CT评估成人后髁导静脉及其骨管

CT evaluation of posterior condylar emissary vein and bone tube in adults

目的基于头颈部CTA评估成人后髁导静脉的解剖学特征。方法分析254例受检者(508侧)的头颈部CTA资料,经多平面重建后评估后髁导静脉的发生情况、走行、长度、截面积、内口连接位置及其与静脉回流优势和颈静脉球窝高位的关系。结果 254例(508侧)中,后髁导静脉发生率为50.98%(259/508),性别、侧别间差异均无统计学意义,其中双侧37.40%(95/254);走行为S型者175侧,直线型14侧,不规则型70侧;后髁导静脉中位长度为2.14(1.04,2.97)cm,中位截面积7.55(4.93,11.68)mm^2;后髁导静脉内口与乙状窦下曲段连接43侧(43/259,16.60%),与颈静脉球连接149侧(149/259,57.53%),与二者交界处连接67侧(67/259,25.87%);脑静脉回流优势侧(116/218,53.21%)与非优势侧(143/290,49.31%)间同侧后髁导静脉的出现率差异无统计学意义(P=0.759);在19侧粗大后髁导静脉中,14侧脑静脉回流为同侧优势型,粗大与非粗大后髁导静脉间静脉回流优势侧所占比差异有统计学意义(P=0.021);颈静脉球窝高位侧后髁导静脉出现率(158/288,54.86%)高于无高位侧(101/220,45.91%;P=0.028)。结论后髁导静脉不同个体间变化差异大,CT可清晰显示其解剖学特征。

Objective To observe the anatomic characteristics of the posterior condylar emissary vein（PCEV）in adults based on head and neck CTA.Methods Data of head and neck CTA of 254 patients（508 sides）were analyzed.MPR was used to evaluate the prevalence,course,length,cross-sectional area and location of the inner opening of PCEV and the relationship with venous outflow advantage and high jugular bulb（HJB）,respectively.Results The prevalence of PCEV in 254 patients（508 sides）accounted for 50.98%（259/508）,there was no statistical difference between genders or sides.The bilateral occurrence of PCEV was 37.40%（95/254）.There were 175 sides with S course,14 sides with short and straight course,and the other 70 sides with irregular course.The median length of PCEV was 2.14（1.04,2.97）cm,and the median sectional area was 7.55（4.93,11.68）mm^2.The rate for the abouchement of PCEV into the hypo-segment of sigmoid sinus was 16.60%（43/259）,57.53%（149/259）into the jugular bulb and 25.87%（67/259）into the junction.The difference of appearance rate of ipsilateral PCEV between cranial venous reflux advantage（116/218,53.21%）and the disadvantage（143/290,49.31%）were not statistically significant（P=0.759）.Among 19 sides of PCEV with gross cross-sectional area,14 sides were with reflux advantage,the difference of proportion of dominant side of venous reflux was statistically significant（P=0.021）.The appearance rate of PCEV in the side of HJB（158/288,54.86%）was higher than that in the side without HJB（101/220,45.91%,P=0.028）.Conclusion PCEV is variable in different individuals.High-resolution CT can be used to clearly observe the anatomic characteristics of PCEV.