颅底动脉解剖影像特征的量化研究及其临床意义

目的　探讨颅底动脉的内径、各主要动脉之间所构成的角度、颈内动脉 (ICA)解剖三维影像特征 (3D特征 )以及Willis环的变异情况。方法　对 30具甲醛固定的成人湿头颅标本的颅底动脉进行乳胶灌注后解剖观察和测定 ,同时对 6 2例脑血管病 (CVD)患者ICA及其分支的 3D特征进行观察和分析。结果　 (1)颅底各主要动脉的内径 :ICA起始部左为 5 12mm± 1 4 8mm ;右为 5 11mm±1 4 2mm ;MCA起始部左为 2 93mm± 1 4 4mm ;右为 2 92mm± 1 4 6mm ;ACA起始部左为 2 6 3mm±1 33mm ;右为 2 6 1mm± 1 32mm ;VA颅外段左为 4 37mm± 1 2 1mm ;右为 3 2 2mm± 1 6 4mm ;BA近心端为 4 4 5mm± 1 2 8mm ;PCA起始部左为 2 6 2mm± 1 36mm ;右为 2 6 1mm± 1 2 2mm。 (2 )颅底各主要动脉所构成的角度 :虹吸部近心端与虹吸部远心端为左 32°± 2 2° ;右为 36°± 2 8°;ICA与ACA左为4 3°± 2 6° ;右为 4 6°± 2 8°。 (3)ICA解剖特征和 3D特征分级具有一致性 (P >0 0 5 ) ,Ⅳ级病例血管内治疗 (EVT)成功率低。 (4 )Willis环的变异分型 :普通型 17具 (占 5 6 7% ) ;前型 5具 (占 16 7% ) ;后型 6具 (占 2 0 0 % ) ;前后型 2具 (占 6 7% )。结论　颅底动脉内径的测量值有助于EVT中各种导管的选择 ;颅底各主

Anatomical study and three dimensional image characteristic analysis of basicranial artery and its clinical significance

OBJECTIVE: To observe and measure the inside diameter of basicranial arteries, the angulation of main arteries, the three dimensional image characteristic of internal carotid arteries and the anatomical variation of Willis circle. METHODS: The arteries of 30 formalin-fixed adult heads were injected with latex after which the caliber and characteristic of cerebral arteries were observed and measured. The three dimensional image characteristic of internal carotid arteries and its branches were measured using 3D-DSA. RESULTS: (1) Main artery caliber: origin of internal carotid artery (Left 5.12 +/- 1.48 mm; Right 5.11 +/- 1.42 mm); origin of middle cerebral artery (Left 2.93 +/- 1.44 mm; Right 2.92 +/- 1.46 mm); origin of anterior cerebral artery (Left 2.63 +/- 1.33 mm; Right 2.61 +/- 1.32 mm); origin of vertebral artery (Left 4.37 +/- 1.21 mm; Right 3.22 +/- 1.64 mm); origin of basilar artery (4.45 +/- 1.28 mm); origin of posterior cerebral artery (Left 2.62 +/- 1.36 mm; Right 2.61 +/- 1.22 mm). (2) The angulation of main arteries: C1, 2 of ICA and C4, 5 of ICA (Left 32 +/- 22 degrees; Right 36 +/- 28 degrees ); ICA and ACA (Left 43 +/- 26 degrees; Right 46 +/- 28 degrees). (3) The results show that anatomical and three dimensional image characteristic of internal carotid arteries have no difference (P > 0.05). (4) The anatomical variation of Willis circle: Type O (56.7%); Type A (16.7%); Type P (20.0%); Type AP (6.7%). CONCLUSIONS: It is helpful to measure the inside diameter of basicranial arteries for the selection of various catheter in interventional neuroradiology, to observe the angulation of main arteries and the three dimensional image characteristic of internal carotid arteries for the moulding of various catheter in endovascular therapy and to master the anatomical variation of Willis circle for decreasing complications of endovascular treatment and judging prognosis of cerebrovascular diseases.