【摘要】 目的获得正常人脑池段后组脑神经及相关动脉血管的 MRI 和断层解剖资料。方法对59名正常体检者进行三维(3D)积极干预稳态(3D-CISS)序列扫描、多平面重组(MPR)成像,其中22名同时行3D-时间飞跃法(TOF)脑干区血管成像。对这些受检者脑池段后组脑神经的走行和神经血管位置关系进行显示,并将脑池段后组脑神经 MRI 结果与5具尸体脑断层切片、尸体脑3D-CISS 结果进行对照分析。结果(1)显示概率:59名正常体检者脑池段舌咽、迷走、副复合体神经在斜横断面、斜矢状面重组图像上分别以100%(118/118)、99%(117/118)的概率清晰显示;舌下神经在斜横断面、斜矢状面重组图像上分别以90%(106/118)、91%(107/118)的概率清晰显示;3D-TOF 序列成像不能清晰显示后组脑神经。(2)神经走行显示:59名正常体检者的双侧舌咽、迷走、副复合体神经均从橄榄后沟发出,自上而下依次为舌咽、迷走、副神经;颈静脉孔为舌咽、迷走、副复合体神经出现的标志层面;45%(53/118)的舌咽、迷走、副神经呈分离平行状走行,55%(65/118)三者呈聚拢状走行;舌下神经从延髓前外侧沟出延髓,舌下神经管为舌下神经出现的标志层面。(3)3D-CISS 序列 MR 影像:椎动脉(VA)是显示率较高的动脉,72%(85/118)的 VA 与后组脑神经无接触;28%(33/118)的VA 与后组脑神经接触。(4)将脑池段后组脑神经成像结果与尸体3D-CISS MRI、断层切片标本进行对照,显示良好的对应关系。结论3D-CISS MRI 可以清晰显示脑池段后组脑神经及相关动脉血管。更多还原

【Abstract】 Objective To obtain normal MRI and sectional anatomical data of posterior nerves and their related arteries.Methods A total of 59 volunteers underwent 3D-CISS sequence scanning,and 22 of these volunteers also underwent MR angiography in which a time-of-flight sequence was used.Anatomical features and neurovascular relationships of posterior nerves were observed from multi-planar reconstruction (MPR)images of volunteers,sectional specimens and 3D-CISS imaging of cranial specimens.Results(1) Cisternal segments of CN Ⅸ,Ⅹ,Ⅺ complex were identified with certainty in 100%(118/118)obtained in oblique axial planes,99%(117/118)obtained in oblique sagittal planes;hypoglossal nerves were identified with certainty in 90%(106/118)obtained in oblique axial planes,91%(107/118)obtained in oblique sagittal planes.On the contrary,we were never able to identify posterior nerves by using 3D-TOF sequence in 22 volunteers.(2)All of posterior nerves emerged from the anterior sulcus of olive,we successively identified CN Ⅸ,Ⅹ,Ⅺ from top to bottom;the jugular foramen was the important landmark to find the posterior nerves;CN Ⅸ,Ⅹ,Ⅺ were found parallel to each other in 45%(53/118)of complex;55% (65/118)of CN Ⅸ,Ⅹ,Ⅺ complex gathered together;hypoglossal nerves emerged from posterior sulcus of olive,hypoglossal canal was the important landmark to find hypoglossal nerve.(3)VA were blood vessels more often identified.When VA were identified,they were noted to be in contact with posterior nerves in 28%(33/118)of nerves,and not in contact in 72 %(85/118)of nerves.(4)3D-CISS imaging of volunteers revealed the similar result corresponding to slices and 3D-CISS MPR images of specimens in displaying posterior nerves.Conclusion Anatomical course of posterior nerves and their related blood vessels can be reliably identified using 3D-CISS MR sequence.更多还原