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目的:揭示人三叉神经穿颅段及其周围结构的放射解剖学,为临床诊断和治疗三叉神经痛提供形态学及影像学依据。方法:26具完整成人尸头(10具女性,16具男性,年龄45-81岁,平均63.8岁),分别行显微解剖(8具)、微计算机断层扫描(micro-computed tomography,Micro-CT)(2具)和薄层塑化(16具),观察到的结果与临床无三叉神经疾患人群骨窗位CT图像(32例)、B-FFE序列MRI图像(3例)进行对比研究。结果:研究发现:1.三叉神经眼支与Ⅲ、Ⅳ、Ⅵ对脑神经及眼上静脉被硬脑膜及蛛网膜包绕共同穿越眶上裂,在此形成一个生理性狭窄。CT及MRI结合应用,可以满足该部位的诊断需求。2.圆孔是一个内侧壁中部带有骨嵴的弯曲管道,其突出的骨嵴造成管腔的狭窄,容易压迫到三叉神经上颌支。CT在该部位的应用较MRI有优势。3.三叉神经下颌支穿出卵圆孔处,有大量的静脉丛伴行,容易造成血管性压迫,MRI在该部位的应用较CT有优势。结论:三叉神经的3个分支在穿颅底段时,都存在机械性的压迫可能,这可能是三叉神经痛发生的原因之一。CT和MRI在上述三处部位的联合应用,可以满足临床上诊断的需求。
OBJECTIVE: To reveal the radiological anatomy of the human cranial segment and its surrounding structures and to provide morphological and imaging evidences for clinical diagnosis and treatment of trigeminal neuralgia. Methods: Totally 26 adult cadaveric heads (10 females, 16 males, aged 45-81 years, average 63.8 years old) were examined with micro-computed tomography (Micro-computed tomography, Micro- (32 cases) and B-FFE sequence (3 cases) were compared with the CT images (32 cases) and the thin layer plasticization (16 cases) . Results: The study found that: 1. trigeminal nerve branches and Ⅲ, Ⅳ, Ⅵ of the cranial nerves and supraorbital veins were dura and arachnoid wound together through the supraorbital fissure, where the formation of a physiological stenosis. CT and MRI combined application, to meet the diagnostic needs of the site. 2 round hole is a medial wall with bone crest curved pipe, the prominent bone crest of the lumen caused by stenosis, easy compression to the trigeminal maxillary branch. The application of CT in this area has advantages over MRI. 3. The mandibular branch of the trigeminal nerve piercing the foramen ovale, there are a large number of venous plexus accompanies, easily lead to vascular compression, MRI in the application of this site has advantages over CT. CONCLUSION: The three branches of the trigeminal nerve have the possibility of mechanical compression when they penetrate the skull base, which may be one of the causes of trigeminal neuralgia. CT and MRI in the joint application of the above three parts, to meet the needs of clinical diagnosis.