大脑前交通动脉成窗现象的解剖学特征及其临床意义

Anatomic characteristics of anterior communicating arterial fenestration in human fetal cadaver and its clinical significance

目的探讨胚胎大脑前交通动脉成窗现象的解剖学特征及其临床意义。方法对60具用质量分数为20％的甲醛溶液固定的胚胎，行大脑血管彩色乳胶灌注。胎龄为16—40周，平均（28±6）周。在手术显微镜下，观察前交通动脉成窗的解剖学特征。按胎龄分为16—20周7例，21—24周10例，25—28周19例，29—32周9例，33—36周12例，37—40周3例。结果胚胎前交通动脉成窗的发生率为20％（12／60）。根据形态学大致分为4类：线型为8％（5／60），网状型为3％（2／60），丛状型3％（2／60），复合型5％（3／60），各组间前交通动脉成窗的发生与胎龄无相关性（x^2=1．134，P〉0．05）。结论前交通动脉成窗的发生与胎龄无明显相关性，可能与胚胎个体发育和血流动力学等多种因素相关，并容易被误诊为动脉瘤。

Objective To explore the anatomic characteristics of anterior communicating arterial fenestration in human fetal cadaver and its clinical significance. Methods Cerebrovascular perfusion with color latex in 60 human fetal cadaves fixed in formalin. Fetal ages were 16 to 40 weeks （mean 28 ±6 weeks）. The anatomic characteristics of the anterior communicating arterial fenestration were observed under the operating microscope. The specimens were divided into 16 to 20 weeks （n = 7 ）, 21 to 24 weeks （n= 10）, 25 to 28 weeks （n= 19）, 29 to 32 weeks （n =9）, 33 to 36 weeks （n = 12）, and 37 to 40 weeks （n = 3） according to the fetal ages. Results The incidence of anterior communicating arterial fenestration in the fetus was 20% （12/60）. They were roughly divided into four categories according to the morphology： linear pattern 8% （5/60）, reticular pattern 3% （2/60）, plexiform pattern 3% （2/60）, and complex pattern 5% （3/60）. The occurrence of the anterior communicating arterial fenestration was not correlated with the fetal age in all groups （x^2 = 1. 134, P 〉 0. 05 ）. Conclusions The occurrence of the anterior communicating arterial fenestration has no obvious correlation with the fetal ages, and it may be correlated with many factors, such as the individual development of fetus and hemodynamics. It is easy to be misdiagnosed as an aneurysm.