【摘要】 目的为选择血管支架的类型和放置部位提供解剖学基础。方法选取无病变的全脑血管造影像100例,观测大脑中动脉的走行、分支及其穿支的开口部位。选取头部标本20具,经双侧翼点入路解剖观测大脑中动脉及其分支、穿支血管。采用两样本均数t检验的统计学方法,比较血管造影像与标本解剖和男性与女性之间有无显著性差异。结果大脑中动脉M1段血管造影的长度和直径分别为(10.65±5.61)mm、(2.30±0.35)mm,标本解剖的长度和外径分别为(13.14±3.62)mm、(3.41±0.38)mm,血管造影与标本解剖有显著性差异(t=9.423、t=12.764,P<0.05)。大脑中动脉M1段中央支的内侧群动脉发自大脑中动脉M1段的上壁和内侧壁,较细小;外侧群动脉发自大脑中动脉M1段分叉处动脉干的上壁和内侧壁,较粗、长。男、女性大脑中动脉M1段血管造影的长度、直径有显著性差异(t=4.223、t=2.356,P<0.05),男性较女性的大脑中动脉M1段长,直径粗。结论大脑中动脉的血管造影与标本解剖对照研究对选择血管支架的类型和放置部位,避免血管支架阻塞中央支开口处,防止术后中央支供应区域缺血等具有重要的临床意义。更多还原

【Abstract】 Objective To provide anatomical basis for selecting the types and placing parts of vascular stent. Methods100 angiography without positive diseases were selected,the course and branches of the middle cerebral artery and the opening parts of its perforators were observed. 20 head specimens were selected,the middle cerebral artery and its branches,perforators were observed through the pterion approach. Results M1 segment of middle cerebral artery was( 10. 65 ±5. 61) mm,( 2. 30 ± 0. 35) mm in the length and diameter on the angiography,( 13. 14 ± 3. 62) mm,( 3. 41 ± 0. 38) mm in the length and external diameter of specimens of the M1 segment of middle cerebral artery separately. There were significant difference in the length and diameter between the angiography and specimens separately( P < 0. 05). Medial group of central branches were originated from the superior and medial wall of the M1 segment of middle cerebral artery,it was fine and small. Lateral group of central branches were originated from the superior and medial wall of bifurcation of the arterial trunk,it was coarse and long. There were significant difference in length and diameter between the male and female on the angiography respectively( P < 0. 05),the male M1 segment of middle cerebral artery were more long and coarse than that of the female. Conclusion Angiography and specimens control study has an important clinical significance for selecting the types and placing parts of vascular stent,avoiding obstruction the opening parts of central branches,preventing postoperative ischemia of the supply area by central branches.更多还原