幕下小脑桥静脉的显微解剖与影像学观察及其临床意义  

Microanatomy and imageology of cerebellar bridging veins below the tentorium and its clinical significance

作　　者：邓雪飞[1] 陶伟[1] 刘斌[2] 陈方宏[3] 夏春华[1] 韩卉[1] 

机构地区：[1]安徽医科大学人体解剖学教研室,合肥230032 [2]安徽医科大学第一附属医院放射科,合肥230022 [3]浙江省人民医院放射科,杭州310014

出　　处：《中国临床解剖学杂志》2010年第1期41-44,共4页Chinese Journal of Clinical Anatomy

基　　金：国家自然科学基金(30771137);安徽省自然科学基金(070413072);安徽省学术与技术带头人科研基金

摘　　要：目的通过幕下小脑桥静脉的显微解剖、影像学观察及其对照研究,为幕下小脑上手术入路中桥静脉的保护提供形态学基础。方法分别对20例(40侧)上矢状窦和颈内静脉灌注蓝色乳胶的成人头颅湿标本、22例(40侧)DSA静脉相、20例(40侧)CTV和20例(40侧)MRV图像进行观测。结果以显微解剖结果作为对照标准,DSA、CTV和MRV分别观察到89%、40%和38%的桥静脉,测得的直径值分别大11%、17%和33%。桥静脉注入硬脑膜处的形态分为直接或经脑膜静脉(小脑幕窦)间接注入两种,脑膜静脉在影像学上表现为信号的不连续、缺失或者局部强度增加。桥静脉注入硬脑膜处主要分布在窦汇附近、小脑幕和岩上窦前部。结论术前影像学检查有助于幕下小脑上手术入路的设计和术中桥静脉的保护。Objective To correlate microanatomy of cerebellar bridging veins below the tentorium with its venograms,and provide anatomic basis for the preservation of cerebellar bridging veins during the infratentorial supracerebellar route.Methods A total of 20 human cadavers（40 sides） and 62 patients（120 sides） were examined in this study.Each head of the cadavers was injected with blue-coloured latex via the superior sagittal sinus and internal jugular veins.The venograms of each patient was obtained from the venous phases of digital subtraction angiography（DSA）（40 sides out of 22 patients） or computed tomographic venography（CTV）（40 sides out of 20 patients） or magnetic resonance venography（MRV）（40 sides out of 20 patients）.Results Compared to the cadavers,DSA,CTV and MRV revealed 89%,40% and 38% of the cerebellar bridging veins because the veins depicted by the imageology were 11%,17% and 33% larger than that of the cadavers.The cerebellar bridging veins entered into TS and petrosal sinus either directly or indirectly via meningeal ＂lake＂.The lumen of the meningeal ＂lake＂ was flattened,and discontinuity,weaken or intensive signal was often observed on neuroimagings.The dural entrence of cerebellar bridging veins were clustered along the medial end of transverse sinus,the tentorial sinus and the antero-medial segment of the petrosal sinus.Conclusions The preoperative venogram is useful to design the individualized surgical approach for the preservation of cerebellar bridging veins below the tentorium.

关 键 词：桥静脉 幕下小脑上入路 显微解剖 影像学检查 

分 类 号：R651.11[医药卫生—外科学]