大脑外侧裂影像解剖学研究及其临床意义

目的：探讨大脑外侧裂在MRI横断面图像上的形态学规律及临床意义。方法：采集30名正常成人颅脑连续横断面MRI数据，在e—film2．1工作站中，采取连续追踪法及3D—Cursor技术准确识别外侧裂，将图像导入AdobePhotoshopCS8．0软件包中标记外侧裂并观测、统计其形态学特征。结果：外侧裂在Z=-18～33mm层面范围内出现，随着层面下移依次呈现“一”字型、“Y”型、“T’’型、“L”型和“一”字型的变化规律。依据从下向上岛叶在层面上的出现和消失的规律将外侧裂分为三段。第一段，从外侧裂出现到岛叶出现层面；第二段，从岛叶出现到岛叶消失层面；第三段，从岛叶消失到外侧裂消失层面。左右半球三段垂直深度差异均无统计学意义（P〉0．05）。右侧大脑半球在Z=6～9mm范围内，左侧大脑半球在Z=9—15mm范围内大脑外侧裂弯曲折叠，左侧多于右侧。结论：大脑外侧裂MRI横断面图像上的形态学研究，可为外侧裂及相邻脑区病变的识别和定位，经外侧裂行鞍区、岛叶区及基底核区手术人路部位的选择提供解剖学资料。

The imaging anatomy study of sylvian fissure and its clinical significance

Objective：To investigate the morphological pattern of sylvian fissure in the cross-sectional MRI images and its clinical significance. Methods：The cross-sectional MRI data of 30 normal adults＇ brain were collected. The sylvian fissure was accurately identified using continuous tracking method and the 3D-Cursor technology in e-film 2.1 workstation, the images of sylvian fissure were imported into Adobe Photoshop CS 8.0 package and observed, their morphological characteristics were analysed. Results：Sylvian fissure occurred at the level of Z = - 18 to 33 mm. With the present level down,the sylvian fissure showed gradually type ＂ - ＂ ,＂ Y＂ ,＂ T＂ ,＂ L＂ and ＂ - ＂ variation. The sylvian fissure was divided into three sections according to the appearance and disappearance pattern of the insula from the bottom up. The first section located from the aspect of sylvian fissure appearance to the insula disappearance, the second section located from the aspect of the insula appearance to disappearance, the third section located from the aspect of insula disappearance to sylvian fissure disappearance. The differences of vertical depth in three sections of left and right hemisphere had no statistical significance（P 〉0.05）. During the range of Z = 6 to 9 mm in right hemisphere and Z = 9 to 15 mm in left hemisphere, sylvian fissure was bent and folded, which in left side was significantly more than that in right side. Conclusions：The morphological pattern of sylvian fissure in the MRI cross-sectional images can provide the basis of identifing and locating the adjacent brain lesion, and the anatomical information of the surgical approach choosing in saddle area,insula area and basal ganglia area operation.