低中凸面脑沟回矢状面MRI定位体系的临床应用价值初探

Priliminary Clinical Evaluation of System for Localizing Gyri and Sulci Along the Low-middle Convexity Surface on Sagittal MRI

分析大脑矢状面脑沟回ＭＲＩ上的毗邻关系，建立低中凸面脑沟回矢状面ＭＲＩ定位体系并初步探讨其临床应用价值。材料和方法：选择５０例无神经系统病变的健康者行ＭＲＩ矢状面扫描，层厚５ｍｍ，ＳＥ序列，Ｔ１Ｗ和Ｔ２Ｗ分别成像。两位医生双盲记录脑沟回的特殊解剖标志显示率；并收集同期病例分析其临床应用价值。结果：低中凸面脑沟回矢状面ＭＲＩ定位体系由七大解剖标志组成，包括外侧裂及分枝、额下回及分枝、汇合征、Ｔ形征、分离征、木偶脚征和双马踢征，它们在ＭＲ矢状面成像上的显示率分别为８８％、６８％、９６％、７８％、８１％、９８％和６８％。分析其病理定位价值发现：病灶较小时，局部结构没有破坏，可直接利用定位标志明确定位；病灶较大时，局部结构破坏，可利用远隔定位标志明确定位；某些横断面不能准确定位的病灶，可借助矢状面定位标志进行定位。

Purpose:To analyses anatomic relationships along the low-middleconvexity on sagittal MRI and construct the localizing system for deciding pathology and planning effective therapy.Material and Method:50 cases of normal brain with sagittal scans of SE T1W and T2W sequences were chosen on Resonex 0.38T MRI system.Anatomic features of cerebral sulcus and their relationships were recorded and observed with double blindmethods.Results:Anatomic landmarks for localizing gyri and sulci along the low-middle convexity on sagittal MRI were seven major rami of the sylvian fissure、the subdivision triangular inferior frontal gyrus、the posterior middle frontal gyrus fused with the anterior surface of precentral gyus、T-shape sign、separated ning of the central sulcus from the sylvian fissure、Puppy-paw appearance of the post CG and Horseshoe shape of the supramarginal gyrus and angular gyrus.The rates of displayment on MRI were 88%、68%、96%、78%、81%、98%and 68% sespectively.The clinical value is for the localization of pathology and planning a surgical approach to the lesion that might be difficult to gain on the basis of axial, or coronal plane MRI.Conlusion:System for localizinggyri and sulci along the low-middle convexity on sagittal MRI,providing an effective and valuable tool for localization.