Sheng Bo, Lv Furong, Xiao Zhibo, Ouyang Yu, Lv Fajin, Deng Jinmu, You Yunfeng, Liu Nan
Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Surg Radiol Anat. 2012 Oct;34(8):701-8. doi: 10.1007/s00276-011-0916-5. Epub 2011 Dec 11.
The purpose of this study was to determine the reliability of applying conventional anatomical landmarks to locate venous sinus in posterior fossa using subtraction computed tomography angiography (CTA) technique.
We retrospectively reconstructed transverse sinus (TS), sigmoid sinus (SS), and cranial imaging from 100 patients undergoing head CTA examination. Subtraction CTA data was merged with nonenhanced data and then cranium transparency was adjusted to 50% on three-dimensional volume rendering, indicating the anatomical relationship between surface landmarks of cranium and confluens sinuum, TS, and SS.
CTA technique precisely displayed the anatomical relations between venous sinus in posterior fossa and cranial surface landmarks. The asterion was located directly over the transverse-sigmoid sinus junction (TSST) in 81% cases, inferior to TSST in 15%, and superior to TSST in 4%, mainly distributing on the TS side of TSST, namely the distal-end of TS. Superior nuchal line had complex relation with TS and the line drawn from the zygoma root to the inion (LZI), but failed to represent the location of TS and the trend of LZI. In proximal-end of TS, majority of LZI overlapped with TS line. However, most LZI was gradually positioned below TS line as TS moved outwards. Almost half of line drawn from the squamosal-parietomastoid suture junction to the inion and line drawn from the asterion to the inion shared the same trend with TS.
Subtraction CTA merged into nonenhanced cranial bone with 50% skull transparency provides a feasible method to identify the anatomical relation between venous sinus and surface landmarks of cranium, which is significantly varied among individuals, so it is not accurate to determine venous sinus in posterior fossa merely using surface landmarks.
本研究旨在确定使用减影计算机断层血管造影（CTA）技术，应用传统解剖标志定位后颅窝静脉窦的可靠性。
我们回顾性重建了100例接受头部CTA检查患者的横窦（TS）、乙状窦（SS）及颅脑影像。将减影CTA数据与平扫数据融合，然后在三维容积再现时将颅骨透明度调整为50%，以显示颅骨表面标志与窦汇、横窦和乙状窦之间的解剖关系。
CTA技术精确显示了后颅窝静脉窦与颅骨表面标志之间的解剖关系。81%的病例中星点直接位于横窦-乙状窦交界处（TSST）上方，15%位于TSST下方，4%位于TSST上方，主要分布在TSST的横窦侧，即横窦远端。上项线与横窦及从颧根至枕外隆凸的连线（LZI）关系复杂，无法代表横窦位置及LZI走向。在横窦近端，多数LZI与横窦线重叠。然而，随着横窦向外走行，多数LZI逐渐位于横窦线下方。从鳞部-顶乳突缝交界处至枕外隆凸的连线和从星点至枕外隆凸的连线中，近半数与横窦走行趋势相同。
50%颅骨透明度下将减影CTA与平扫颅骨融合，为识别静脉窦与颅骨表面标志之间的解剖关系提供了一种可行方法，个体间差异显著，仅用表面标志确定后颅窝静脉窦并不准确。
