多层螺旋CT血管成像对面动脉的解剖学研究

目的 利用16排螺旋CT血管造影技术(CTA)对面动脉进行解剖学研究.方法 挑选已行CTA检查并无血管及其他病变的病例共45例,采用荷兰PHILIPS公司Brilliance 16排螺旋CT,经肘静脉注入欧乃派克350 mgI/ml.后处理技术主要采用MIP及Volume Render(VR),按左右面动脉分别进行统计.结果 左侧面动脉:45例中有44例(97.8%)起自颈外动脉,距离颈动脉分叉处4.50～47.90 mm,平均(18.77±8.98)mm;1例(2.2%)起自颈总动脉.右侧面动脉:45例(100%)均起自颈外动脉,距离颈动脉分叉处6.80～39.70mm,平均(19.23±8.25)mm.双侧面动脉均以独立起于颈外动脉多见,其次为舌、面动脉共干起于颈外动脉,左侧面动脉中颏下动脉与面动脉共于以及甲、舌、面动脉共干各1例.左侧面动脉干管径1.40～4.70 inln,平均(2.83±0.77)mm;右侧面动脉干管径1.60～4.30mm,平均(2.8±0.79)mm.左侧面动脉终止于口角以下12例(26.67%),口角至鼻翼之间7例(15.56%),鼻翼以上26例(57.77%).右侧面动脉终止于口角以下7例(15.56%),口角至鼻翼之间12例(26.67%),鼻翼以上26例(57.77%).双侧面动脉均以穿过下颌下腺实质多见(左侧23例、右侧24例),其次为下颌下腺深面走行(左侧11例、右侧9例).结论 16排螺旋CTA可以无创性术前评价面动脉,借助功能强大的后处理功能,可以清晰显示双侧面动脉的起源、走行、分布及中止部位.为临床医师提供详细的资料,有利于整形外科的皮瓣设计和显微血管外科手术的术前评价.

Anatomic study of the facial artery using multislice spiral CT angiography

OBJECTIVE: To study the anatomy of the facial artery using 16-slice spiral CT angiography (CTA). METHODS: Forty-five patients without vascular pathologies or other anomalies underwent 16-slice spiral CT angiography after injection of 350 mg I/ml Omnipaque through the ulnar vein. MIP and volume rendering of the images were performed to analyze the left and right facial artery. RESULTS: The left facial artery arose from the external carotid artery with the distances from the carotid artery bifurcation of 4.5-47.90 mm (mean 18.77-/+8.98 mm), and in 1 case (2.2%), the artery arose from the common carotid artery. The right facial artery arose from the external carotid artery in all the 45 cases (100%) with distances from the carotid artery bifurcation of 6.8-39.70 mm (mean 19.23-/+8.25 mm). The bilateral facial arteries more commonly arose from the external carotid artery independently, and the lingual artery and facial artery sharing the same trunk arising from the external carotid artery was less common. In 1 case, the left facial artery and the submental artery shared the same trunk, and in another case, the left facial artery, thyroid artery and lingual artery shared the same trunk. The diameter of the left facial artery ranged from 1.40 to 4.70 mm (mean 2.83-/+0.77 mm), and that of the right facial artery was 1.60-4.30 mm (mean 2.81-/+0.79 mm). The left facial artery ended below the angle of the mouth in 12 cases (26.67%), between the angle of the mouth and the nasal wing in 7 cases (15.56%), and above the nasal wing in 26 cases (57.77%). The right facial artery ended below the angle of the mouth in 7 cases (15.56%), between the angle of the mouth and the nasal wing in 12 cases (26.67%), and above the nasal wing in 26 cases (57.77%). The bilateral facial arteries frequently passed through the submandibular gland parenchyma (23 cases on the left and 24 cases on the right), and the facial arteries were found occasionally to run below the submandibular gland (11 cases on the left and 9 on the right). CONCLUSION: 16-slice spiral CT angiography can help in preoperative facial artery evaluation noninvasively. This modality can clearly display the bilateral facial arteries, including their origin, course, distribution and ending to provide detailed information for flap designing before plastic surgery and for preoperative evaluation for microvascular surgery.