岛叶动静脉的显微解剖学研究

Microsurgical anatomy of insular arteries and veins

目的明确岛叶区域局部解剖、动脉供应及静脉引流，了解岛叶解剖及血管构成是成功进行此区显微外科手术的前提。方法有色硅胶灌注10个福尔马林固定的成人尸头（20侧大脑半球），研究其岛叶解剖及血管构成。结果岛盖包覆岛叶，环岛沟是其明确界线；大脑中动脉为岛叶提供惟一血供，其中主要由M2段为岛叶提供血供。岛叶动脉主要供应岛叶皮质、最外囊，偶尔供应屏状核和外囊，但不供应壳核、苍白球及内囊；岛叶主要有4条静脉，主要汇人大脑中深静脉，也常与侧裂浅静脉有联系。结论理解岛叶复杂的血管构筑方式，熟悉岛叶解剖，将有助于完成此区域手术。

Objective To define the topographic anatomy, arterial supply and venous drainage of the insula, which is essential to perform accurate microsurgical procedures in this region. Methods The topographic anatomy, arterial supply and venous drainage of insula were examined in 10 human cadaver brains （20 hemispheres） in which the arteries and veins had been perfused with colored silicone. Results The anterior, superior, and inferior limiting sulci clearly demarcated the insula and distinguished it from surrounding cortical areas. The MCA provided the sole supply to the insula. The insula was supplied predominantly from M2 segment of MCA, occasionally from M1 and M3 segmenL The majority of insular arteries were short and supplied the insular cortex and extreme capsule, but not the putamen, globus pallidus, or internal capsule, which were vascularized by the lateral lenticulostriate arteries. The minority of insular arteries were medium sized and also supplied the claustrum and external capsule. The least part of insular arteries were long and extended as far as the corona radiate, these arteries mostly located in the posterior region of the insula. The insula had four main veins according to their relationship with the insular sulci and gyri： anterior, precentral, central, and posterior veins. Insular veins drained predominantly to the deep middle cerebral vein, although their frequent connections to the superficial venous system were found. Conclusion The knowledge of arterial and venous relationships of the insula will assist neurosurgeons in dealing with disorders in this area.