Naito Michiko, Yu Hee Chul, Kim Ji Hyun, Rodríguez-Vázquez José Francisco, Murakami Gen, Cho Baik Hwan
Department of Anatomy, Nihon University School of Medicine, Tokyo, Japan.
Department of Surgery & Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Republic of Korea.
Clin Anat. 2015 Jul;28(5):627-37. doi: 10.1002/ca.22489. Epub 2014 Nov 25.
To understand anomalies in Chiari's network better, we assessed the topographical anatomy of the fetal inferior vena cava (IVC), coronary sinus, and atria. We examined sagittal serial paraffin sections of 15 human fetuses of crown-rump length 24-36 mm, corresponding to a gestational age of 8 weeks. Although their outflow tract morphologies were similar, these 15 specimens could be classified into two groups. In eight specimens, the left common cardinal vein reached the body wall, whereas in the other seven the vein was obliterated near the left pulmonary vein. Irrespective of the group in which the specimen was included, the anteroposterior arrangement of the coronary sinus, the sinus septum (septum), and the right sinus valve (right valve) could be classified into three types: the right valve-septum-coronary sinus arrangement in seven specimens; the right valve-coronary sinus-septum arrangement in five; and the coronary sinus-right valve-septum arrangement in three. Depending on differences in topographical anatomy, the sinus septum separated the coronary sinus opening from either the right or the left atrium. Likewise, the coronary sinus opening was either adjacent to or distant from the IVC terminal. Rather than the counter-side position of the right valve being at the IVC terminal, the left sinus valve protruded leftward, forming an incomplete interatrial septum. Fetal variations seemed to be closely connected with individual variations and a high frequency of Chiari's network anomalies in adults.
为了更好地理解奇阿里网的异常情况，我们评估了胎儿下腔静脉（IVC）、冠状窦和心房的局部解剖结构。我们检查了15例头臀长24 - 36毫米的人类胎儿的矢状连续石蜡切片，其对应孕周为8周。尽管这15个标本的流出道形态相似，但可分为两组。在8个标本中，左总主静脉到达体壁，而在另外7个标本中，该静脉在左肺静脉附近闭锁。无论标本属于哪一组，冠状窦、窦间隔（间隔）和右窦瓣（右瓣）的前后排列可分为三种类型：7个标本为右瓣 - 间隔 - 冠状窦排列；5个为右瓣 - 冠状窦 - 间隔排列；3个为冠状窦 - 右瓣 - 间隔排列。根据局部解剖结构的差异，窦间隔将冠状窦开口与右心房或左心房分隔开。同样，冠状窦开口与IVC末端相邻或远离。左窦瓣向左突出，形成不完全房间隔，而不是右瓣位于IVC末端的对侧位置。胎儿变异似乎与个体变异以及成人奇阿里网异常的高发生率密切相关。
