心包横窦的范围、通连及其变异

Territory, connections and variations of transverse sinuses of the pericardia

目的：明确正常心包横窦的范围、通连及变异，为临床影像学及心脏外科疾病的诊断及治疗提供依据。方法：选用正常成人胸部连续断层标本４０例及心包完整的离体心脏１０例。对横窦的形态、通连关系、毗邻关系及变异进行观察。结果：５０例标本中，２例可见前垂直部与主动脉上窦后部直接延续，未见中间水平部；４８例可见中间水平部或／及后垂直部，其中２４％（１２例）中间水平部延续到右肺动脉前下方，３０％（１５例）延续到右肺动脉中点下方，１６％（８例）延续到右肺动脉后下方，２６％（１３例）可见后垂直部，其中１０例紧贴左房上部后方向下，３例向上贴于右肺动脉后下壁；７０％（３５例）可见主动脉上窦后部。结论：心包横窦的前垂直部及中央水平部前段解剖结构较固定，但横窦中央水平部中、后段变异较大，而主动脉上隐窝后部有３０％的人不发育。

To confirm the territories,the connections and the variations of the normal transverse sinus (TS) of the pericardium, thus provide anatomical basis for clinical imaging and cardiosurgery. Methods: The territories, connections, relationships with the adjacent structures and the anatomical variations were observed on serial thorax sections of forty cadavers and ten heart specimens with complete pericardium. Results: It can be found in two of the specimens that the anterior vertical segments connected with the posterior parts of the superior aortic recesses straightly, lacking the middle horizontal segments. Forty - eight of the specimens have the middle horizontal segments and the posterior vertical segments. The middle horizontal segments at the area under the anterior right pulmonary arteries in 24%(12 cases) of the specimens, reached the area under the right pulmonary arteries in 30% (15 cases), get at the area under the posterior right pulmonary arteries in 16% (8 cases). The posterior vertical segments were found in 26% (13cases) at the same time. Ten of which went down along the posterior walls of the left atria, and three of which went down along the lower and posteroinferior wall of the right pulmonary arteries. Conclusions: The structures of anterior vertical segments and anterior parts of the middle horizontal segments of TS are uniform, while the structures of the middle and posterior parts the posterior vertical segments of TS are various, the posterior parts of the superior aortic recesses have not developed in 3 % of the specimens.