| 上胸椎前方手术入路的CT影像学研究 |
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投稿时间：2009-03-27
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| 作者 | Author | 单位 | Address | E-Mail |
| 黄义星 |
HUANG Yi-xing |
温州医学院附属第二医院骨科,浙江 温州 325000 |
Department of Orthopaedics Surgery,the Second Affiliated Hospital of Wenzhou Medical College,Wenzhou 325000,Zhejiang,China |
sunnyknight@126.com |
| 池永龙 |
CHI Yong-long |
温州医学院附属第二医院骨科,浙江 温州 325000 |
Department of Orthopaedics Surgery,the Second Affiliated Hospital of Wenzhou Medical College,Wenzhou 325000,Zhejiang,China |
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| 何家维 |
HE Jia-wei |
温州医学院附属第二医院放射科 |
Department of Orthopaedics Surgery,the Second Affiliated Hospital of Wenzhou Medical College,Wenzhou 325000,Zhejiang,China |
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| 章华真 |
ZHANG Hua-zhen |
温州市龙湾区第一人民医院外科 |
Department of Orthopaedics Surgery,the Second Affiliated Hospital of Wenzhou Medical College,Wenzhou 325000,Zhejiang,China |
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| 期刊信息：《中国骨伤》2009年，第22卷，第9期，第685-687页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的：上胸椎前方手术入路的相关研究鲜见文献报道，并且其研究结果之间存在着较大的差异。本研究利用CT影像定位分析的方法，研究上胸椎前方不同血管间隙所能暴露的椎体范围，为制定上胸椎前路手术的术前计划提供参考。
方法：自2008年10月至12月，随机选取120例正常胸部CT片，男58例，女62例；年龄16～75岁，平均(40.3±12.3)岁。利用胸部CT片的X线定位图像，定位左头臂静脉上缘与正中矢状面交点、左右头臂静脉汇合点上缘、气管分叉上缘所平对的椎体水平；在垂直视野下且不向尾侧牵拉重要解剖结构的情况下，上述各点分别代表前方入路间隙E1(气管食管鞘与两侧血管鞘之间的间隙)、E2(右头臂静脉、头臂干与左头臂静脉根部之间的间隙)、E3(升主动脉与上腔静脉之间的间隙)尾侧暴露的椎体水平。
结果：在120例样本中，有105例T2椎体可通过E1显露(87.5%),有82例T3椎体可通过E2显露(68.3%),有89例T4椎体可通过E3显露(74.2%).
结论：3种上胸椎前方入路间隙所能暴露的椎体范围存在差异，术前可根据患者的胸部CT片选择恰当的入路间隙。 |
| 【关键词】胸椎 体层摄影术，X线计算机 临床方案 外科手术 |
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| CT imaging study of anterior approaches to the upper thoracic spine |
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ABSTRACT
Objective: There are small smount of literatures on the study of the anterior surgical approaches to the upper thoracic spine (UTS). Moreover,there are many differences among the results of these studies. This study is to investigate the exposure ranges of different anterior surgical approaches to the UTS for making the preoperative plan by means of CT images analysis.
Methods: From October to December in 2008,120 CT images of normal chests were chosen. These subjects(58 males,62 females) ranged in age from 16 to 75 years(mean 40.3±12.3 years). By using the X-ray positioning images of these CT images,following indexes were studied: the location of the superior margin of the left brachiocephalic vein on the sagittal plane,the confluence of the bilateral brachiocephalic veins,and the vertebrae level of the tracheal bifurcation. The caudal access of E1(the interval between the tracheo esophageal sheath and the bilateral carotid sheath),E2(the interval between the right brachiocephalic vein and the brachiocephalic artery),and E3(the interval between the ascending aorta and superior caval vein)were respectively defined as the above mentioned three points.
Results: Among the 120 studies,105 T2 vertebral bodies could be exposured through E1(87.5%),82 T3 vertebral bodies could be exposed through E2(68.3%),and 89 T4 vertebral bodies could be exposed through E3(74.2%).
Conclusion: The exposure ranges of three different anterior surgical approaches to the upper thoracic spine are different. Proper surgical approaches could be selected according to the chest CT images of the patients. |
| KEY WORDS Thoracic vertebrae Tomography scanners,X-ray computed Clinical protocols Surgical procedures,operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 黄义星,池永龙,何家维,章华真.上胸椎前方手术入路的CT影像学研究[J].中国骨伤,2009,22(9):685~687 |
| 英文格式: | HUANG Yi-xing,CHI Yong-long,HE Jia-wei,ZHANG Hua-zhen.CT imaging study of anterior approaches to the upper thoracic spine[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(9):685~687 |
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