摘要
目的 探讨穹窿及其周围结构的显微解剖特点,为经胼胝体-穹窿间入路处理第三脑室病变提供解剖学基础.方法 （1）在15具（30侧）经彩色乳胶灌注血管的成人尸头上模拟经胼胝体-穹窿间入路,显微镜下对穹窿及其周围结构进行显微解剖和测量,并对数据进行统计分析;（2）通过50例正常成人（平均年龄为36岁）的正中矢状位头颅MRI,观察穹窿嵌入胼胝体的相对关系.结果 （1）穹窿起自颞角底部海马回的脑室面,止于乳头体,在侧脑室壁内侧围绕丘脑呈“C”型;穹窿共分为四部分,各部位均伴随重要的神经、血管走行;（2）经胼胝体-穹窿间入路中：胼胝体切口后缘距穹窿嵌入胼胝体处的距离为16.26 （11.72～22.04） mm,途经透明隔的高度为13.58（12.46～14.16） mm,途径穹窿的厚度为3.14（2.86～4.06） mm,室间孔的横径为3.22（1.86 ～4.62） mm;（3）穹窿嵌入胼胝体的相对位置：前交叉型占28％,标准型占58％,后交叉型占14％.结论 穹窿的解剖结构复杂、形态多变,与第三脑室及其周围结构关系密切.明确穹窿的显微解剖特点并进行充分的术前评估,对经胼胝体-穹窿间入路时正确处理穹窿及相关结构具有重要意义.
Objective To investigate the microsurgical anatomical structures of fornix and provide the anatomical basis for the surgery of transcallosal-interforniceal approach to the third ventricle.Methods （1） The surgery of transcallosal-interforniceal approach was performed on 15 formalin-fixed and dye-injected cadaveric head specimens.The microsurgical anatomy structures of the fornix were observed and measured by microscopes.Subsequently,the measured data was analyzed; （2） The 50 midline sagittal T1-weighted MRI of normal adults with average age of 36 years old and the relationship between the fornix and the corpus callosum were studied.Results （1） The fornix originated from the bottom of the temporal horn and the ventricle surface of the hippocampus and terminated in mammillary body.It presented C shape around the thalamus at the medial side of the medial wall of the lateral ventricle.There were many important nerves and vascular structures surrounding it.（2）The measured data obtained through the surgery of transcallosal-interforniceal approach：the distance between the posterior margin of the incision in corpus callosum and the borderline of fornix connected with corpus callosum was 16.26（11.72-22.04） mm,the height of the septum pellucidum was 13.58 （12.46-14.16） mm,the thickness of the fornix was 3.14（2.86-4.06） mm,the transverse diameter of the foramen of Monro was 3.22（1.86-4.62） mm.（3） The relative position of the fornix and the corpus callosum：type anterior cross,type standard cross and type posterior cross were 14（28%）,29（56%） and 9（14%） respectively.Conclusions The anatomical structures of the fornix were complex,morphology and close association with the microstructures of the third ventricle.The understandings of the microanatomy of the fornix and sufficient preoperative evaluation had important significance for surgery of transcallosal-interforniceal approach.
出处
《中华神经外科杂志》
CSCD
北大核心
2014年第12期1266-1270,共5页
Chinese Journal of Neurosurgery
基金
国家自然科学基金（81172192）
关键词
穹窿
显微解剖
第三脑室
经胼胝体-穹窿间入路
Fornix
Microsurgical anatomy
Third ventricle
Transcallosal-interforniceal approach
