胼胝体-穹窿间入路切除第三脑室肿瘤的显微解剖学特点  

Microanatomic features of third ventricle tumor removal via transcallosal-interfornix approach

作　　者：刘宏斌[1] 周厚杰[1] 吴涛[1] 郭强[1] LIU Hong-bin;ZHOU Hou-jie;WU Tao;GUO Qiang(Department of Neurosurgery,Peking University Shenzhen Hospital,Shenzhen 518036,China)

机构地区：[1]北京大学深圳医院神经外科,广东省深圳市518036

出　　处：《广西医学》2018年第19期2311-2313,共3页Guangxi Medical Journal

基　　金：广东省深圳市科技创新委员会科研课题(200903076)

摘　　要：目的探讨胼胝体-穹窿间入路切除第三脑室肿瘤的显微解剖学特点。方法选取8例第三脑室肿瘤解剖样本作为研究对象,模拟手术操作步骤,在显微镜下观察第三脑室的解剖结构,测量以分别位于大脑半球内侧面中央沟上端前5 cm和7 cm的两点(P5、P7)为参照的相关径线、冠矢点至鼻根距离和丘脑中间块的相关径线。结果冠矢点至鼻根距离为(128. 30±3. 87) mm;以P5点、P7点作为参照点,距胼胝体沟的距离分别为(38. 64±3. 59) mm、(37. 39±2.98) mm,胼胝体厚度分别为(6.71±1.50) mm、(7.15±1.26) mm,胼胝体下缘至穹隆间距离分别为(8.45±2. 60) mm、(10.18±1. 69) mm,穹隆厚度分别为(4. 06±0. 55) mm、(5. 13±0. 68) mm,胼胝体下缘至室间孔距离分别为(15. 62±2. 83) mm、(15. 68±1. 80) mm,穹隆上缘嵌入胼胝体与胼胝体下表面相交点的连线距离分别为(12. 84±2. 09) mm、(18. 46±2. 70) mm,胼胝体膝内表面最前点与胼胝体下表面相交点的距离分别为(21. 04±2. 95) mm、(14. 84±3. 11) mm;前连合和孟氏孔上缘距离为(5. 03±0. 80) mm,丘脑中间块断面前后径为(5. 75±0. 78) mm,丘脑中间块断面上下径为(5. 23±0. 89) mm,丘脑中间块断面距前连合的距离为(9. 62±1. 37) mm,丘脑中间块断面距后连合的距离为(15. 49±1. 85) mm。结论胼胝体-穹隆间入路是到达第三脑室较为直接、损伤较小的路径,可作为显微外科切除第三脑室肿瘤的重要手术入路。建议以冠矢点作为骨瓣后界,以胼胝体中部双侧纵纹在胼胝体表面形成的浅沟作为中线切开标志,从而可在显微镜下顺利抵达穹隆间。Objective To explore the microanatomic features of the third ventricle tumor removal via the transcallosal-interfornix approach.Methods The anatomic samples from 8 cases of the third ventricle tumor were enrolled as the subjects.After stimulating the operation procedures,the anatomic structure of the third ventricle was observed under microscope.The relevant diameters and lines were measured using two reference points,P5 and P7,5 cm and 7 cm anteriorly near the top of central sulcus on the medial side of cerebral hemisphere respectively,and the distance between bregma and nasion and the relevant diameters and lines for massa intermedia were measured as well.Results The distance between bregma and nasion was 128.30±3.87 mm;P5 and P7 were taken as the reference points,the distances to callosal suleus were 38.64±3.59 mm and 37.39±2.98 mm respectively,the thicknesses of corpus callosum were 6.71±1.50 mm and 7.15±1.26 mm respectively,the distances between the inferior fringe of corpus callosum and the interfornix were 8.45±2.60 mm and 10.18±1.69 mm respectively,the thicknesses of fornix were 4.06±0.55 mm and 5.13±0.68 mm respectively,the distances between the inferior fringe of corpus callosum and the interventricular foramen were 15.62±2.83 mm and 15.68±1.80 mm respectively,the line distances from that where the superior fringe of fornix inserted corpus callosum to the intersection on the inferior surface of corpus callosum were 12.84±2.09 mm and 18.46±2.70 mm respectively,the distances from the most anterior point on the medial surface of genu of corpus callosum to the intersection on the inferior surface of corpus callosum were 21.04±2.95 mm and 14.84±3.11 mm respectively,the distance between anterior commissure and the superior fringe of Monro foramen was 5.03±0.80 mm,the anteroposterior diameter of the massa intermedia section was 5.75±0.78 mm,the superoinferior diameter of the massa intermedia section was 5.23±0.89 mm,the distance between the massa intermedia section and anterior commissure was

关 键 词：第三脑室肿瘤 胼胝体-穹隆间入路 显微解剖学 

分 类 号：R739.4[医药卫生—肿瘤]