Role of preoperative midsagittal magnetic resonance imaging in endoscopic third ventriculostomy
Role of preoperative midsagittal magnetic resonance imaging in endoscopic third ventriculostomy
复制标题
DOI：
10.1055/s-2008-1053375
复制
发表时间：
1999-06-01
影响因子：
--
通讯作者：
Takaku, A
中科院分区：
文献类型：
--
作者：
Hayashi, N;Endo, S;Takaku, A
我们测量了217例无颅内疾病患者（平均年龄54.7岁）和8例经神经内镜治疗的脑积水患者在正中矢状位磁共振（MR）图像上漏斗窝与基底动脉（BA）尖端之间的距离。在217例无颅内疾病的受试者中测量的平均距离为10.5 ± 2.3 mm，各年龄组之间的该距离无显著差异。在这217例受试者中，28例（12.9%）的BA尖端在MR图像上向前移位至乳头体。这28例受试者中有26例（93%）年龄≥ 60岁。在8例脑积水患者中，漏斗隐窝与BA尖端之间的平均距离为12 ± 3.7 mm。在此距离上，无颅内疾病的受试者与脑积水患者之间没有显着差异。在1例老年导水管狭窄患者中，漏斗隐窝与BA尖端之间的距离为6 mm，术前正中矢状位MR图像上BA尖端向前移位至乳头体并缩进第三脑室底，因此必须小心进行第三脑室底穿孔，以避免BA损伤。术前正中矢状位MRI能清晰显示三脑室底下神经血管结构，提高三脑室底造瘘术的安全性。
We measured the distance between the infundibular recess and the tip of the basilar artery(BA) on midsagittal magnetic resonance (MR) images in 217 subjects (mean age, 54.7 years) without intracranial disorders and 8 patients with hydrocephalus treated neuroendoscopically. The mean distance measured in the 217 subjects without intracranial disorders was 10.5 +/- 2.3 mm, There were no significant differences in this distance among age groups. In 28 of these 217 subjects (12.9%), the tip of the BA had shifted anterior to the mamillary bodies on MR images. Twenty-six of these 28 subjects (93%) were 60 years of age or older. The mean distance between the infundibular recess and the tip of the BA was 12 +/- 3.7 mm in 8 patients with hydrocephalus. There was no significant difference between the subjects without intracranial disorders and the patients with hydrocephalus in this distance. In an elderly patient with aqueductal stenosis for whom the distance between the infundibular recess and the tip of the BA was 6 mm, the tip of the BA had shifted anterior to the mamillary bodies and indented the floor of the third ventricle on preoperative midsagittal MR images, and perforation of the floor of the third ventricle therefore had to be carefully performed in order to avoid injury of the BA. Preoperative midsagittal MR images can dearly reveal neurovascular structrues beneath the floor of the third ventricle and increase the safety of endoscopic third ventriculostomy.