大脑中动脉M1段解剖与CT血管造影对照研究及其临床价值

目的 研究大脑中动脉M1段的解剖结构及其穿支的开口位置,为该段血管性疾病的介入治疗提供解剖学依据.方法 选取24例头颅标本作为解剖组,经双侧翼点入路进行解剖,观察大脑中动脉M1段的解剖结构及其穿支;同时选取张家口市第一医院2014年7月至2016年6月期间45例无明确脑部血管病变患者的脑血管CT血管造影(CTA)资料作为CTA组,观察大脑中动脉M1段的影像解剖及穿支开口位置.结果 解剖组及CTA组所测量大脑中动脉M1段的长度、管径分别为(12.44±1.74)mm、(3.00±0.23)mm和(10.13±2.42)mm、(2.23±0.25)mm,两组测量数据比较差异均有统计学意义(P均<0.05);CTA组显示男性大脑中动脉M1段管径平均值为(2.31±0.24)mm,大于女性组的(2.15±0.24)mm,差异有统计学意义(P<0.05).结论 大脑中动脉M1段的解剖与CTA影像解剖对照有助于该段血管病变介入治疗时支架类型和支架置入部位的选择,对防止介入术后中央支供血区域缺血的发生具有重要临床指导意义.

Comparative study of M1 segment of middle cerebral artery in anatomy and CT angiography and its clinical value

Objective To study the anatomical structure and original of branches of M1 segment of middle ce-rebral artery, and provide the anatomical basis for interventional treatment of the vascular disease. Methods Twenty-four head specimens were selected as the specimens group. The branches and anatomical structure of M1 segment of middle ce-rebral artery was observed by the anatomy of bilateral pterional approach. At the same time, 45 patients without brain vas-cular lesions of cerebral vessel, who admitted to and underwent CT angiography in the First Hospital of Zhangjiakou City from July 2014 to June 2016, were selected as the CTA group, and the branches and structure of the M1 segment of middle cerebral artery was observed. Results The length and diameter of the M1 segment of middle cerebral artery in the speci-mens group and CTA group were respectively (12.44 ± 1.74) mm, (3.00 ± 0.23) mm, (10.13+2.42) mm, (2.23 ± 0.25) mm, with significant differences between the two groups in the above-mentioned measurement data (P<0.05). The average di-ameter of the M1 segment of the middle cerebral artery of males in CTA group was (2.31±0.24) mm, which was signifi-cantly larger than (2.15 ± 0.24) mm of the females (P<0.05). Conclusion The anatomy of M1 segment of middle cere-bral artery and CTA image are helpful to choose stent type and placement site in the interventional treatment of vascular disease. It is important to prevent the occurrence of ischemia in the central branches after the interventional therapy.