侧脑室额角穿刺平面相关参数测量的初步研究

The preliminary study on the parameter measurement associated with the planes for lateral ventricular frontal angle puncture

目的通过C T重建正常人侧脑室额角穿刺冠状位平面并测量该平面上侧脑室宽度,探讨脑室额角穿刺的偏开角度。方法对204例正常人行头部C T扫描,并分为〈35岁、≥35～50岁、≥50～65岁和≥65岁年龄段。三维重建侧脑室额角穿刺冠状位平面,在此平面上测量单侧侧脑室的宽度;选择中线旁开2.0 cm为穿刺点来模拟脑室额角穿刺过程,定义穿刺点到侧脑室额角内任一点连线与正中矢状面的夹角为偏开角度。结果在脑室额角穿刺的冠状位平面,单侧侧脑室宽度平均为（1 6.22±3.56）m m,最小偏开角度为（5.90±3.82）°。随着年龄增加,脑室宽度变大,最小偏开角度变小（P〈0.05）。脑室宽度和最小穿刺偏开角度之间呈负相关（r=-0.876,P〈0.001）。结论正常人脑室额角穿刺成功的最小偏开角度是（5.90±3.82）°。把握好穿刺方向,确保穿刺成功,减少损伤。

Objective To reconstruct the coronal planes of lateral ventricular frontal horn（LVFH） puncture by CT in normal adults,measure the width of the lateral ventricle and explore the deviation angle of LVFH puncture. Methods Brain CT examination was performed on 204 normal adults, who were divided into less than 35 years old group, 35 to 50 years old group, 50 to 65 years old group and 〉 65 years old group according to the age. The coronal planes based on the frontal horn puncture way of the ventricles were reconstructed on the CT images. The width of one side ventricle on the plane was measured. The puncture point was chosen at 2.0 cm lateral to the midline of the head to simulate the process of LVFH puncture. The angle between the reconstructed coronal plane and the line from puncture point to any point of LVFH was named as deviation angle. Results On the coronal plane of LVFH puncture, the average width of the one side ventricle was（16.22 ± 3.56） mm and the least deviation angle was（5.90 ± 3.82）°. As the age increased, the ventricle width enlarged and least deviation angle decreased（P 〈 0.05）. The width of one side ventricle was negatively related with the least deviation angle（r =-0.876, P 〈 0.001）. Conclusions The least deviation angle of successful LVFH puncture is（5.90 ± 3.82）° in normal adults. The proper puncture direction would guaranty the successful puncture to LVFH and reduce the injury.