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目的通过对海绵间窦的显微解剖与磁共振对照研究,为蝶鞍区手术入路的设计提供形态学基础。方法分别对18例成人头颅湿性标本、24例对比增强磁共振静脉造影(CE-MRV)图像进行观测。结果①以垂体为标志,CE-MRV可以观察到各海绵间窦的位置和形态,且与显微解剖比较大致相同;②以显微解剖作为参照标准,CE-MRV可以观察到37%的前海绵间窦、48%的下海绵间窦、30%的后海绵间窦、30%的鞍背窦和100%的基底窦。③根据前、下海绵间窦的出现与否,显微解剖和CE-MRV均可将海绵间窦分为仅前海绵间窦出现型、仅下海绵间窦出现型、前下海绵间窦同时出现型以及前下海绵间窦均未出现型。结论术前CE-MRV可以观察到各海绵间窦的形态、判定其分型,有助于蝶鞍区手术入路的设计、提高手术的成功率。
OBJECTIVE: To provide a morphological basis for the design of the surgical approach to the sellar region by microsurgical anatomy and magnetic resonance contrast studies of the cavernous sinus. Methods Eighteen adult skull wet specimens and 24 contrast-enhanced magnetic resonance venography (CE-MRV) images were observed. Results ① The position and morphology of the intercavernous sinus were observed by CE-MRV with the pituitary as a sign, and were almost the same as that of the microdissected anatomy. ② With microdissection as the reference standard, 37% of the anterior Spontaneous sinus, 48% of the lower sponge sinus, 30% of the posterior intercavernous sinus, 30% of the posterior sinus and 100% of the basal sinus. ③ According to the presence of the anterior and posterior sponge sinus, microsurgical dissection and CE-MRV can be divided into only spontaneous sinus cavernous anterior type, only the sponge anastomosis, the former under the sponge sinus at the same time Appearance and type before the next sponge sinus are not seen. Conclusions Preoperative CE-MRV can observe the morphology of the intercavernous sinus and determine its classification, which is helpful for the design of the surgical approach in the sellar region and the success rate of operation.