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颈内静脉与颅底骨三维空间关系 |
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张海钟 步荣发 赵红 赵绍宏 黄大明
【摘要】目的：显示对比正常侧和病变侧颈内动静脉与周围骨结构的解剖关系，以完善术前准备。方法：10例颌颈部肿瘤患者，术前行颈动脉三维CT血管成像(CTA)，同步注射造影剂，螺旋CT对病变区血管段进行重点薄层螺旋扫描，由Easy Vision工作站三维重建。结果：5例颈外动脉和颈内静脉受压狭窄，其中3例出现颈总动脉、颈内动脉向内侧移位。CTA能够显示病变区血管段(包括颈总动脉、颈内动脉、颈外动脉、颈内静脉)与下颌骨、舌骨、颈椎、颅底骨结构的三维解剖关系，进行旋转、放大，三维测量，多视角观察，无重叠干扰。结论：对颌颈、口咽部肿瘤患者术前CTA检查，能够判断颈部大血管的情况及颈部巨大肿瘤造成项内动脉移位，CTA可显示血管性肿瘤的三维形状和与颅底骨空间关系，为手术入路及术式提供参考，有助于降低手术风险。
【关键词】CT 血管成像 颈内动脉 肿瘤 颅底骨
The three-dimensional spatial relationship
between the carotid artery and skull base
Zhang Haizhong,Bu Rongfa,Zhao Hong,et al.
Department of Stomatology,General Hospital of PLA,Beijing 100853
Objective:To compare the normal carotid atery and abnomal carotid artery in skull base via computerized topographic angiography (CTA).Methods:Contrast mediums were administrated intravenously during the three-dimensional CT imaging in ten patients with tumor in mandible or neck.Three-dimensional CTA imaging in ten patients with tumor in mandible or neck.Three-dimensional CTA images were reconstructed compared and analyzed on Easy Vision Workstaion.Results:Stenosis of extenal carotid artery and internal jugular artery were found in five cases.Displacement of the internal carotid artery in three of them was detected.The aneurysm in the left internal carotid artery was clearly located in another case.The images of the cervical vessels (external carotid artery,intemal carotid artery,carotid bifurcation and intemal jugular )of both sides and the skull bass were displayed in arbitrary views without disturbing superposition by cutting,rotating and 3D measurement procedures.Conclusions:Some large cervcal tumor could change the position of the carotid artery.CTA was able to display the shape and localization of aneurysm and this could reduce the risk of operation.
Key words:Computerized topographic angiography Carotid artery Tumor Skull base
对于颌颈部肿瘤患者，不论是恶性肿瘤或良性肿瘤增大到一定程度均挤压颈部大血管，造成血管解剖位置改[1] [2] 下一页
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