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椎动脉近端V1段的应用解剖学及临床意义。

The applied anatomy and clinical significance of the proximal, V1 segment of vertebral artery.

作者信息

Li X, Guan L, Zilundu Prince L M, Chen J, Chen Z, Ma M, Zhuang H, Zhuang Z, Qiu Y, Ye F, Wu X, Sang H, Ye Y, Han Y, Yao H, Li H, Zhong G, Wu H, Jiang Z, Chu G, Xu D, Zhou L

机构信息

Department of Human Anatomy, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China.

Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China.

出版信息

Folia Morphol (Warsz). 2019;78(4):710-719. doi: 10.5603/FM.a2019.0039. Epub 2019 Apr 5.

Abstract

BACKGROUND

The aim of the study was to probe the morphological features of the proximal segment (V1) of vertebral artery (VA) in a sample of Chinese cadavers.

MATERIALS AND METHODS

The origin, course and outer diameter at origin of the pre-vertebral part of the VAs were evaluated in 119 adult cadavers.

RESULTS

It was found that 94.12% of the VAs originated from the subclavian arteries, bilaterally. The variant origins were present in 5.88% of the cadavers and all originated directly from the arch of the aorta. All the variations were observed on the left side of male cadavers. The average outer diameters at origin of the normal and variation groups were 4.35 ± 1.00 mm and 4.82 ± ± 1.42 mm, respectively, p = 0.035. In the normal group, but not in the variation group, the average diameter in the males was significantly larger than that in the females (4.50 ± 0.99 mm, 3.92 ± 0.92 mm, respectively, p = 0.000). In addition, only 5 cadavers in the normal group had hypoplastic VAs (4.20%, 4 males, 3 right-sided). Vertebral artery dominance (VAD) was present in 91 (69 males) out of 112 cadavers and more common on the left (n = 48). In addition, 3 cadavers satisfied conditions for coexistence of VAD and vertebral artery hypoplasia. All 7 cadavers in the variation group exhibited VAD, which was more common on the right side (n = 5).

CONCLUSIONS

The morphologic variations and frequencies described above have implications for the early prevention, abnormal anatomy detection, accurate diagnosis, safe surgery and endovascular treatment of cardiovascular and neurological disease.

摘要

背景

本研究旨在探究中国尸体样本中椎动脉(VA)近段(V1)的形态特征。

材料与方法

对119具成年尸体的椎动脉椎体前部的起源、走行及起始外径进行评估。

结果

发现94.12%的椎动脉双侧起源于锁骨下动脉。5.88%的尸体存在变异起源,均直接起源于主动脉弓。所有变异均在男性尸体左侧观察到。正常组和变异组的平均起始外径分别为4.35±1.00mm和4.82±1.42mm,p = 0.035。在正常组中,男性的平均直径显著大于女性(分别为4.50±0.99mm和3.92±0.92mm,p = 0.000),但变异组中并非如此。此外,正常组中只有5具尸体的椎动脉发育不全(4.20%,4例男性,3例右侧)。112具尸体中有91具(69例男性)存在椎动脉优势(VAD),且在左侧更常见(n = 48)。此外,3具尸体满足VAD与椎动脉发育不全共存的条件。变异组的所有7具尸体均表现出VAD,在右侧更常见(n = 5)。

结论

上述形态学变异及发生率对心血管和神经疾病的早期预防、异常解剖结构检测、准确诊断、安全手术及血管内治疗具有重要意义。

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