海绵窦的断层标本与MRI对照研究

MR Anatomy of the Cavernous Sinus

为海绵窦的影像学和神经外科学提供基础资料。利用３５具三维头颅断层标本，１０３例正常三维头颅ＭＲＩ对照研究了海绵窦的位置、形态和内容。结果：海绵窦为颅中窝两层硬脑膜构成的硬脑膜窦，前端达眶上裂，后端达颞骨岩部尖。颈内动脉和脑神经Ⅵ位于海绵窦内，脑神经Ⅲ～Ⅴ位于海绵窦外侧壁内，这些神经与颈内动脉之间有恒定的位置关系，脑神经Ⅲ和Ⅳ位于颈内动脉外上，Ⅴ１和Ⅵ位于颈内动脉外侧稍下，Ⅴ２位于海绵窦外下角。在ＭＲＩ上，海绵窦静脉间隙呈稍低信号，脑神经呈点状或不规则形稍高信号。结论：ＭＲＩ能较好地显示海绵窦的详细解剖，与断层标本相一致，以经过蝶鞍中部的冠状位显示最佳。

This survey is designed to provide anatomic data for imaging diagnosis and microsurgical treatment of the cavernous sinus (CS) lesions. In this investigation, the position, shape and inner structures of CS of 35 sets of adult cadaveric head sections and 103 individuals of normal head MR images were compared. CS, a meningeal sinus formed between two layers of the dura mater, is located anteriorly to the superior orbital fissure and posteriorly to the apex of petrous portion of the temporal bone. Internal carotid artery (ICA) and cranial nerve Ⅵ are embedded inside CS, and cranial nerve Ⅲ, Ⅳ and Ⅴ 1 and Ⅴ 2 transversed along the lateral wall of CS. These nerves keep a constant relationship to ICA, in which cranial nerve Ⅲ and Ⅳ are superolateral to ICA, Ⅴ 1 and Ⅵ inferolateral to ICA and Ⅴ 2 in ferolateral to CS. On MR images, the venous spaces of CS show slightly hypo intense signals and cranial nerves above show dot like or irregular hyperintense signals. It is concluded that MRI shows the anatomical structures of CS in detail and best in a coronal image through median sella, corresponding well with the sectional cadavers.