Skadorwa T, Eibl M, Zygańska E, Ciszek B
Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warszawa, Poland.
Folia Morphol (Warsz). 2010 May;69(2):78-83.
Ambient cistern (AC) is a thin extension of the subarachnoid space surrounding the brainstem at the level of the mesencephalon and pons. Despite various definitions, it constitutes an important landmark in clinical assessment of intracranial volume reserve. Although it is indisputably useful, there exists no defined standard for radiological examination for the dimensions and ranges in specific age groups. This paper aims to describe the ambient cistern anatomically and give the ranges of dimensions for proper radiological interpretation. The study was performed on 160 axial computed tomography (CT) examinations of Polish children of both sexes, aged 1-18 years, admitted to the hospital because of mild brain concussion. Pictures were made using a Siemens 8-row CT scanner, without contrast administration. We estimated distances at the level of the pons and midbrain, based on axial cross-sections, according to standard radiological protocol. The parameters included the width of the AC in its anterior and posterior part, the width of the tentorial notch, and the distance from the pons and sella. All measurements were analyzed statistically with StatSoft Statistica 8.0 software. The average width of the AC differs between age groups. It is greatest at 1-3 years (2.8 +/- 0.6 mm) and lowest at 4-10 years (2.4 +/- 0.6 mm). AC is more likely to be greater in its anterior part in boys. The distance from the sella to the pons is greatest in 1-3-year-old girls (6.9 +/- 1.3 mm), and the tentorial notch is widest in the 15-18-year-old group (24.6 +/- 2.4 mm). Dimensions of the AC correlate with intracranial reserve volume. This is particularly visible in the youngest children. Thin and narrow AC is not always a sign of raised intracranial pressure. It may be specific for the child's age.
环池（AC）是蛛网膜下腔在中脑和脑桥水平围绕脑干的一个薄的延伸部分。尽管有各种定义，但它是颅内容积储备临床评估中的一个重要标志。虽然它无疑是有用的，但对于特定年龄组的尺寸和范围，目前尚无明确的放射学检查标准。本文旨在从解剖学角度描述环池，并给出合适的放射学解读的尺寸范围。该研究对160例因轻度脑震荡入院的1至18岁波兰儿童的轴向计算机断层扫描（CT）检查进行。使用西门子8排CT扫描仪进行扫描，未使用造影剂。根据标准放射学协议，基于轴向横截面，我们估计了脑桥和中脑水平的距离。参数包括环池前部和后部的宽度、小脑幕切迹的宽度以及脑桥与鞍的距离。所有测量数据均使用StatSoft Statistica 8.0软件进行统计分析。环池的平均宽度在不同年龄组之间有所不同。在1至3岁时最大（2.8±0.6毫米），在4至10岁时最小（2.4±0.6毫米）。男孩的环池前部更可能较宽。1至3岁女孩从鞍到脑桥的距离最大（6.9±1.3毫米），15至18岁组的小脑幕切迹最宽（24.6±2.4毫米）。环池的尺寸与颅内储备容积相关。这在最年幼的儿童中尤为明显。薄而窄的环池并不总是颅内压升高的迹象。它可能与儿童的年龄有关。
