大脑外侧白质显微解剖：二维视频演示
White matter microdissection of the lateral aspect of the brain: 2-dimensional video demonstration.
作者信息
Zanuttini Luca, Staartjes Victor E, Chen Shao-Ching, Lin Chun-Fu, Hsu Sanford P C, Martins Carolina, Wen Hung Tzu, Serra Carlo, Türe Uğur
机构信息
Machine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland.
Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.
出版信息
Acta Neurochir (Wien). 2025 Aug 7;167(1):215. doi: 10.1007/s00701-025-06635-z.
BACKGROUND
The white matter dissection technique owes its modern recognition to Josef Klingler, whose fixation protocol enabled detailed fiber bundle visualization and led to an outstanding and still relevant atlas of white matter anatomy. After a period of decline in the late twentieth century, the technique was reintroduced into neurosurgical training with the aid of the surgical microscope, emphasizing the importance of fiber dissection and its practical applications in clinical neuroanatomy. This article provides a structured, step-by-step demonstration of white matter microdissection, progressing from superficial anatomy to deeper fiber layers. Its main contribution is the supplementary video, which offers a detailed, structured demonstration of the dissection steps and white matter layers, replicating the format and clarity of hands-on dissection courses. Careful editing and post-processing were applied to optimize educational impact.
METHODS
The dissection was recorded during the 7th Sulci, Gyri, Ventricles and Fiber Dissection Hands-on Course (Taipei, November 2024). Identifiable participants gave informed consent for publication.
RESULTS
The video illustrates a systematic lateral-to-medial dissection, beginning with sulcal and gyral identification. Grey matter is removed to expose U-fibers, followed by progressive visualization of the superior longitudinal fasciculus, insular cortex, extreme and external capsules, claustrum, basal ganglia, and anterior commissure. Each step is accompanied by commentary and technical tips to guide the dissection and preserve anatomical integrity.
CONCLUSION
By mastering the topography of white matter, neurosurgeons can enhance their understanding of pathological anatomy, allowing for precise mental rehearsal and strategic planning before surgery. This approach underscores the enduring importance of anatomical studies in improving surgical outcomes and advancing neurosurgical practice.
背景
白质解剖技术的现代认知归功于约瑟夫·克林格勒，其固定方案使详细的纤维束可视化成为可能，并由此产生了一部杰出且至今仍具相关性的白质解剖图谱。在20世纪后期经历了一段衰落期后，借助手术显微镜，该技术被重新引入神经外科培训，强调了纤维解剖及其在临床神经解剖学中的实际应用的重要性。本文提供了一个结构化的、逐步的白质显微解剖演示，从浅表解剖深入到更深的纤维层。其主要贡献在于配套视频，该视频详细、结构化地展示了解剖步骤和白质层，重现了实践解剖课程的形式和清晰度。通过精心编辑和后期处理以优化教育效果。
方法
解剖过程记录于第七届脑沟、脑回、脑室及纤维解剖实践课程（台北，2024年11月）。可识别的参与者已就发表事宜给予知情同意。
结果
该视频展示了从外侧到内侧的系统解剖过程，首先是识别脑沟和脑回。去除灰质以暴露U形纤维，随后逐步显示上纵束、岛叶皮质、极端囊和外囊、屏状核、基底神经节和前连合。每一步都配有解说和技术提示，以指导解剖并保持解剖完整性。
结论
通过掌握白质的局部解剖结构，神经外科医生可以加深对病理解剖学的理解，从而在手术前进行精确的心理演练和战略规划。这种方法强调了解剖学研究在改善手术效果和推动神经外科实践方面的持久重要性。
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