椎动脉V3段与寰椎相互关系的CT三维应用解剖研究  

Three-dimensional CT anatomical study on the relationship between vertebral artery V3 segment and atlas

作　　者：何宏伟[1,2] 段少银[1] 赵慧毅[3] 杨烈[1] 张平[1] 吴年玮[1] 陈丽君[1] 隋桐[1] 

机构地区：[1]厦门大学附属中山医院放射科,福建厦门361000 [2]宁波市第一医院影像科 [3]厦门大学附属中山医院骨科

出　　处：《实用放射学杂志》2012年第9期1456-1459,共4页Journal of Practical Radiology

基　　金：国家自然科学基金资助项目

摘　　要：目的 研究椎动脉V3段的走行特点及相对寰椎的空间位置关系,为寰椎椎弓根螺钉置入及其他相关手术提供解剖基础.方法 采用后处理工作站对影像存档与传输系统（picture archiving and communicating system,PACS）内60例需除外头颈部血管病变而做CT血管造影（CT angiography,CTA）的患者进行回顾性三维成像,研究椎动脉V3段相对寰椎的空间位置关系,同时研究观察到的椎动脉变异.结果 寰椎椎动脉沟与相应椎动脉下缘的距离自外侧向内侧逐渐增大,左、右最外侧分别为（1.41±1.08） mm、（1.67±1.03）mm;左、右最内侧分别为（2.33±1.03） mm、（2.59±0.89） mm.椎动脉和寰椎椎动脉沟外缘交界处与正中线的距离左侧为（19.94±2.07）mm,右侧为（20.46±2.17） mm.椎动脉V3段外弓最凸点与寰椎的距离,左侧为（7.61±2.51） mm,右侧为（7.18±2.71）mm.发现椎动脉变异2例.结论 寰椎椎动脉沟与椎动脉下壁之间存在潜在间隙,该间隙自外侧向内侧逐渐扩大,其内充填静脉丛.国人暴露寰椎后弓上缘的安全距离为距中线18mm以内.椎动脉V3段变异并不少见,建议行寰枢关节螺钉固定患者术前常规行头颈部CTA检查.Objective To study the relationship between vertebral artery （VA） V3 segment and atlas. Methods 60 cases underwent computed tomography angiography （CTA） due to screening bead and neck vascular diseases chosen from picture archiving and communicating system（PACS） were retrosperctively analyzed with three dimensional reconstruction. The spatial relationship between VA V3 segment and atlas was analysed, the variations of VA V3 segment were also studied. Results The distance between the groove of VA{GVA） and VA were gradually increased from outer to inner aspect of GVA, the corresponding distance on outer aspect of GVA was （1.41± 1.08）mm in left and {1. 67± 1.03） mm in right, and hmer aspect was { （2.33± 1.03）ram in left and （2.59±0.89）mm in right. The distance from intersection of the VA and the outer cortex of GVA to midline was （19.94±2.07） mm in left and {20.,16±2. 17）mmin right. The distance from the most protrusive point of the VA V3 segment to the posterior arch of the atlas was （7.61±2.51） mm in left and （7. 18±2.71） mm in right. Two cases of VA wtriation were found out on this study. Conclusion There is a space between C;VA and VA, in which venous plexus are filled, its volume is gradually increasing from outer to inner aspect of GVA. Lateral exposure of the posterior arch of the C1 should remain within 18mm. Considering the variations of VA V3 segment are not rare, head and neck CTA is suggested in patients preparing for atlantoaxial joint screw fixation.

关 键 词：寰椎 椎动脉 体层摄影术 X线计算机 螺钉置入 

分 类 号：R322.7[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]