枕骨大孔的形态学特征及临床意义

Morphological characteristics and clinical significance of foramen magnum

目的通过影像学技术观测枕骨大孔的形态学特征,为临床诊疗和法医人类学性别鉴定提供理论依据。方法回顾性分析2018年1~12月内蒙古医科大学附属医院颅底扫描的559例影像学资料,利用Mimics 16.0软件测量枕骨大孔的长度、宽度和面积,并进行枕骨大孔的形态学分类。结果男性枕骨大孔的长度、宽度和面积均大于女性,且部分年龄段组间存在显著性别差异(P<0.05);枕骨大孔各径线和面积发育峰值位于10~19岁,随着年龄的增长各值处于缓慢下降的波浪状变化状态,并且差异性主要集中于10~19岁组与其余各年龄组间(P<0.05);枕骨大孔的形态分为7类,即椭圆形(男37%、女47%)、圆形(男19%、女20%)、六边形(男16%、女15%)、菱形(男9%、女11%)、盾形(男9%、女3%)、不规则形(男7%、女2%)和五边形(男3%、女2%)。结论枕骨大孔特殊的解剖位置、重要的功能区、稳定的形态学特征及性别差异性可为神经外科手术治疗及法医人类学性别鉴定等提供重要的参考依据。

Objective To observe the morphological characteristics of the foramen magnum by imaging techniques,so as to provide the theoretical basis for clinical diagnosis and treatment and forensic human identification.Methods A retrospective study of 559 cases of imaging data of the skull base scan,which were provided by the affiliated hospital of Inner Mongolia Medical University from January to December 2018,was conducted with the Mimics 16.0 software.Measured the length,width and area of the foramen magnum,and carried out the morphological classification of the foramen magnum.Results The length,width and area of foramen magnum in males were larger than those in females,and there were significant gender differences among some age groups(P<0.05).The development peaks of each diameter and area of the foramen magnum were located in the age of 10 to 19 years old,and the values were decreased slowly in a wavy state with the increase of age,and the differences mainly concentrated in the group of 10 to 19 years old and other age groups(P<0.05).The shape of the foramen magnum was divided into seven types:oval(male 37%,female 47%),round(male 19%,female 20%),hexagonal(male 16%,female 15%),diamond(male 9%,female 11%),shield(male 9%,female 3%),irregular(male 7%,female 2%)and pentagon(male 3%,female 2%).Conclusion The special anatomical location,important functional areas,stable morphology characteristics,and gender differences of the foramen magnum may provide important reference for neurosurgical treatment and forensic human gender identification.