本文選題：Klingler技術 + DTI　； 參考：《寧夏醫科大學》2009年碩士論文

【摘要】： 目的運用Klingler解剖技術及DTI技術,對顳葉區域白質纖維結構進行研究,為選擇手術入路,減少神經損傷提供科學依據。 方法1.運用Klingler解剖技術,將10例成人頭顱濕標本進行福爾馬林固定和冰凍,后在×4～25倍的手術顯微鏡下,對顳葉區域各白質纖維結構進行逐層分離,并注意觀察和測量。2.運用DTI技術對10名健康志愿者應用DTI技術行腦白質纖維成像,對顳葉的重要白質纖維束應用解剖學知識基礎上的多興趣區方法進行重建。3.結合Klingler解剖技術和DTI技術,對視輻射進行對比研究。 結果1.運用Klingler解剖技術可清晰顯示顳葉區域各白質纖維結構:弓狀束、外囊、屏狀核、下縱束、鉤狀束、額枕下束、視輻射、前聯合等纖維束的解剖結構和位置。2.運用DTI技術可清晰顯示顳葉區域重要白質纖維結構:顳干,其由鉤狀束、前連合、額枕下束、視輻射、丘腦下腳構成。它開始于島閾,結束于島葉后下點,其長度平均為33.5mm(30～40 mm)。鉤狀束和前連合占據顳干前1/3,額枕下束走行于全部顳干,視輻射的大部走行于顳干的后2/3。3.結合Klingler解剖技術和DTI技術,視輻射的結構在解剖和DTT上顯示是一致的,其由外側膝狀體發出分三束覆蓋于顳角前極外側半、全部顳角上壁及外側壁,Meyer袢走行于顳角頂壁,并超過顳角尖部前方平均2.1mm(1～3mm)。經側裂入路的顳葉手術中,在外側裂底部存在著一個可以避免損傷視輻射進入顳角的安全三角區域(島閾或下環島溝周圍5mm范圍內垂直進入顳角不會損傷視輻射),而在其后10、15、20mm水平處切口,向內下與矢狀面成一定的角度可避免損傷視輻射。 結論1.運用Klingler解剖技術及在解剖基礎上的DTI技術可清晰顯示顳葉區域重要纖維結構和位置關系。2.顳干的基本構筑是相同的,但顳干的大小及形態也存在明顯的個體差異性。島閾、顳角前極和島葉后下點可以被用于對顳干在MR或手術中定位。3.視輻射走行于顳角頂壁,并超過顳角尖,到達顳角與顳極之間。經側裂進入顳角的手術,切口靠近島閾或下環島溝周圍5mm范圍對視輻射的損傷機會小。
[Abstract]:Objective to study the structure of white matter fibers in temporal lobe using Klingler anatomical technique and DTI technique in order to provide scientific basis for selecting operative approach and reducing nerve injury. Methods 1. Using Klingler anatomical technique, 10 adult head wet specimens were fixed and frozen with formalin, then the white matter fiber structure in temporal lobe was separated layer by layer under a 25 times operation microscope, and observed and measured. DTI technique was used to reconstruct the important white matter fiber bundle of temporal lobe by DTI technique in 10 healthy volunteers. Combined with Klingler anatomical technique and DTI technique, a comparative study of visual radiation was carried out. Results 1.Results 1. By using Klingler anatomical technique, the structures of white matter fibers in temporal lobe area can be clearly displayed: arcuate bundle, outer capsule, palmatoid nucleus, inferior longitudinal bundle, hook bundle, frontal suboccipital bundle, visual radiation and anterior syndesmosis. Using DTI technique, the important white matter fiber structure in temporal lobe region can be clearly displayed: temporal trunk, which is composed of uncinate fascicle, anterior junction, frontal suboccipital tract, visual radiation and hypothalamic foot. It begins at the island threshold and ends at the lower point behind the islet, with an average length of 33.5mm(30~40. A third of the temporal trunk was occupied by the uncinate bundle and the anterior conjunction. The frontal and occipital bundles were located in all the temporal trunks, and the majority of the apparent radiation was in the posterior 2 / 3.3 of the temporal trunk. Combined with Klingler anatomical technique and DTI technique, the structure of visual radiation was identical in anatomy and DTT. It was covered by three beams of lateral geniculate body on the lateral side of the anterior pole of the temporal horn. All the superior and lateral walls of the temporal horn and the lateral wall of Meyer's loop walked along the parietal wall of the temporal horn. And above the tip of the temporal horn, the average was 2.1 mm and 3 mm above the anterior part of the temporal horn. In temporal lobe surgery via lateral fissure approach, At the base of the lateral fissure, there is a safe triangular region (island threshold or vertical entry into the temporal horn within the range of 5mm around the lower circumferential sulcus) that can avoid the injury of visible radiation into the temporal horn, but an incision at the level of 1015mm or 20mm is not damaged at the bottom of the lateral fissure. The damage to visual radiation can be avoided at a certain angle between the inward and sagittal plane. Conclusion 1. Using Klingler anatomical technique and DTI technique on the basis of anatomy can clearly display the important fibrous structure and position relation of temporal lobe. The basic construction of the temporal trunk is the same, but the size and shape of the temporal trunk also have obvious individual differences. The island threshold, the anterior temporal horn and the posterior inferior point of the insular lobe can be used to locate the temporal trunk on Mr or during surgery. The visible radiation travels along the parietal wall of the temporal horn and above the tip of the temporal horn, reaching between the temporal horn and the temporal pole. Through lateral fissure into the temporal horn, the incision near the island threshold or the 5mm area around the inferior island groove has little chance of damage to visual radiation.
【學位授予單位】：寧夏醫科大學
【學位級別】：碩士
【學位授予年份】：2009
【分類號】：R651;R322

【參考文獻】

相關期刊論文 前1條

1 陳桂生,戴秀英,孔繁元,許兆禮,趙新民,訾秀娟,王文志,吳建中;WHO/IEM/ILAE全球抗癲癇運動—寧夏農村癲癇的流行病學調查[J];中華神經醫學雜志;2003年06期

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本文編號：1983813