脑桥小脑角区的薄层横断层解剖及其临床意义  

The thin transverse sectional anatomy of the pontocerebellar trigone region and its clinical significance

作　　者：孟庆成[1] 丁娟[1] 刘树伟[1] 樊令仲[1] 张忠和[1] 孙博[1] 尹训涛[1] 林祥涛[1,2] 

机构地区：[1]山东大学医学院断层影像解剖学研究中心,济南250012 [2]山东省医学影像学研究所,济南250021

出　　处：《中国临床解剖学杂志》2009年第3期247-250,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的:为临床脑桥小脑角区病变的影像学诊断和术前评估提供断层解剖学基础。方法:选取1例无明显器质性病变的成人头部标本,用1.5T MRI以AC-PC线为基线扫描获取薄层磁共振图像,然后在冰冻包埋条件下采用铣削精度为0.001 mm的SKC500型数控机床以AC-PC线为基线铣削层厚为0.1mm的横断面薄层标本,从中选取典型断面,与相应的MRI图像相对照,观察脑桥小脑角区的重要解剖结构。结果:共获得与脑桥小脑角区相关的薄层断面图像240幅,在薄层断层标本上进行连续追踪,并与相应的MR图像对照。(1)连续薄层横断面能很好显示脑桥小脑角区的微细结构变化,在颈动脉管层面小脑下前动脉从基底动脉发出先向后延伸,越过面神经走行于面神经与前庭蜗神经之间并发出分支环绕前庭神经形成袢,后上行至小脑;(2)在脑桥小脑角层面,能够显示面神经桥段的长度;(3)在内耳门层面上,内耳门后唇最隆起,左右两侧后唇的高度均小于同侧面神经桥池段长度的三分之一。结论:铣削的薄层横断面与MRI对照能精确显示脑桥小脑角区的解剖结构及其位置关系,为该区病变的断层影像学诊断和术前评估提供断层解剖学依据。Objective： To provide anatomic data for evaluation of presurgery and imaging diagnosis of pontocerebellar trigone region. Methods： after CT and MRI examinations to exclude organic lesion, one head specimen of Chinese adult wasselected from four cadavers , then embedded with gelatin and frozen under profoundhypothermia, subsequently, the specimen was sliced into 0.1mm transverse serial sections along AC-PC line with SK500 computerized freezing milling machine at -15 ℃ in a low temperature laboratory. The slices of the pontocerebellar trigone region were as thin as 0.05mm, and then the serial sections were photographed with high-resolution digital camera and saved in computer. The microstructure ofpontocerebellar trigone region were observed and measured on typical cross sections of cadaver head and its MRI. Results： The transverse sections involving with pontocerebellar trigone region about 240 layers were obtained, Comparing with the MRI and thin sectional images we investigated the sectional anatomy of the pontocerebellar trigone region. （1）The anatomy of the pontocerebellar trigone region could be observed clearly on the successive thin sections. The anterior inferior cerebellar artery was origined from the basilar artery on the transverse section through internal carotid artery and extended to the internal auditory foramen following the facial nerves, then run between the facial nerves and the vestibulocochlear nerves to the cerebellum. （2）The length of the pontocerebellar trigone segment of facial nerve could be demonstrated on the section through pontocerebellar trigone ; （3）The height of the posterior lip of internal auditory foramen was the highest on the transverse section through internal auditory foramen, and the height of the posterior lip of internal auditory foramen of two sides were all less than the one third of the longitude of the facial nerves ipsilaterally in the pontine cistern. Conclusions： Combination of slices obtained from digital freezing milling technique and magnet

关 键 词：脑桥小脑角区 断层解剖 MRI 数控冷冻铣切技术 

分 类 号：R322.85[医药卫生—人体解剖和组织胚胎学] R455.2[医药卫生—基础医学]