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首页> 外文期刊>Neurosurgery >Utility of three-dimensional computed tomographic angiography for assessment of relationships between the vertebrobasilar system and the cranial base.
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Utility of three-dimensional computed tomographic angiography for assessment of relationships between the vertebrobasilar system and the cranial base.

机译：三维计算机断层血管造影用于评估椎基底动脉系统和颅底之间关系的实用程序。

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OBJECTIVE: The optimal surgical exposure for basilar tip aneurysms is dictated by the relationship of the basilar bifurcation to the cranial base. This study was designed to evaluate three-dimensional computed tomographic angiography as a means of obtaining detailed anatomic information on the basilar artery and the surrounding cranial base in individual patients before surgery. METHODS: We studied 30 patients using three-dimensional computed tomographic angiographic reconstructions from 1-mm computed tomographic slices. Detailed anatomic measurements were performed to define the relationship between the basilar artery and the cranial base. Particular attention was paid to the height of the dorsum sellae and its relationship to the basilar bifurcation. RESULTS: The heights of the basilar apex and the vertebrobasilar junction, relative to the cranial base, were extremely variable. Considerable asymmetries in the heights of the left and right posterior clinoid processes were identified; in one case, this difference was more than 1 cm (mean difference in height, 0.9 mm; range, 0-10.3 mm). The heights of the posterior clinoid processes above the sellar floor ranged from 5.8 to 14.1 mm (mean height, 9.5 mm). We were able to determine the feasibility of the pterional/orbitozygomatic, middle fossa/ anterior petrosal, and presigmoid retrolabyrinthine approaches to an individual basilar bifurcation. We also estimated the amount of bone removal required and determined the operative distances via those approaches. CONCLUSION: Three-dimensional computed tomographic angiography is a useful tool for assessing critical anatomic relationships and represents an adjunct to conventional angiography in the planning of individualized, precisely tailored, cranial base approaches to the vertebrobasilar system.
机译：目的：基底动脉瘤的最佳外科手术暴露取决于基底分叉与颅底的关系。这项研究旨在评估三维计算机断层血管造影术，作为获取术前个体患者基底动脉和周围颅底解剖学详细信息的一种手段。方法：我们使用1毫米计算机断层摄影切片的三维计算机断层血管造影重建术研究了30例患者。进行了详细的解剖学测量，以定义基底动脉和颅底之间的关系。特别注意了背侧蝶鞍的高度及其与基底分叉的关系。结果：相对于颅底，基底顶点和椎基底基底交界处的高度变化很大。在左右后斜突的高度中发现了相当大的不对称性。在一种情况下，这种差异超过1厘米（平均高度差异为0.9毫米;范围为0-10.3毫米）。鞍底上方的后斜突的高度范围为5.8至14.1 mm（平均高度9.5 mm）。我们能够确定翼状/眶fur，中窝/前岩质和前乙状后迷路进入单个基底分叉的可行性。我们还估计了所需的去骨量，并通过这些方法确定了手术距离。结论：三维计算机断层血管造影是评估关键解剖关系的有用工具，并且在规划个性化，精确定制的椎基底系统的颅底方法时，是常规血管造影的辅助工具。

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