Objective To study the neural, arterial and venous relationship in the middle incisural space in the region of the tentorial incisura and to determine the important clinical anatomical landmarks of these important neu...Objective To study the neural, arterial and venous relationship in the middle incisural space in the region of the tentorial incisura and to determine the important clinical anatomical landmarks of these important neurovascular structures. Methods Twenty adult cadaveric heads were examined using ×6 to ×40 magnification after perfusing the arteries and veins with colored latex and the relationship of the neural structures, arteries, veins were observed. The distances between the important neursovascular structures and landmarks were measured. Results The important cranial nerves related to the middle incisural space of the tentorial incisura are the oculomotor, the trochlear and the trigeminal nerves. And the important arteries related to the middle incisural space are posterior cerebral arteries and superior cerebellar arteries. The entrance site of oculomotor nerve to the roof of the cavernous sinus located at (11.2±4.3) mm posterior to the anterior clinoid process, (4.4±1.4) mm lateroposterior posterior to the posterior clinoid process. The entrance site of trochlear nerver located at (23.3 ± 3.0) mm posterior to anterior clinoid process, (14.5±3.9) mm lateroposterior posterior to the posterior clinoid process. The entrance site of oculomotor nerve located at (6.3±1.6) mm posterior to the supraclinoid portion of internal carotid artery, while that of the trochlear nerve at ((17.9±3.5)) mm to the supraclinoid portion of internal carotid artery. The entrance site of trochlear nerve located at (11.5±3.0) mm posterior to the entrance site of oculomotor nerve. Conclusions Anterior, posterior clinoid process and the supraclinoid portion of internal carotid artery are the important landmarks for the entrance site of the oculomotor and trochlear nerve. The superior cerebellar artery, the posterior cerebral artery and its important branches including the medial posterior choroidal artery and the long circumflex branch are all closely related to the middle incisural space, and should not be injured during operation.展开更多
文摘目的探讨5.0 T超高场MRI中T2加权液体衰减反转恢复序列(T2-weighted fluid-attenuated inversion recovery,T2W-FLAIR)在可疑脑血管病患者脑白质高信号(white matter hyperintensities,WMH)检测中的图像质量优势及病灶可视化的价值。材料与方法前瞻性纳入2023年11月至2024年9月73例因疑似或确诊脑缺血事件患者。所有患者均接受5.0 T及3.0 T头颅MRI检查。由经验丰富的放射科医师采用Likert 5分量表法评估两种场强下T2W-FLAIR序列的图像质量,并定量计算信噪比(signal-to-noise ratio,SNR)、对比度噪声比(contrast-to-noise ratio,CNR),比较同一患者相同脑区的WMH病灶面积及数量。统计学分析采用Wilcoxon符号秩检验及配对χ^(2)检验。结果相较于3.0 T T2W-FLAIR,5.0 T T2W-FLAIR的图像质量评分(5.0 vs.4.5)、SNR(2.44 vs.1.97)、CNR(1.43 vs.0.97)更高,且WMH检出效果更好。此外,同一患者相同区域5.0 T T2W-FLAIR显示的WMH病灶面积更大(P<0.001)、数量更多(P<0.001),尤其是对微小病灶的检测能力提升显著。结论5.0 T T2W-FLAIR在WMH的显示上优于3.0 T T2W-FLAIR,尤其在图像清晰度、微小病灶检出方面更具优势,有助于脑内小缺血灶的早期诊断及准确评估,具有重要临床价值。
文摘Objective To study the neural, arterial and venous relationship in the middle incisural space in the region of the tentorial incisura and to determine the important clinical anatomical landmarks of these important neurovascular structures. Methods Twenty adult cadaveric heads were examined using ×6 to ×40 magnification after perfusing the arteries and veins with colored latex and the relationship of the neural structures, arteries, veins were observed. The distances between the important neursovascular structures and landmarks were measured. Results The important cranial nerves related to the middle incisural space of the tentorial incisura are the oculomotor, the trochlear and the trigeminal nerves. And the important arteries related to the middle incisural space are posterior cerebral arteries and superior cerebellar arteries. The entrance site of oculomotor nerve to the roof of the cavernous sinus located at (11.2±4.3) mm posterior to the anterior clinoid process, (4.4±1.4) mm lateroposterior posterior to the posterior clinoid process. The entrance site of trochlear nerver located at (23.3 ± 3.0) mm posterior to anterior clinoid process, (14.5±3.9) mm lateroposterior posterior to the posterior clinoid process. The entrance site of oculomotor nerve located at (6.3±1.6) mm posterior to the supraclinoid portion of internal carotid artery, while that of the trochlear nerve at ((17.9±3.5)) mm to the supraclinoid portion of internal carotid artery. The entrance site of trochlear nerve located at (11.5±3.0) mm posterior to the entrance site of oculomotor nerve. Conclusions Anterior, posterior clinoid process and the supraclinoid portion of internal carotid artery are the important landmarks for the entrance site of the oculomotor and trochlear nerve. The superior cerebellar artery, the posterior cerebral artery and its important branches including the medial posterior choroidal artery and the long circumflex branch are all closely related to the middle incisural space, and should not be injured during operation.
