翼状韧带的影像解剖学研究

Image-anatomic research of the alar ligament

目的探讨翼状韧带的位置、形态及走行,并深入研究其断面解剖形态及CT和MRI表现。方法采用经福尔马林固定的正常成人头颅标本12例,其中3例用于大体解剖观察,3例制成5.0mm厚的冰冻切片,6例制成0.5mm厚的薄层切片;选取2组各51例健康志愿者分别行CT和MRI检查。结合大体和断面解剖,分析翼状韧带的CT和MRI表现,并对其进行影像学测量。结果大体和断层解剖均能清晰显示翼状韧带的位置、形态及走行。齿状突上部的横断面和齿状突中部的冠状面是显示翼状韧带的理想层面。翼状韧带在CT和MRI横断面、冠状面及矢状面上的显示率均为100%(51/51)。对于翼状韧带结构的显示,MRI优于CT,尤其是质子密度加权成像的显示效果最佳。翼状韧带宽度在男女性别及左右侧别间的差异无统计学意义(P>0.05)。结论CT和MRI均能较好地显示翼状韧带,结合大体和断层解剖进行研究,可为翼状韧带创伤、畸形及感染等病变的诊断提供影像解剖学支持。

Objective To detect position and morphous as well as coursing of the alar ligament, and to further investigate the sectional anatomy and CT and MRI imaging of the alar ligament. Methods Twelve formalin fixed specimens including head and neck utilized, three of the twelve were observed in gross anatomy, nine of them were dissectioned. Fifty-one healthy volunteers from each group were selected to perform CT and MRI examination respectively. By combining gross and sectional anatomy, CT and MRI manifestations of the alar ligament were analyzed, the alar ligament width was mea- sured. Results Location and shape, as well as coursing of the alar ligament could be demonstrated clearly in gross and sectional anatomy. The transverse plane across the upper dens and the coronal plane by the middle dens were the optimal planes for demonstrating the alar ligament. The display ratio of the alar ligament was even 100%（51/51 ）in both images of CT and MRI. MRI had better advantages than CT in respect of demonstrating the alar ligament, PDWI （proton density weighted imaging, PDWI） is the most optimal sequence for the alar ligament. There were no significant differences of the alar ligament width between male and female and between the right and the left side（P〉0.05）. Conclusion In combination with gross and sectional anatomy, CT and MRI could both provide an imageo-anatomic basis for diagnosis of the alar ligament trauma and malformation as well as infection.