摘要
观察了１００例正常人ＣＴ扫描轴位像及正中矢状重建像，３０例正常人ＭＲ矢状像及轴位像。设计了ＣＴ定位扫描基准线─—外耳孔下缘为体表定位标志，其水平延伸线与ＯＭ线呈向前开放的１０度夹角，及定位基准面─—ＡＣ─ＰＣ线上４ｍｍ层面。从而使ＣＴ图像与脑标准切面图谱一致起来，免除了繁琐的靶点坐标换算。这一新的ＣＴ定位方法经临床应用治疗４５例锥体外系疾病，靶点命中率９２．３％。与对照组（Ｘ线脑室造影定位）７０例靶点命中率８６．７％相比较，两组靶点坐标值及靶点命中率无显著差异（ｔ检验，Ｐ＞０．０５，ｘ￣２检验，Ｐ＞０．１０）。结果提示：ＣＴ定位新方法，可代替Ｘ线脑室造影定位，且具更多优越性。
ntroduction:We developed a new
CT-located method to aid in the localization of VL and
globusPallidus(Pa)for the treatment of extrapyramical disease(EPD)in
stereotactic surgery. Materials andMethods: The new CT-located method
was used in 100 normal adults and 45 cases of EPD with TO-MOSCAN 350
scanner (Philips,Holland) and LEKSELL stereotactic system(Elekta,
Sweden).The MRIdata of 30 normal adnlts and 30 cases of EPD,whose
targets were located by ventriculography, were usedin contrast.The
scannig baseline (Sb) was the inferiority of porus acusticus externus
and an angle of 10°with OML.Results:Having reserched into middle
sagital reconstruction of CT in 30 mormal adults and direct middle
sagital MR image in other 30 ones,we found that Sb was parallel to
the AC-PC line andforman occipital was constantly shown in an axial
plane of Sb,which was used as location plane (LP).Theanatomic atlas
of standard plane (SP)(56.6±4.0mm above LP)was 4mm above AC-PC line,
comparedwith the structuer of brain standard section.The reference
structure(FM,Great cevebral vein cisternGCVC, 3rd ventricle and
capsula inter)for locating VL,well showed in the SP and the distance
fromFM to GCVC was 22.5±1.18mm and VL was 13.75±1.88mm beside
FM-GCVC line.Pa shown at thelevel of 6mm below SP was located at
17-25mm beside the middle line,6-6.5mm in front of VL.Thenew method
was applied in treating 45 cases of EPD. The accuracy of primary
target was 93.3%. And in the ventriculogvaphy contrast group,that was
86.6%,Statistically there are no difference in the accu-racy of
primary targets and target corrdinates between the CT-located method
and the vevtriculography method.Conelusion:The new CT-located method
can simplify the locating process and improve the surgery effect.It
is a valuable approach to locate brain nuclei for EPD in stereotactic
surgery.
