尺神经深支的影像解剖

Imaging anatomic study of deep branch of ulnar nerve

目的通过对尺神经深支进行显微解剖和影像学研究，为腕掌部尺神经深支损伤的早期诊治提供影像学和解剖学依据。方法自2008年10月至2010年8月，在16侧成人防腐上肢和4侧成人新鲜上肢标本上，以钩骨钩中点为原点O，在手掌平面建立X、Y坐标轴，尺神经深支与X轴交点到原点的距离为OE；X轴与钩骨钩基底部尺侧界的交点到原点的距离为OF；Y轴与远端尺神经深支的交点到原点的距离为OG，与近端尺神经深支的交点到原点的距离为OH，钩骨钩尺侧界与尺神经深支的距离为EF。确定第2～5掌骨远侧缘及近侧缘掌侧面中心点，分别经两中心点作矢状面，观测尺神经深支与矢状面上各掌骨的相关长度。将硫酸钡（Ⅱ型）干混悬剂均匀涂于尺神经深支表面，进行CT扫描观测，所得的数据采用SPSS13．0统计包进行分析。结果OE为（4．96±0．11）mm，CT结果为（5．02±0．12）ram；OF（3．69±0．12）mm，CT结果为（3．75±0．12）mm；OG（10．55±1．07）mm，CT结果为（10．48±0．84）mm：OH（7．23±0．85）mm，CT结果为（7．29±0．84）mm；EF（1．27±0．15）mm，CT结果为（1．17±0．16）mm。同时对尺神经深支与矢状面掌骨进行了相关测量和CT测量。每组数据的解剖学结果与CT结果经t检验，差异无统计学意义（P〉0．05）。结论解剖学和CT影像学结果差异无统计学意义，CT影像学结果可直接作为临床参考值。解剖和影像结果对临床诊治尺神经深支伤病具有指导意义。

Objective To dissect and observe the course of the deep branch of the ulnar nerve and its＇ distribution of the muscular branch, to provide imaging and anatomical basis for early diagnosis and treatment of the wrist deep branch of ulnar nerve injury in clinical. Methods From October 2008 to August 2010, dissected 16 fresh and 4 antiseptic samples, with the most bump of the hook of the hamate bone as the origin O, set the axis over the O point. The distance from O to the intersection point of the X axis and the deep branch of ulnar nerve was OE ; the distance from O to the intersection point with the ulnaris of hook of hamate bone was OF ; the distance from O to the proximal deep branch of ulnar nerve intersection point of the Y axis was OG ; the distance from O to the distal deep branch of ulnar nerve respectively was OH. Named the head of the metacarpal bone and the palm side of the center of the basal of the 2nd to the 5th metacarpal bone, through these two points, the measure related data from the deep branch of the ulnar nerve and the metacarpal bone in the sagittal plane. Having a CT scan image data, the Barium Sulfate （ Ⅱ ） dry suspension was uniformly smeared onto the surface of the deep branch of ulnar nerve, the data obtained was analyzed using SPSS 13.0. Results The length of OE was （4.96 ± 0.11 ）mm, CT result was（5.02 ± 0.12）mm; the length of OF was（3.69 ± 0.12）mm, CT result was（3.75 ± 0.12）mm; the length of OG was（10.55 ± 1.07）mm, CT result was（10.48 ± 0.84）mm; the length of OH was（7.23 ± 0.85）mm, CT result was（7.29 ± 0.84）mm; the length of EF was（1.27± 0.15） mm, CT result was（ 1.17 ± 0.16）mm. The measure related data from the deep branch of the ulnar nerve and the metacarpal bone in the sagittal plane. Each data set of the anatomical results and CT results had been tested by T, P values were more than 0.05. Conclusions There is no significant difference between anatomic and CT observations of deep branch of ulnar nerve, CT observations can be regarded as a clinical reference directly. Anatomic and CT observations can be seen as a guide for clinical work in the diagnosis and treatment of deep branch of ulnar nerve injury.