0~2.2mm,0.0~3.6mm and 0.0~4.8mm,2.0~7.9mm,respectively.There was no significant difference between the measurements of anatomical and imaging method（P0.05）.Conclusion：Anatomical method has advantages in obseving the CN and SF,while the imaging method shows clearly and directly the VA-A and AAJ.Both are mutually complementary with consistent measurements.The combination of two methods provides a new way to study the complicated anatomy in this region.