上肢CT血管造影与彩色多普勒超声对鼻烟窝区桡动脉等解剖结构的可视化  

Visualization research in the anatomical snuffbox region using gross anatomy,upper limb CT angiography and color Doppler ultrasound

作　　者：王雪梅 夏阳 马萍 侯建飞 陈文彬 宫铭海 徐崇峻 张祥 王平 Wang Xuemei;Xia Yang;Ma Ping;Hou Jianfei;Chen Wenbin;Gong Minghai;Xu Chongjun;Zhang Xiang;Wang Ping(School of Medicine,Tarim University,Alaer 843300;Department of Ultrasonography,Mianyang Hospital of T.C.M,Mianyang 621000;Department of Neurosurgery,Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Mianyang 621000;Department of Anatomy,Faculty of Basic Medical Sciences,Kunming Medical University,Kunming 650500,China)

机构地区：[1]塔里木大学医学院,阿拉尔843300 [2]绵阳市中医医院超声医学科,绵阳621000 [3]电子科技大学医学院附属绵阳医院·绵阳市中心医院神经外科,绵阳621000 [4]昆明医科大学基础医学院解剖学实验室,昆明650500

出　　处：《解剖学杂志》2024年第3期200-204,234,共6页Chinese Journal of Anatomy

基　　金：兵团指导性科技计划项目(2022ZD159);塔里木大学校长基金自然科学项目(TDZKSS202321);塔里木大学教务处项目(TDGJYB2333,TDYLKC202451,TDKCSZ12409)。

摘　　要：目的:探究通过CT血管造影(CTA)与彩色多普勒超声(彩超)对经远桡介入鼻烟窝区内解剖结构进行可视化研究。方法:选取局解教学用成人尸体标本对鼻烟窝区结构进行解剖,并对经远桡介入相应大体解剖结构进行观察,再选取成人双上肢CTA图像及成人鼻烟窝区彩超,在CTA与彩超上对大体观察的结果进行重现,并比较鼻烟窝区桡动脉在3种不同方法上的差异和测量鼻烟窝区桡动脉的管径。结果:大体解剖对各部分的结构观察非常清晰,但对骨性结构与浅层结构的空间关系表现较为困难。上肢CTA对骨性结构、桡动脉及部分静脉可视化效果较好,对肌、肌腱的可视化效果稍差,无法复显桡神经浅支。鼻烟窝区彩超对动、静脉内径可视化效果较好,较难辨认桡神经浅支。3种方法测量远端桡动脉管径的均值为(2.45±0.56)mm,大体解剖、CTA、彩超测量值分别为(2.62±0.55)mm、(2.48±0.62)mm、(2.36±0.20)mm,两两比较差异无统计学意义。结论:上肢CTA结合彩色多普勒超声的使用基本可复现鼻烟窝区诸多解剖结构,但对浅筋膜内桡神经浅支及脂肪等组织可视化效果较差。Objective:To investigate the visualization of the anatomical structures in the snuffbox region using gross anatomy dissection,CT angiography(CTA)and color Doppler ultrasound based on the background of the distal radial artery access.Methods:Adult cadaver specimens for anatomical teaching were selected to dissect the anatomical structures of the snuffbox region and observe the corresponding gross anatomical structures through transradial intervention.Then,adult upper limb CTA images and adult snuffbox region ultrasound images were taken to reproduce the gross anatomical observations on CTA and ultrasound.The differences in the radial artery of the snuffbox region using these three different methods were compared and the diameter of the radial artery in the snuffbox region was measured.Results:Gross anatomy provided a clear view of the structures of each part,but it was difficult to express the relations between the bones and superficial structures.Upper limb CTA provided a good visualization of the bones,radial artery and some veins,but the muscles and tendons were barely recognizable,and the radial nerve cannot be reproduced.Color Doppler ultrasound of the snuffbox region provided a good visualization of the diameter of arterial and venous vessels,and the radial nerve could be recognized with difficulty.The diameter of the distal radial artery was measured by the three methods and the average result was(2.45±0.56)mm,while the diameter was(2.62±0.55)mm using gross observation,(2.48±0.62)mm using CTA,and(2.36±0.20)mm using color Doppler ultrasound.There was no statistical difference among the pairwise comparisons.Conclusions:Combining upper limb CTA with color Doppler ultrasound can generally reproduce the anatomical structures in the snuffbox region,but the visualization of some structures is poor,such as the radial nerve and adipose tissue within the superficial fascia.

关 键 词：远桡介入 桡动脉 鼻烟窝 CT血管造影 彩色多普勒超声 

分 类 号：R322-33[医药卫生—人体解剖和组织胚胎学]