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基底池薄层横断面解剖形态与CT图像的对比研究及其在急性颅脑创伤中的应用

A comparative study of thin-layer cross-sectional anatomic morphology and CT images of the basal cistern and its application in acute craniocerebral traumas.

作者信息

Chen Rong, Zhang Shaoxiang, Zhang Weiguo, Tan Liwen, Li Qiyu, Zhao Hui

机构信息

Department of Anatomy, College of Medicine, Third Military Medical University, 400038, Chongqing, China.

出版信息

Surg Radiol Anat. 2009 Feb;31(2):129-38. doi: 10.1007/s00276-008-0417-3. Epub 2008 Oct 22.

Abstract

AIM

To compare the cross-sectional morphologic features of successive thin-layers and CT images of the basal cistern and its application in the diagnosis and management of acute craniocerebral traumas.

MATERIALS AND METHODS

Successive thin-layer cross-sectional images of the basal cistern were retrieved from the second Chinese visible human (CVH) data set and observed. A total of 40 healthy volunteers were subjected to 64-slice spiral CT scan of the head, and CT images of the basal cistern were compared with CVH images. A total of 413 patients with acute craniocerebral traumas were subjected to 64-slice spiral CT scan of the head, CT image changes of the basal cistern were observed.

RESULTS

Thin-layer cross-sectional images retrieved from the CVH data set clearly displayed the sectional anatomic morphology, morphologic change pattern and important adjacent structures of the basal cistern. The quadrigeminal cistern was pateriform or sellaeform; the suprasellar cistern was hexagonal or pentagonal star-shaped; the ambient cistern encircled both sides of the brainstem like an arc band. CT images of the quadrigeminal and ambient cisterns were similar with their CVH images; however, the morphology of the suprasellar cistern changed substantially. In 413 patients with acute craniocerebral traumas, the basal cistern may be normal, or presented with narrowing, obliteration, shift, hematocele, and pneumatosis. Narrowing or obliteration of the basal cistern occurred mostly at the side of dominant intracranial lesions, and frequently occurred in patients with diffuse axonal injury or combination of SDH + CONT + ICH.

CONCLUSIONS

Thin-layer cross-sectional images of the basal cistern retrieved from the CVH data set correspond satisfactorily to CT images of the basal cistern. Comparison of the two types of images can provide a sectional anatomic basis for the image identification of acute craniocerebral traumas. A careful observation on the initial CT images of the basal cistern for anatomic morphologic changes will help diagnose acute craniocerebral traumas early, improve the management, and appropriately predict the prognosis of the condition.

摘要

目的

比较基底池连续薄层图像与CT图像的横断面形态学特征及其在急性颅脑创伤诊断和治疗中的应用。

材料与方法

从中国虚拟人数据集(CVH)中检索基底池的连续薄层横断面图像并进行观察。对40名健康志愿者进行头部64层螺旋CT扫描,将基底池的CT图像与CVH图像进行比较。对413例急性颅脑创伤患者进行头部64层螺旋CT扫描,观察基底池的CT图像变化。

结果

从CVH数据集中检索到的薄层横断面图像清晰显示了基底池的断面解剖形态、形态变化模式及重要毗邻结构。四叠体池呈盘状或鞍状;鞍上池呈六边形或五角星形;环池像弧形带一样环绕脑干两侧。四叠体池和环池的CT图像与CVH图像相似;然而,鞍上池的形态有很大变化。在413例急性颅脑创伤患者中,基底池可能正常,或表现为变窄、闭塞、移位、血肿和气肿。基底池变窄或闭塞多发生在颅内主要病变侧,常见于弥漫性轴索损伤或硬膜下血肿+脑挫裂伤+脑出血联合存在的患者。

结论

从CVH数据集中检索到的基底池薄层横断面图像与基底池的CT图像吻合良好。两种图像的比较可为急性颅脑创伤的图像识别提供断面解剖学依据。仔细观察基底池初始CT图像的解剖形态变化有助于早期诊断急性颅脑创伤,改善治疗,并合理预测病情预后。

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