CT血管成像对星点与静脉窦关系的研究  

An Anatomic Position Study of Asterion and Venous Sinus with Computed Tomographic Angiography

作　　者：盛波[1] 吕富荣[1] 肖智博[1] 欧阳羽[1] 吕发金[1] 尤云峰[1] 刘楠[1] 

机构地区：[1]重庆医科大学附属第一医院放射科,400016

出　　处：《临床放射学杂志》2011年第4期469-472,共4页Journal of Clinical Radiology

摘　　要：目的利用CT血管成像(CTA)技术观察星点的位置,为临床手术操作提供解剖依据,同时评价减影CTA技术在观察星点与横窦和乙状窦连接部(transverse and sigmoid sinus transition,TSST)关系的价值。资料与方法回顾性重建100例行头部CTA检查患者的星点影像资料,观察星点与体表骨性标志及静脉窦位置的关系。结果星点到乳突尖、颧弓根、颞鳞-顶乳缝交点、外耳道口的距离分别为(49.6±4.3)mm、(55.6±4.6)mm、(24.6±4.1)mm、(44.1±3.6)mm,横窦和乙状窦连接部内角到乳突尖、颧弓根、星点、外耳道口、颞鳞-顶乳缝交点的距离分别为(35.4±4.9)mm、(41.4±4.7)mm、(17.6±4.2)mm、(27.8±3.8)mm、(15.2±3.9)mm,星点及TSST位置男性高于女性,左侧TSST位置较右侧靠后。星点主要位于横窦末段,右侧星点3%位于TSST前上方,83%恰好位于TSST水平,14%位于TSST后下方,左侧分别为5%、79%、16%。结论减影CTA可以清楚显示TSST与星点的关系,乙状窦后入路手术第一钻孔点应选在星点后下>17 mm以上位置,减影CTA术前检查获得个体解剖资料与传统定位TSST方法结合,对减少手术并发症及缩短手术进程具有重要价值。Objective To evaluate the anatomical relationship of asterion and transverse sigmoid sinuses transition（TSST）for clinic operation by computed tomographic angiography.Materials and Methods A total of 100 images of asterion and TSST were reconstructed retrospectively after CT angiography of head to determine the position of the asterion and TSST.Results The average distance（±standard deviation）between the asterion and mastoidale,the root of zygoma,the junction of temporo squamosal parietomastoid sutures,external auditory canal opening was（49.6±4.3）mm,（55.6±4.6）mm,（24.6±4.1）mm,（44.1±3.6）mm respectively.The average distance（±standard deviation）from the interior angle of the TSST to mastoidale,the root of zygoma,asterion,external auditory canal opening,the junction of temporo-squamosal parietomastoid sutures was（35.4±4.9）mm,（41.4±4.7）mm,（17.6±4.2）mm,（27.8±3.8）mm,（15.2±3.9）mm,respectively.The male asterion and TSST ware significantly higher than that in the female,The TSST was posterior located on the left side compared to right.Regarding its position from the TSST,it was at the transition in 83% on the right and 79% on the left,below it in 14% cases on the right and 16% on the left,only 3% on the right and 5% on the left had the asterion above this transition.Conclusion The safe approach can be posteroinferior（more than 17mm）to the asterion so as to avoid lacerating the TSST.Subtraction CT angiography is a reliable method in the localization of the TSST for retrosigmoid craniotomies,and thereby decreasing complication and shorten surgical approaches.

关 键 词：星点 横 乙状窦 解剖 CT血管成像 

分 类 号：R816.1[医药卫生—放射医学]