动眼神经及相关动脉MRI与薄层断面解剖学研究

A study on anatomy of oculomotor nerve and its related arteies with MRI and sectional plastination

目的 研究动眼神经及其相关动脉的正常表现和相互关系 ,获得正常MR影像和断层解剖资料。方法 在多平面重建图像上测量动眼神经的最佳显示角度及脑池段长度 ,并在该图像、塑化切片、源图像及最大信号强度投影图像上观察动眼神经与基底动脉 (BA)、大脑后动脉 (PCA)、小脑上动脉 (PCA)及后交通动脉 (PCoA)的关系。结果 薄片断面上动眼神经和动脉节段性显示 ,与MRI有良好的对应关系 ,动眼神经脑池段长 (14 0 7± 2 15 )mm ,与脑干背侧连线夹角 (6 9 6 8± 7 15 )°,与正中矢状面夹角左右分别为 (2 4 44± 4 6 4)°、(2 4 44± 5 0 6 )°。年龄越大BA发生偏移例数越多 ,多数PCA和SCA与动眼神经紧贴 ,少数使神经受压 ,PCoA仅胚胎型与神经紧贴或使之受压。结论 MRI能够显示动眼神经脑池段的走行、形态及动脉与神经的关系 ,是评价动眼神经与毗邻动脉的准确的影像学技术。

Objective To obtain the normal image and sectional anatomical data of the oculomotor nerve and its related arteries with MRI and plastination. Methods The optimal angles and the length of intracisternal segment of the oculomotor nerve were measured on multiplanar reconstruction (MPR) images. Meanwhile, the relationship between the nerve and the basilar artery(BA), posterior cerebral artery(PCA), superior cerebellar artery(SCA) and posterior communicating artery(PCoA) were observed from the plastination slices, the original images, MPR and maximum intensity projections (MIP) images. Results MRI revealed the similar result corresponding to the plastination section in displaying the oculomotor nerve and its related arteries. The length of the intracisternal segment of the nerve was (14 4±2 15) mm and it formed an angle of (69.68±7.15)°with the posterior plane of the brain stem. The angle between the oculomotor nerve and the median sagittal plane was (24 44±4 64)°on the left and (24.44±5.06)°on the right. Shift of the BA was more likely found in aged individuals. Most of the PCA and SCA were close to the nerve,and a few of them compressed it, as for the PCoA, only the embryonic type was close to or compressed the nerve. Conclusion MRI is an accurate imaging technique for determination of the syntopy of the oculomotor nerve to its related arteries.