基于三维CT血管成像的旋股内侧动脉的解剖学研究

An anatomical study of the medial femoral circumflex artery based on three-dimensional computerized tomographic angiography

目的 探讨基于三维CT血管成像（3DCTA）的旋股内侧动脉的特点,以期为髋部损伤的病情判断及相关治疗提供解剖学参考. 方法 收集2012年3月至2014年6月因各种原因行骨盆、下肢3DCTA检查的103例（206髋）患者[男55例,平均年龄为（54.7±15.9）岁）;女48例,平均年龄为（50.0±16.1）岁]CT数据,进行以下研究：①观察旋股内侧动脉的起源及走行特点.②测量旋股内侧动脉主干的长度、旋股内侧动脉主干的起点（A）至主要解剖标志[大转子顶点（B）、小转子内侧顶点（C）、股动脉与耻骨缘或髋臼前缘相交点（D）]的距离,比较不同性别间的差异.③E点为股深动脉主干的起点,测量AE的距离,比较不同性别间的差异. 结果 双侧旋股内侧动脉均起源于股动脉者占2.9％ （3/103）,均起源于股深动脉者占94.2％ （97/103）,一侧起源于股动脉、另一侧起源于股深动脉者占2.9％ （3/103）.螺旋型、迂曲型、较平直型旋股内侧动脉分别占1.9％ （4/206）、76.7％ （158/206）、21.3％ （44/206）.旋股内侧动脉主干发出后先向内后方走行,途中发出分支,主干延续环绕股骨颈后方并向后外上方走行.男、女性之间旋股内侧动脉主干长度、旋股内侧动脉主干的起点至主要解剖标志的距离（AB、AC、AD、AE）比较差异均无统计学意义（P＞0.05） 结论 3DCTA能清晰显示旋股内侧动脉的起源、走行、解剖形态及其与邻近主要解剖标志的关系,可为髋部损伤的病情判断及相关治疗提供解剖学参考.

Objective To characterize the medial femoral circumflex artery based on three-dimensional computed tomographic angiography （3DCTA） so as to provide anatomical aids for diagnosis and treatment of hip injuries.Methods To do this research the 3DCTA data of 103 patients （206 hips） were collected who underwent 3DCTA from March 2012 to June 2014 for examination of the pelvis and lower extremities.They were 55 men （mean age,54.7 ± 15.9 years） and 48 women （50.0 ± 16.1 years）.① The origin and course of the medial femoral circumflex artery was observed.② The length of the artery trunk was measured.The distances between the origin（A） of the artery to the main anatomical marks [the peak of greater trochanter （B）,the inward peak of lesser trochanter （C）,and the crosspoint （D） of the femoral artery and the pubic edge or the acetabulum inlet edge] were measured.Comparisons of the measurements were conducted between genders.③ The distance between point A and point E,the starting point of the femoral profound artery,was measured.Comparisons of the measurements were conducted between genders.Results 2.9% （3/103） of the subjects had their bilateral medial femoral circumflex arteries originate from the femoral artery,94.2% （97/103） had their bilateral medial femoral circumflex arteries originate from the femoral profound artery,and 2.9% （3/103） had one medial femoral circumflex artery originate from the femoral artery and the other from the femoral profound artery.1.9% （4/206）,76.7% （158/206） and 21.3% （44/206） of the subjects had the artery of screw type,of circuitous type and of straight type,respectively.The artery trunk goes posteriorly and medially after it is issued,divides into branches along the course,continues to go around the back of the femoral neck,and finally goes to the outward and upper direction.There were no statistical differences between males and females regarding length of the artery trunk,or distances between points AB,AC,AD or AE （P 〉 0.05）.Conclusion Since 3DCTA can clearly demonstrate the origin,course and anatomical morphology of the medial femoral circumflex artery,it can be used to provide anatomical aids for clinical evaluation and treatment of hip injury.