Anatomical variations of the torcular Herophili: macroscopic study and clinical aspects

Anatomical variations of the torcular Herophili: macroscopic study and clinical aspects
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Herophili 环的解剖变异:宏观研究和临床方面

DOI:
10.1007/s12565-018-0436-z
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发表时间:
2018
影响因子:
1.2
通讯作者:
Ueda Shuichi
Ueda Shuichi
中科院分区:
医学4区
文献类型:
--
作者:
Matsuda Wakoto;Sonomura Takahiro;Honma Satoru;Ohno Sachi;Goto Tetsuya;Hirai Shuichi;Itoh Masahiro;Honda Yoshiko;Fujieda Hiroki;Udagawa Jun;Takano Shingo;Fujiyama Fumino;Ueda Shuichi

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观察窦汇的解剖变异,重点观察上级矢状窦(SSS)和横窦(TS)的连续性。在142例标本中,有72例(50.7%)为对称病例,70例(49.3%)为不对称病例。对称型(无优势型)分为分叉型34例(23.9%)和汇合型38例(26.8%)。不对称组中,右优势型54例(38.0%),左优势型16例(11.3%)。右优势型又分为部分交通型38例(26.8%)和非交通型16例(11.3%)。左侧优势型分为部分交通型11例(7.7%)和非交通型5例(3.5%)。总之,在大约一半的研究病例中,SSS不对称地流入一个TS。右优势型大约是左优势型的三到四倍。不对称组的引流方式可能因单侧颈静脉阻塞而引起颅内高压。为了避免颈淋巴结清扫术、颈静脉导管插入术或高凝血症的风险,建议术前通过MR静脉造影、三维CT或头颅X线平片评估硬脑膜窦变异。
The anatomical variations of the confluence of sinuses were examined, focusing on the continuity of the superior sagittal sinus (SSS) and the transverse sinuses (TSs). In the 142 specimens studied, there were 72 symmetric cases (50.7%) and 70 asymmetric cases (49.3%). The symmetric group (no dominant type) was categorized into 34 cases of bifurcation (23.9%) and 38 cases of confluence (26.8%). The asymmetric group was categorized into 54 cases of the right-dominant type (38.0%) and 16 cases of the left-dominant type (11.3%). The right-dominant type was further categorized into 38 partially-communicating (26.8%) and 16 non-communicating types (11.3%). The left-dominant type was categorized into 11 partially-communicating (7.7%) and 5 non-communicating types (3.5%). In summary, the SSS asymmetrically drained into one TS in about half of the cases studied. The right-dominant type was about three to four times as common as the left-dominant type. The draining pattern shown by the asymmetric group could provoke intracranial hypertension due to unilateral jugular vein obstruction. In order to avoid this risk in cases of neck dissection, jugular vein catheterization, or hypercoagulopathy, preoperative evaluations of the dural sinus variations via MR venography, three-dimensional CT, or plain X-ray of the skull are recommended.
鼻窦汇合处鼻窦血流的形态学研究
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