三维螺旋CT血管造影检查在连头婴显微分离手术中的应用

Application of spiral computerized tomographic angiography in microsurgery of separating craniopagus twins

目的 探讨三维螺旋CT血管造影在连头婴显微分离术术前影像检查中的作用。 方法 采用表面遮盖显示法进行三维重建图像处理。 结果 螺旋CT血管造影结果显示连头婴双头颅骨相互连续 ,连接部部分骨质、硬脑膜缺如 ;双侧脑组织相连 ,部分相融。双婴上矢状窦后 1/ 3融合并汇入同一窦汇 ,两婴一侧横窦相融。 结论 螺旋CT血管造影可以较清晰显示连头婴颅骨、脑组织及颅内血管的变异 ,尤其是颅内血管与颅骨的立体关系 ,有助于在手术中准确设计骨瓣及手术入路 。

Objective To evaluate the role of 3 D spiral computerized tomographic angiography (SCTA) in microsurgery of separating craniopagus twins Methods A case of craniopagus twins underwent spiral CTA Image reconstruction was made by shaded surface display Result SCTA demonstrated osseous fusion in twins skull Parts of bone and dura mater were found to be absent in the fused area Two parts of brain tissues were linked together, and some area were fused Twins' one third of posterior superior sagittal sinuses were fused and converged into a common sinus One side of their transverse sinuses were fused Conclusion SCTA can clearlly reveal the abnormalities of skull, cerebrum, intracranial blood vessels, especially the stereostruction between intracranial blood vessels and skull SCTA is useful for intraoperative bone design and decision of surgical route and has important value in formulating surgical plans