本文選題：顱頸交界區(qū) + 解剖��； 參考：《天津醫(yī)科大學(xué)》2007年碩士論文

【摘要】： 第一部分顱頸交界區(qū)大體和斷層解剖學(xué)研究 目的:了解顱頸交界區(qū)重要結(jié)構(gòu)及其毗鄰,深入研究顱頸交界區(qū)重要結(jié)構(gòu)的斷層解剖,為該區(qū)域影像學(xué)研究提供解剖學(xué)依據(jù)。 資料和方法:本研究采用經(jīng)福爾馬林固定的正常成人頭顱標(biāo)本12例(天津醫(yī)科大學(xué)解剖教研室提供),男9例,女3例,年齡47—73歲,平均年齡67.8歲。其中3例用于進(jìn)行顱頸交界區(qū)大體解剖觀察,3例制成5.0mm厚的冰凍切片,6例制成0.5mm厚的薄層切片。觀察顱頸交界區(qū)重要結(jié)構(gòu)的形態(tài)及其毗鄰關(guān)系。 結(jié)果:顱頸交界區(qū)位于枕骨、乳突、顳骨巖部、寰樞椎椎體等骨性結(jié)構(gòu)所圍成的間隙內(nèi),一些重要的支撐韌帶(翼狀韌帶、十字韌帶、齒突尖韌帶、寰枕前、后膜、覆膜)和神經(jīng)、血管等結(jié)構(gòu)穿行其中。該區(qū)域韌帶結(jié)構(gòu)從后向前依次為:寰枕后膜、覆膜、十字韌帶(包括上下縱束、橫韌帶)、翼狀韌帶、齒突尖韌帶及寰枕前膜,其中覆膜、十字韌帶上縱束、齒突尖韌帶在枕骨基底部粘連緊密,不易分離。椎動(dòng)脈與第1、2頸神經(jīng)關(guān)系密切。 結(jié)論:大體解剖及斷層切片能較好地顯示顱頸交界區(qū)韌帶、神經(jīng)、血管等重要結(jié)構(gòu)及其毗鄰,為深入進(jìn)行顱頸交界區(qū)影像學(xué)研究提供了解剖學(xué)依據(jù)。 第二部分顱頸交界區(qū)CT和MRI影像解剖學(xué)研究 目的:研究正常顱頸交界區(qū)重要結(jié)構(gòu)的CT和MRI表現(xiàn),優(yōu)化該區(qū)域重要結(jié)構(gòu)的影像學(xué)檢查方法,為該區(qū)域的臨床診斷提供有價(jià)值的影像解剖學(xué)基礎(chǔ)。 資料和方法:在2006年10月至2007年5月期間,于我院行頭頸部平掃及增強(qiáng)CT檢查中,隨機(jī)選取51例正常者,其中男31例,女20例,年齡34—60歲,平均年齡49.4歲,行螺旋CT橫斷面掃描,冠狀面、矢狀面重組,增強(qiáng)掃描采用經(jīng)肘靜脈注射非離子型碘對(duì)比劑100ml(350mg I/ml),流速4.0ml/s。選取無(wú)頭頸部外傷、不適的健康志愿者51例,其中男30例,女21例,年齡20—39歲,平均年齡27.3歲,采用MRI多脈沖序列行橫斷面、冠狀面、矢狀面掃描。結(jié)合大體和斷面解剖,分析顱頸交界區(qū)各斷面重要結(jié)構(gòu)的CT和MRI表現(xiàn)。比較MRI各脈沖序列對(duì)顱頸交界區(qū)主要韌帶(寰枕后膜—硬膜復(fù)合體、覆膜—硬膜復(fù)合體、橫韌帶、翼狀韌帶、寰枕前膜)的顯示效果。測(cè)量該區(qū)域重要結(jié)構(gòu)的影像解剖參數(shù)。 結(jié)果:CT和MRI能較好地顯示顱頸交界區(qū)重要結(jié)構(gòu)及其毗鄰。寰枕后膜—硬膜復(fù)合體、覆膜—硬膜復(fù)合體、橫韌帶及翼狀韌帶均能在CT和MRI上清晰顯示,顯示率為100%(51/51);齒突尖韌帶只可在正中矢狀面識(shí)別,在CT上的顯示率為29.4%(15/51),在MRI上的顯示率為43.1%(22/51);寰枕前膜在MRI上的顯示率為100%(51/51),但在CT上難以識(shí)別。兩名醫(yī)師分別分析MRI各脈沖序列對(duì)顱頸交界區(qū)主要韌帶的顯示情況,研究結(jié)果表明質(zhì)子密度加權(quán)像顯示該區(qū)域主要韌帶的效果最佳。比較CT和MRI測(cè)量值,結(jié)果顯示基底角、寰枕關(guān)節(jié)角、枕齒間距、齒狀突位置及左右側(cè)寰齒間隙差在CT和MRI上的差異無(wú)統(tǒng)計(jì)學(xué)意義(P＞0.05)。 結(jié)論:CT和MRI能較好地顯示顱頸交界區(qū)重要結(jié)構(gòu)及其毗鄰。質(zhì)子密度加權(quán)像能清晰顯示顱頸交界區(qū)主要韌帶,可作為該區(qū)域韌帶結(jié)構(gòu)的理想MRI成像序列,恰當(dāng)?shù)某上駥用嬗欣陧g帶的顯示。該區(qū)域重要結(jié)構(gòu)的影像學(xué)測(cè)量將有助于疾病的診斷。
[Abstract]:Part one: gross and sectional anatomy of craniofacial junction
Objective: to understand the important structures and adjacent areas of the craniofacial junction, and to study the anatomy of the important structures in the craniofacial junction area, and to provide an anatomical basis for the study of the region.
Materials and methods: in this study, 12 cases of normal adult head specimens (Medical University Of Tianjin anatomy teaching and Research Department) fixed by formalin were used, 9 men and 3 women, aged 47 to 73 years old, with an average age of 67.8 years. 3 cases were used for gross anatomical observation in the craniofacial junction, 3 cases of 5.0mm thick frozen section, and 6 cases of thick thin slice of 0.5mm. The morphology and adjacent relationship of the important structures in the craniofacial junction were observed.
Results: the craniocalderm junction is located in the interoccipital bone, mastoid, petrous and atlantoaxial vertebral structures. Some important supporting ligaments (pteroid ligaments, cruciate ligaments, odontoid ligaments, anterior atlantooccipital, posterior membrane), and nerves and vessels are worn. The ligament structure from the posterior to the posterior membrane of the atlantooccipital, overlying the posterior membrane of the atlantooccipital, overlying the posterior membrane of the occipital. The membrane, cruciate ligament (including upper and lower longitudinal fascicles, transverse ligaments), pterygoid ligaments, apex ligaments and occipital anterior membrane, including the membrane, the longitudinal fasciculus on the cruciate ligament, and the apex of the odontoid in the basal part of the occipital bone, is not easy to separate. The vertebral artery is closely related to the 1,2 cervical nerve.
