咽鼓管薄层断面与磁共振成像对照研究

目的研究咽鼓管和毗邻结构的断面形态及相互解剖关系,为临床影像学诊断提供解剖学依据.方法利用生物塑化技术,将9侧咽鼓管区及相邻结构制成三个平面(横断、冠状位及矢状位)的薄层断层标本,并与磁共振成像(MRI)对照,观察咽鼓管及毗邻结构在各方位的走行与解剖关系.结果在横断、冠状断面上可较好显示咽鼓管的正常解剖结构及毗邻关系,咽鼓管纤维软骨位于咽鼓管后内侧,其上缘向外弯曲形成软骨部的顶.咽鼓管咽筋膜封闭咽鼓管前外侧并向下延伸构成咽鼓管的下壁.腭帆张肌位于咽鼓管前外侧,腭帆提肌位于其外后下方.粘膜下筋膜位于腭帆提肌的内侧,咽颅底筋膜走行于腭帆张肌和腭帆提肌之间,Weber-Liel筋膜位于腭帆张肌外侧.结论MRI可较好显示咽鼓管软骨部及其肌肉、筋膜;应用塑化薄层断面可直接与MRI扫描图像进行对照研究,对鼻咽区病变的影像诊断具有重要参考价值.

The thin sectional anatomy and MRI of the eustachian tube

Objective:To provide the sectional anatomic data for clinical imaging diagnosis of the eustachian tube.Method:9 cadaver eustachian tube were sectioned on transverse,coronal and sagittal planes using plastination,comparing with the MRI of the eustachian tube.Result:The coronal and transversal images clearly delineates the anatomical details of the eustachian tube and its fascia and muscles and their retionship,the fibrocartilaginous tube is posteromedial;its upper margin is curled outward to form the roof of the cartilaginous tube.Anterioly and laterally,the eustachian tube is closed by the salpingopharyngeal fascia extending along the inferior suface of the eustachian tube to or its floor.The tensor veli palatini anterolateral and the levator veli palatini muscle posterolateral and inferior.The submucosal fascia is medial to the levator veli palatini muscle,the pharyngobasilar fascia is between the tensor and levator veli palatini muscles;the fascia of Weber Liel is lateral to the tensor veli palatini muscle.Conclusion:The cartilaginous portion,muscle and fascia of the eustachian tube could be displayed clearly on MRI.The thin sections of the eustachian tube can be directly compared with the MR images,providing valuable information to image diagnosis of the nasopharyngeal diseases.