颈内动脉虹吸部三维重建影像研究及临床应用

Research and Clinical Application of Three-dimensional Reconstruction Imaging of Internal Carotid Artery Siphon

目的通过测量颈内动脉虹吸部相关参数及三维重建函数,模拟颈内动脉虹吸部走形特征,以防止在前床突手术、栓子切除术等外科操作时对颈内动脉的损伤。方法选取吉林大学中日联谊医院2017~2018年的颈内动脉虹吸部图像进行回顾性分析,其中U型89例、V型29例。测量冠状面、矢状面和水平面重建后的坐标;通过MATLAB7.0软件重构函数,绘制图像;利用测得坐标计算距离、角度等参数(AD:颈内动脉C4段长度;DF:颈内动脉C5段长度;FI:颈内动脉C6~C7段长度;OF:轴向平面上坐标原点到颈内动脉发出眼动脉分支点的长度;OI:轴向平面上坐标原点到颈内动脉发出大脑前动脉分支点的长度;∠ADF:颈内动脉虹吸部的下角度;∠DFI:颈内动脉虹吸部的上角度)。结果函数公式,U型:0.0963×(X-1.8657)2+(-0.0287)×(Y-5.6018)2+0.0208=(-0.0060)×(X-4.0741)3+0.9782,X∈[-2.8201,-0.6722],Y∈[-0.3803,10.3121];V型:0.2785×(X-1.3346)2+(-0.0702)×(Y-2.9686)2-0.1029=(-0.0187)×(X-3.0730)3-0.0002×(Y-7.3186)5-0.1074,X∈[-2.7631,-0.8702],Y∈[-1.7432,10.2411]。V型的DF和OF距离短于U型(P<0.05),U型和V型的AD,FI及OI距离比较,差异均无统计学意义(P>0.05)。V型的∠ADF大于U型的(P<0.05),U型和V型的∠DFI比较,差异无统计学意义(P>0.05)。结论以前床突为骨性标志的三维重建函数可应用于颈内动脉虹吸部形态学评估及前床突手术、栓子切除术前的评估中。

Objective By measuring the relevant parameters and three-dimensional reconstruction function of the internal carotid artery siphon,the shape characteristics of the internal carotid artery siphon were simulated to prevent damage to the internal carotid artery during surgical procedures such as anterior clinoid process surgery and embolectomy.Methods A retrospective analysis was conducted on the images of the internal carotid artery siphon from China-Japanese Union Hospital of Jilin University from 2017 to 2018,with 89 cases of U-type and 29 cases of V-type.Measure the coordinates of the reconstructed coronal,sagittal,and horizontal planes;Reconstruct functions and draw images using MATLAB 7.0 software;Calculate parameters such as distance and angle using measured coordinates(AD:length of C4 segment of internal carotid artery;DF:length of C5 segment of internal carotid artery;FI:length of C6~C7 segment of internal carotid artery;OF:length of ophthalmic artery branch point from the origin of coordinates on axial plane to the internal carotid artery;OI:length of anterior cerebral artery branch point from the origin of coordinates on axial plane to the internal carotid artery;ADF:lower angle of internal carotid artery siphon;DFI:upper angle of internal carotid artery siphon).Results Function formula,U-type:0.0963×(X-1.8657)~2+(-0.0287)×(Y-5.6018)~2+0.0208=(-0.0060)×(X-4.0741)~3+0.9782,X∈[-2.8201,-0.6722],Y∈[-0.3803,10.3121];V-type:0.2785×(X-1.3346)~2+(-0.0702)×(Y-2.9686)~2-0.1029=(-0.0187)×(X-3.0730)~3-0.0002×(Y-7.3186)~5-0.107·4,X∈[-2.7631,-0.8702],Y∈[-1.7432,10.2411].DF and OF distances were shorter in type V than in type U(P0.05),and there were no significant differences in AD,FI and OI distances between type U and type V(P0.05).The ADF of type V was higher than that of type U(P0.05),and there was no significant difference in DFI between type U and type V(P0.05).Conclusion The three-dimensional reconstruction function of the previous clinoid process as a bony landmark can be applied in the morphological evaluation of the siphon part of the internal carotid artery and in the evaluation before anterior clinoid process surgery and embolectomy.