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目的利于64排螺旋CT确定横窦和乙状窦的体表定位,评价采用上项线和颧弓-枕外隆突连线作为横窦标志的准确性,为横窦区入路相关手术的骨窗定位提供解剖学基础。方法回顾性重建100例进行过64排螺旋CT头部CTA检查患者的横窦和乙状窦影像,对比观察体表骨性标志与静脉窦的位置关系,确定横窦的体表定位。结果星点主要位于横窦和乙状窦连接部的横窦侧;星点位于横窦和乙状窦连接部前上方占4%,星点恰好位于连接部占81%,星点位于连接部后下方占15%。颧弓-枕外隆突连线和上项线走行不完全一致,它们与横窦的关系多样;上项线与横窦走行不一致;颧弓-枕外隆突连线可作近段横窦的定位标志,但是随着它们向外移行,颧弓-枕外隆突连线则主要位于横窦下方,并且它们的距离越来越远。结论上项线不能代表颧弓-枕外隆突连线的走行,同时它们都不是定位横窦的可靠标志,64排螺旋CT的头部减影CTA检查可作为常规术前检查来明确个体解剖资料从而定位横窦和乙状窦,以便指导横窦区相关手术入路设计。
Objective To facilitate the 64-slice spiral CT to determine the location of the transverse sinus and sigmoid sinus and evaluate the accuracy of using the upper line and the zygomatic arch-occipital line as the sign of transverse sinus for transverse sinus surgery Bone window positioning provides anatomical basis. Methods We retrospectively reconstructed 100 images of transverse sinus and sigmoid sinus in 100 patients who underwent CTA with 64-slice spiral CT. Compare the relationship between the surface markers of bony and venous sinuses and determine the location of the transverse sinus. Results The constellation was mainly located in the transverse sinus side of the junction between the transverse sinus and the sigmoid sinus. The apical point was located 4% ahead of the junction of the transverse sinus and sigmoid sinus, the star point was located at 81% of the junction and the satellite was located at the junction After the bottom accounted for 15%. The relationship between zygomatic arch and occipital protuberance and the superior line is not exactly the same. The relationship between zygomatic arch and occipital lobe is not consistent. The relationship between zygomatic arch and occipital lobe is not consistent. But as they move outward, the zygomatic arch-occipitobulbar connections lie mainly below the transverse sinus, and their distances are further and further apart. Conclusion The upper line can not represent the line of zygomatic arch-occipital extension, and neither of them is a reliable sign of positioning the transverse sinus. The 64-slice spiral CTA can be used as a routine preoperative examination to confirm the individual anatomy Data to locate the transverse sinus and sigmoid sinus, in order to guide the transverse sinus related surgical approach design.