本文選題：Klingler技術(shù) + DTI�。� 參考：《寧夏醫(yī)科大學(xué)》2009年碩士論文

【摘要】： 目的運(yùn)用Klingler解剖技術(shù)及DTI技術(shù),對顳葉區(qū)域白質(zhì)纖維結(jié)構(gòu)進(jìn)行研究,為選擇手術(shù)入路,減少神經(jīng)損傷提供科學(xué)依據(jù)。 方法1.運(yùn)用Klingler解剖技術(shù),將10例成人頭顱濕標(biāo)本進(jìn)行福爾馬林固定和冰凍,后在×4～25倍的手術(shù)顯微鏡下,對顳葉區(qū)域各白質(zhì)纖維結(jié)構(gòu)進(jìn)行逐層分離,并注意觀察和測量。2.運(yùn)用DTI技術(shù)對10名健康志愿者應(yīng)用DTI技術(shù)行腦白質(zhì)纖維成像,對顳葉的重要白質(zhì)纖維束應(yīng)用解剖學(xué)知識基礎(chǔ)上的多興趣區(qū)方法進(jìn)行重建。3.結(jié)合Klingler解剖技術(shù)和DTI技術(shù),對視輻射進(jìn)行對比研究。 結(jié)果1.運(yùn)用Klingler解剖技術(shù)可清晰顯示顳葉區(qū)域各白質(zhì)纖維結(jié)構(gòu):弓狀束、外囊、屏狀核、下縱束、鉤狀束、額枕下束、視輻射、前聯(lián)合等纖維束的解剖結(jié)構(gòu)和位置。2.運(yùn)用DTI技術(shù)可清晰顯示顳葉區(qū)域重要白質(zhì)纖維結(jié)構(gòu):顳干,其由鉤狀束、前連合、額枕下束、視輻射、丘腦下腳構(gòu)成。它開始于島閾,結(jié)束于島葉后下點(diǎn),其長度平均為33.5mm(30～40 mm)。鉤狀束和前連合占據(jù)顳干前1/3,額枕下束走行于全部顳干,視輻射的大部走行于顳干的后2/3。3.結(jié)合Klingler解剖技術(shù)和DTI技術(shù),視輻射的結(jié)構(gòu)在解剖和DTT上顯示是一致的,其由外側(cè)膝狀體發(fā)出分三束覆蓋于顳角前極外側(cè)半、全部顳角上壁及外側(cè)壁,Meyer袢走行于顳角頂壁,并超過顳角尖部前方平均2.1mm(1～3mm)。經(jīng)側(cè)裂入路的顳葉手術(shù)中,在外側(cè)裂底部存在著一個(gè)可以避免損傷視輻射進(jìn)入顳角的安全三角區(qū)域(島閾或下環(huán)島溝周圍5mm范圍內(nèi)垂直進(jìn)入顳角不會(huì)損傷視輻射),而在其后10、15、20mm水平處切口,向內(nèi)下與矢狀面成一定的角度可避免損傷視輻射。 結(jié)論1.運(yùn)用Klingler解剖技術(shù)及在解剖基礎(chǔ)上的DTI技術(shù)可清晰顯示顳葉區(qū)域重要纖維結(jié)構(gòu)和位置關(guān)系。2.顳干的基本構(gòu)筑是相同的,但顳干的大小及形態(tài)也存在明顯的個(gè)體差異性。島閾、顳角前極和島葉后下點(diǎn)可以被用于對顳干在MR或手術(shù)中定位。3.視輻射走行于顳角頂壁,并超過顳角尖,到達(dá)顳角與顳極之間。經(jīng)側(cè)裂進(jìn)入顳角的手術(shù),切口靠近島閾或下環(huán)島溝周圍5mm范圍對視輻射的損傷機(jī)會(huì)小。
[Abstract]:Objective to study the structure of white matter fibers in temporal lobe using Klingler anatomical technique and DTI technique in order to provide scientific basis for selecting operative approach and reducing nerve injury. Methods 1. Using Klingler anatomical technique, 10 adult head wet specimens were fixed and frozen with formalin, then the white matter fiber structure in temporal lobe was separated layer by layer under a 25 times operation microscope, and observed and measured. DTI technique was used to reconstruct the important white matter fiber bundle of temporal lobe by DTI technique in 10 healthy volunteers. Combined with Klingler anatomical technique and DTI technique, a comparative study of visual radiation was carried out. Results 1.Results 1. By using Klingler anatomical technique, the structures of white matter fibers in temporal lobe area can be clearly displayed: arcuate bundle, outer capsule, palmatoid nucleus, inferior longitudinal bundle, hook bundle, frontal suboccipital bundle, visual radiation and anterior syndesmosis. Using DTI technique, the important white matter fiber structure in temporal lobe region can be clearly displayed: temporal trunk, which is composed of uncinate fascicle, anterior junction, frontal suboccipital tract, visual radiation and hypothalamic foot. It begins at the island threshold and ends at the lower point behind the islet, with an average length of 33.5mm(30~40. A third of the temporal trunk was occupied by the uncinate bundle and the anterior conjunction. The frontal and occipital bundles were located in all the temporal trunks, and the majority of the apparent radiation was in the posterior 2 / 3.3 of the temporal trunk. Combined with Klingler anatomical technique and DTI technique, the structure of visual radiation was identical in anatomy and DTT. It was covered by three beams of lateral geniculate body on the lateral side of the anterior pole of the temporal horn. All the superior and lateral walls of the temporal horn and the lateral wall of Meyer's loop walked along the parietal wall of the temporal horn. And above the tip of the temporal horn, the average was 2.1 mm and 3 mm above the anterior part of the temporal horn. In temporal lobe surgery via lateral fissure approach, At the base of the lateral fissure, there is a safe triangular region (island threshold or vertical entry into the temporal horn within the range of 5mm around the lower circumferential sulcus) that can avoid the injury of visible radiation into the temporal horn, but an incision at the level of 1015mm or 20mm is not damaged at the bottom of the lateral fissure. The damage to visual radiation can be avoided at a certain angle between the inward and sagittal plane. Conclusion 1. Using Klingler anatomical technique and DTI technique on the basis of anatomy can clearly display the important fibrous structure and position relation of temporal lobe. The basic construction of the temporal trunk is the same, but the size and shape of the temporal trunk also have obvious individual differences. The island threshold, the anterior temporal horn and the posterior inferior point of the insular lobe can be used to locate the temporal trunk on Mr or during surgery. The visible radiation travels along the parietal wall of the temporal horn and above the tip of the temporal horn, reaching between the temporal horn and the temporal pole. Through lateral fissure into the temporal horn, the incision near the island threshold or the 5mm area around the inferior island groove has little chance of damage to visual radiation.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2009
【分類號】：R651;R322

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

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本文編號：1983813