Kubota Hisashi, Sanada Yasuhiro, Yoshioka Hiromasa, Tasaki Takayuki, Shiroma Jun, Miyauchi Masaharu, Tanikawa Rokuya, Matsuki Mitsuru, Ohtsuki Toshiho, Kato Amami
Department of Neurosurgery, Kinki University Faculty of Medicine, 377-2, Onohigashi, Osakasayama, Osaka, 589-8511, Japan,
Acta Neurochir (Wien). 2015 Jan;157(1):43-8. doi: 10.1007/s00701-014-2253-z. Epub 2014 Oct 16.
The preoperative imaging diagnosis of the distal portion of the internal carotid artery (ICA) is extremely important for carotid endarterectomy (CEA). Herein the authors defined a line from the C1 transverse process to the hyoid bone (C1-H line) and evaluated whether the line can be used to predict an accessible ICA in CEA.
A cross point between the C1-H line and distal ICA was analyzed using three-dimensional computerized tomographic angiography (3D-CTA) in 20 patients. The C1-H line was compared to the line drawn from the mastoid process to the mandible (M-M line). Intraoperative exposure of the distal ICA was evaluated using both lines. Furthermore, the distance of each line from the C2 vertebra was measured to identify the distance difference of each line in relation to the cervical posture.
A distal ICA exposed at a cross point of the C1-H line corresponded well with the intraoperative findings. The cross point between the C1-H line and distal ICA was positioned at an average of 7.0 ± 0.7 mm cranially in comparison to the M-M line. The C1-H line showed smaller distance differences at different cervical positions than the M-M line. The C1-H line moved an average of 2.8 ± 2.5 mm from a cervical neutral position to an extensional one in the perpendicular direction.
The C1-H line measured by 3D-CTA is a simple and useful indicator of the distal ICA exposure in the preoperative diagnosis for CEA.
颈内动脉（ICA）远端的术前影像诊断对于颈动脉内膜切除术（CEA）极为重要。在此，作者定义了一条从C1横突至舌骨的线（C1-H线），并评估该线是否可用于预测CEA中可暴露的ICA。
使用三维计算机断层血管造影（3D-CTA）对20例患者的C1-H线与ICA远端的交叉点进行分析。将C1-H线与从乳突至下颌骨绘制的线（M-M线）进行比较。使用这两条线评估术中ICA远端的暴露情况。此外，测量每条线距C2椎体的距离，以确定每条线相对于颈椎姿势的距离差异。
在C1-H线交叉点暴露的ICA远端与术中发现吻合良好。与M-M线相比，C1-H线与ICA远端的交叉点平均位于头侧7.0±0.7mm处。在不同颈椎位置，C1-H线显示出比M-M线更小的距离差异。从颈椎中立位到伸展位，C1-H线在垂直方向上平均移动2.8±2.5mm。
通过3D-CTA测量的C1-H线是CEA术前诊断中ICA远端暴露的一个简单且有用的指标。
