【摘要】：目的： 研究大腦中動脈中央支的起始的走形，分段以及其外徑；統(tǒng)計(jì)測量研究其發(fā)出穿通支的特點(diǎn)及相關(guān)解剖學(xué)數(shù)據(jù)。目的是更好的理解大腦中動脈中央支的解剖學(xué)結(jié)構(gòu)，為臨床上大腦中動脈動脈瘤的多發(fā)現(xiàn)象提供解剖學(xué)支持，并為外側(cè)裂入路治療腦部疾病的安全性提供解剖學(xué)數(shù)資料。 材料與方法： 選取自2006年1月至2013年1月間，就診于吉林大學(xué)白求恩第一醫(yī)院患者所做的人腦動脈的MRA掃描影像，選取標(biāo)準(zhǔn)有：1）小于15歲兒童；2）無影響腦部正常血供的嚴(yán)重心臟疾病，，大血管疾病；3）無腦動脈病變，以及影響腦部動脈回流的病變，4）均已排除腦血管畸形，狹窄以及動脈瘤者。采用GE公司的DiscoveryTMMR7503.0T磁共振機(jī)對受試者進(jìn)行頭部掃描，所得圖像傳至AW VolumeShare4AW4.5工作站之后再進(jìn)行后處理進(jìn)行觀測。 結(jié)果： 1.大腦中動脈主干是頸內(nèi)動脈的延續(xù)，最終止于島閾處分叉前，它的長度為左側(cè)12.3±2.1mm，右側(cè)11.9±2.8，管徑為左側(cè)3.6±0.4mm，右側(cè)3.4±0.6mm。 2.大腦中動脈內(nèi)側(cè)群穿支的個數(shù)為左側(cè)8.1±1.5支，右側(cè)9.8±1.4支，外側(cè)群穿支的個數(shù)為左側(cè)4.6±2.1支，右側(cè)5.1±2.4支。 3.大腦中動脈中央支內(nèi)側(cè)群穿支的管徑為左側(cè)1.0±0.4mm，右側(cè)1.1±0.4mm，大腦中動脈中央支外側(cè)群穿支的管徑為左側(cè)1.2±0.4mm，右側(cè)1.1±0.3mm。 4.大腦中動脈的主干上常有一段未發(fā)出分支，該段的長度為4.1±0.8mm。 5.大腦中動脈在島閾處大多會發(fā)出多級分支繼續(xù)走形，常見的大腦中動脈分支有，單干型，雙干型以及多干型。本組實(shí)驗(yàn)結(jié)果顯示，單干型約占25%，雙干型約占50%，多干型約占25%。 結(jié)論： 1.大腦中動脈的主干較短，管徑則相對粗大，這兩個特點(diǎn)與其走形可支持這一部位成為腦內(nèi)動脈瘤多發(fā)區(qū)域。 2.大腦中動脈中央支管徑較細(xì)，并且以垂直于動脈主干的方式發(fā)出，這一特點(diǎn)可有力的支持該部位成為腦出血高發(fā)區(qū)域。 3.大腦中動脈的內(nèi)側(cè)群分支多于外側(cè)群，且與動脈瘤關(guān)系最為密切的第一分支多為內(nèi)側(cè)群，在夾閉動脈瘤的手術(shù)過程中應(yīng)給予特別關(guān)注。
[Abstract]:Aim: to study the initial aberration, segmentation and external diameter of the central branch of the middle cerebral artery, and to study the characteristics and anatomical data of the perforating branch of the middle cerebral artery. Objective to better understand the anatomical structure of the central branch of the middle cerebral artery, to provide anatomical support for the occurrence of multiple aneurysms of the middle cerebral artery in clinic, and to provide anatomical data for the safety of the lateral fissure approach in the treatment of brain diseases. Materials and methods: from January 2006 to January 2013, MRA images of human brain arteries were obtained from patients in Bethune first Hospital of Jilin University. The selected criteria were as follows: 1) Children younger than 15 years old; 2) serious heart disease, macrovascular disease, 3) cerebral artery disease, and 4) cerebral vascular malformation, stenosis and aneurysm were excluded. GE's DiscoveryTMMR7503.0T magnetic resonance machine was used to scan the head of the subjects. The images were transmitted to the AW VolumeShare4AW4.5 workstation and then observed. Results: 1. The main trunk of the middle cerebral artery is a continuation of the internal carotid artery, which ends before the bifurcation of the island threshold. Its length is 12.3 鹵2.1 mm on the left side, 11.9 鹵2.8 mm on the right side, 3.6 鹵0.4 mm on the left side and 3.4 鹵0.6 mm2 on the right side. The number of perforating branches in the medial group of middle cerebral artery was 8.1 鹵1.5 on the left, 9.8 鹵1.4 on the right, 4.6 鹵2.1 on the left and 5.1 鹵2.4 on the right. The diameter of the perforating branch of the medial group of the central branch of the middle cerebral artery was 1.0 鹵0.4 mm on the left side and 1.1 鹵0.4 mm on the right side. The diameter of the perforating branch of the lateral group of the central branch of the middle cerebral artery was 1.2 鹵0.4 mm on the left side and 1.1 鹵0.3 mm on the right side. The middle cerebral artery (MCA) often has an unbranched branch on its main trunk, the length of which is 4. 1 鹵0. 8mmm. 5. The middle cerebral artery (MCA) usually sends out multilevel branches at the island threshold. The common branches of the MCA are single trunk, double trunk and multi trunk. The results show that the single type accounts for 25%, the double type about 50% and the multiple type about 25%. Conclusion: 1. The middle cerebral artery (MCA) has a short trunk and a relatively large diameter. These two characteristics and its shape can support this part of the brain to become a multiple area of aneurysm. 2. 2. The central branch of the middle cerebral artery (MCA) is fine in diameter and issued perpendicular to the artery trunk. This feature can support the high incidence of ICH in this area. 3. 3. The medial branch of the middle cerebral artery is more than the lateral group, and the first branch most closely related to the aneurysm is the medial group, which should be paid special attention during the operation of clipping the aneurysm.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R322

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