弓状束及上纵束的显微解剖学与功能磁共振研究  

Microanatomy and functional MRI study of arcuate fasciculus and superior longitudinal fasciculus

作　　者：李陈 狄广福 李强[3] 谭明泽 洪家康 段凯强 梅磊磊 何永胜[4] 江晓春 Li Chen;Di Guangfu;Li Qiang;Tan Mingze;Hong Jiakang;Duan Kaiqiang;Mei Leilei;He Yongsheng;Jiang Xiaochun(Department of Neurosurgery,Ma′anshan People′s Hospital,Ma′anshan 243000,China;Department of Neurosurgery,the First Affiliated Hospital of Wannan Medical College,Wuhu 241000,China;Department of Human Anatomy,School of Basic Medicine,Wannan Medical College,Wuhu 241000,China;Department of Radiology,Ma′anshan People′s Hospital,Ma′anshan 243000,China)

机构地区：[1]马鞍山市人民医院神经外科,马鞍山243000 [2]皖南医学院第一附属医院(弋矶山医院)神经外科,芜湖241000 [3]皖南医学院人体解剖学实验实训中心,芜湖241000 [4]马鞍山市人民医院影像科,马鞍山243000

出　　处：《中华外科杂志》2023年第11期1018-1023,共6页Chinese Journal of Surgery

基　　金：安徽省临床医学研究转化专项项目(202204295107020060,202204295107020010,202204295107020013);马鞍山市科技计划项目(YL-2021-5)。

摘　　要：目的:探讨弓状束及上纵束的显微解剖结构及功能磁共振结构,并分析其功能。方法:2022年2—12月于皖南医学院神经系统疾病转化医学中心对10%甲醛固定的10例成人尸头标本(20侧大脑半球)进行实验研究。使用Klingler纤维束剥离方法,在6~40倍显微镜下进行白质纤维束剥离,研究弓状束及上纵束的显微解剖结构,并探究两者与脑深层纤维束的关系;同期对6名健康成人志愿者进行颅脑功能磁共振检查,收集弥散加权成像(DTI)相关数据并进行后处理,将显微解剖及DTI资料进行综合研究。结果:上纵束Ⅰ位于扣带回的大脑内侧面,扣带沟的上方,上纵束Ⅱ、Ⅲ及弓状束位于大脑外侧面。剥离岛叶灰质皮层、最外囊后,显露外囊和屏状核,后将弓状束和上纵束Ⅱ、Ⅲ剥离,显露放射冠、矢状层纤维束等脑深部纤维束,剥离时发现弓状束、上纵束Ⅱ与脑深部纤维束之间连接紧密。在大脑半球侧裂以上区域,灰质皮层与深部的U形束在冠状位方向无长联络纤维束联系。DTI研究也证实了以上结果。结论:弓状束与上纵束是位于大脑浅层的主要长联络纤维束,与灰质皮层及U形束有密切联系;同时两者与脑深部纤维束连接紧密。在大脑半球侧裂以上区域,放射冠外侧只有弓状束和上纵束Ⅱ、Ⅲ是前后方向的浅层长联络纤维束,可能参与侧裂以上区域冠状位方向上的顶部与底部灰质皮层间的脑功能信息传递。Objectives To explore the microanatomy and functional MRI(fMRI)of arcuate fasciculus(AF)and superior longitudinal fasciculus(SLF),and to analyze their functions.Methods Ten normal adult cadaveric head specimens(20 cerebral hemispheres)were fixed with 10%methanal at the Translational Research Institute for Neurological Disorders of the Wannan Medical College from February to December 2022.The Klingler fiber dissection technique was utilized to perform white matter fiber dissection,with a magnification ranging from 6 to 40.The study focused on the microanatomical structures of the AF and SLF,aiming to explore their relationships with deep brain fibers.Furthermore,six healthy adult volunteers who underwent fMRI of the brain were included.The collected diffusion tensor imaging(DTI)data were processed and integrated with the microanatomical findings for a comprehensive analysis.Results After removing the gray matter of the cerebral cortex,the superficial U fibers were exposed.The long association fibers that beneath the U fibers were the AF and SLF,which were the main long association fibers in the superficial layers of the brain.The AF could be divided into dorsal and ventral parts,while the SLF could be divided intoⅠ,Ⅱ,andⅢ.SLFⅠlied within the upper bank of the cingulate sulcus,travels medial to the callosal sulcus.The SLFⅡ,Ⅲ,and the AF were located on the lateral surface of the brain.By removing the gray matter of the insular cortex and the extreme capsule,exposing the external capsule and claustrum.Subsequently,the AF and SLFⅡ,Ⅲwere dissected,revealing the corona radiata and sagittal stratum,along with other deep brain fibers.During the dissection,it was observed that there was a close connection between the AF,SLFⅡ,and the deep brain fibers.Furthermore,in the regions above the lateral fissure of the cerebral hemisphere,there was no direct connection of long association fibers between the gray matter cortex and the deep U fibers in the coronal plane.These findings were further supported by DTI st

关 键 词：弓状束 上纵束 显微解剖 功能磁共振 脑功能 

分 类 号：R445.2[医药卫生—影像医学与核医学] R322[医药卫生—诊断学]