基于CT血管造影三维重建的Corona Mortis动脉解剖学研究及其临床意义  

The anatomical study of the corona mortis artery on three-dimensional computerized tomography an- giography and its clinical significance

作　　者：赵辉[1] 张轩轩[1] 张丕军[1] 隆腾飞[1] 王钢[1] 

机构地区：[1]南方医科大学南方医院创伤骨科,广州510515

出　　处：《中华创伤骨科杂志》2013年第4期303-307,共5页Chinese Journal of Orthopaedic Trauma

摘　　要：目的在CT血管造影（CTA）三维重建图像上观察Corona Mortis动脉的存在率及位置，以期为骨盆、髋臼骨折的手术入路提供解剖学基础。方法回顾性分析2010年12月至2012年5月期间行腹主动脉CTA检查的80例（160个半骨盆）患者资料，男34例，女46例；年龄19～84岁，平均47．2岁。利用Mimics10．01软件对患者骨盆CTA．dicom格式原始数据进行三维重建，在三维图像上观察Corona Mortis动脉，记录该血管的支数及起源，并测量该血管与耻骨联合的距离。比较左右两侧半骨盆、男女性及年龄≤50岁组与年龄〉50岁组之间Corona Mortis动脉存在率的差异。结果共发现29条Corona Mortis动脉，存在率为18．1％（29／160）。左侧和右侧Corona Mortis动脉存在率分别为17。5％（14／80）、18．8％（15／80）；男性与女性Corona Mortis动脉存在率分别为19．1％（13／68）、17．4％（16／92），年龄≤50岁组与年龄〉50岁组Corona Mortis动脉存在率分别为14．3％（14／98）、24．2％（15／62），以上组别之间比较差异均无统计学意义（P〉0．05）。Corona Mortis动脉经过耻骨上支的交点到耻骨联合上边缘的距离平均为（53。70±4．00）mm。结论CTA三维重建可清晰观察到Corona Mortis动脉。采用髂腹股沟入路和Stoppa入路行骨盆髋臼骨折手术前建议先行腹主动脉CTA检查，以明确是否存在该血管。术中剥离至距离耻骨联合上边缘（53．70±4．00）mm处的耻骨上支表面时，应高度警惕该变异血管的存在。Objective To investigate the incidence and location of the corona rnortis artery by means of three dimensional （3D） reconstruction of computerized tomography angiography （CTA） as well as the clinical significance of the knowledge in the treatment of pelvic and acetabular fractures via ilioinguinal and Stoppa approaches. Methods Radiological and clinical data from 80 patients （160 hemi-pelvises） undergoing aorta abdominalis CTA between December 2010 and May 2012 were collected. This study involved 34 males and 46 females, aged from 19 to 84 years （average, 47.2 years）. The. dicom format CTA data were used for 3D reconstruction using the Mimics software. The incidence and origin of the corona morris artery crossing the superior pubic ramus into the obturator forarnen were observed and the distances between the corona rnortis artely and the pubic symphysis were measured on the 3D reconstruction images. The incidences were compared between hemi-pelvises, genders and age groups of≤50 and 〉 50 years. Results In the 160 hemi-pelvises, ahogether 29 corona morris arteries were detectect giving a total incidence of 18.1% （29/160）.Of them, 14（14/80, 17.5%）werefbundontheleflsideand 15 （15/80, 18.8%）ontheright; 16（16/92,17.4% ） in the female patients and 13 （13/68, 19. 1% ） in the male patients; 14 （ 14/98, 14.3% ） in the ≤50 age group and 15 （15/62, 24.2% ） in the 〉 50 age group. There were no significant differences regarding tile incidence between hemi-pelvises genders or age groups （P 〉 0. 05）. The distances between the corona morris artery and the pubic symphysis averaged 53.70 ± 4. O0 ram. Conclusions Since CTA 3D reconstruction images can clearly demonstrate the corona mortis artery, abdominal aorta CTA should be recommended before operative treatment of pelvic and acetabular fractures via the ilioinguinal and Stoppa approaches to make sure that no operative accident will occur due to presence of the corona morris artery. We should be alert to this artery＂ va

关 键 词：动脉 成像  三维 解剖学 

分 类 号：R816.2[医药卫生—放射医学] R687.3[医药卫生—临床医学]