Conclusion: the gross anatomy and fault section can well display the important structures and adjacent structures of the ligaments, nerves and vessels in the craniofacial junction, and provide an anatomical basis for the in-depth study of the imaging study of the craniofacial junction.
The second part: imaging anatomy of CT and MRI in craniofacial junction area
Objective: To study the CT and MRI manifestations of the important structure of the normal craniocede junction area, and to optimize the imaging examination methods for the important structure of the region, and provide a valuable imaging anatomical basis for the clinical diagnosis of the region.
Data and methods: during October 2006 to May 2007, 51 normal subjects were selected randomly in the head and neck scan and enhanced CT examination in our hospital, including 31 males and 20 females, aged 34 to 60 years old, with an average age of 49.4 years, spiral CT cross-sectional scan, coronary and sagittal reconstruction, and enhanced scan using non ionic iodine contrast injection via the elbow vein. 100ml (350mg I/ml), flow velocity 4.0ml/s. selected 51 healthy volunteers without head and neck trauma and discomfort, including 30 male and 21 female, age 20 to 39 years old, with an average age of 27.3 years old, using MRI multi pulse sequence to cross section, coronal surface and sagittal plane scan. Combined with gross and dissecting anatomy, the CT and MRI tables of the important structures of the sections of the craniofacial junction were analyzed, and the CT and MRI tables were analyzed. To compare the effects of the MRI pulse sequence on the main ligaments of the craniocecular junction (atlantooccipital posterior membrane complex, the laminar epidural complex, the transverse ligament, the winged ligament, the occipital anterior membrane), and to measure the image anatomy parameters of the important structure of the region.
Results: CT and MRI could well display the important structure and adjacent area of the craniocecular junction. The posterior occipital membrane - epidural complex, the membrane - epidural complex, the transverse ligament and the pterygoid ligament were clearly displayed on CT and MRI, and the display rate was 100% (51/51); the apical ligament of the odontoid can only be identified in the median sagittal plane, and the display rate on CT was 15/51, in MRI. The rate of display was 43.1% (22/51), and the occipital anterior membrane showed 100% (51/51) on MRI, but it was difficult to identify on CT. Two physicians analyzed the display of the main ligaments in the craniocal junction with the MRI pulse sequence. The results showed that the proton density weighted image showed the best effect in the main ligaments of the region. Comparison of the CT and MRI measurements, The results showed that there was no significant difference in CT and MRI between basal angle, atlantooccipital joint angle, occipital tooth spacing, dentate position and left and right atlanto odontoid space difference (P > 0.05).
Conclusion: CT and MRI can well display the important structure and adjacent area of the craniofacial junction. The proton density weighted image can clearly display the main ligaments in the craniofacial junction, which can be used as an ideal MRI imaging sequence for the structure of the ligamentum, and the appropriate imaging level is beneficial to the display of the ligaments. Diagnosis.

【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2007
【分類號(hào)】：R322

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