| 王爽,俞磊,温剑坤,等.基于开源软件Horos的颈椎椎动脉V2段解剖变异研究.骨科,2019,10(5): 384-389. |
| 基于开源软件Horos的颈椎椎动脉V2段解剖变异研究 |
| Anatomic variation research about V2 segment of cervical vertebral artery based on Horos software |
| 投稿时间：2019-07-03 |
| DOI：10.3969/j.issn.1674-8573.2019.05.004 |
| 中文关键词: 椎动脉 图像处理，计算机辅助 解剖，局部 颈椎 |
| 英文关键词: Vertebral artery Image processing, computer-assisted Anatomy, regional Cervical vertebrae |
| 基金项目:国家自然科学基金（81772445）；辽宁省自然科学基金（20180551186） |
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| 中文摘要: |
| 目的 分析颈椎椎动脉V2段解剖变异情况。方法 利用个人电脑在Horos软件中对169例中国成人头颈部CT血管造影（CT angiography, CTA）影像学资料进行分析，其中男119例，女50例。将椎动脉V2段首先穿行的横突孔并非C6者定义为走行变异，分析其发生率的侧别差异和性别差异；将椎动脉内壁距中线距离不足1 cm者定义为椎动脉V2段内聚，分析其发生率的侧别差异和性别差异。结果 169例病人的双侧椎动脉（共338侧）中，32侧存在走行变异，其中椎动脉缺如者4侧；椎动脉首先穿行C4、C5横突孔者分别为5侧、23侧，4例病人双侧椎动脉同时存在走行变异，均首先穿行C5横突孔；走行变异存在于左侧者为16侧，存在于右侧者为16侧，差异无统计学意义（P＞0.05）；男性病人椎动脉走行变异发生率为16.81%（20/119），女性病人椎动脉走行变异发生率为16.00%（8/50），差异无统计学意义（χ2=0.017，P=0.898）。共11例病人的椎动脉V2段存在内聚，均为单侧，其中左侧8例（8/169，4.73%），右侧3例（3/169，1.78%），侧别分布差异无统计学意义（χ2=1.503，P=0.221）；11例病人中男性为3例（3/119，2.52%），女性为8例（8/50，16.00%），性别分布差异有统计学意义（χ2=8.413，P=0.004）。结论 椎动脉V2段的解剖结构和走行路径存在变异，首先穿行的横突孔可能位于C5或C4，走行变异的发生率无侧别或性别差异；V2段可发生内聚，使其更靠近中线，其发生率无侧别差异，但有性别差异，女性病人多发。以上变异可能给颈椎手术或穿刺等微创手术相关的操作带来风险，应在术前通过辅助检查明确。 |
| 英文摘要: |
| Objective To analyze the anatomical variation of V2 segment of cervical vertebrae artery by digital technique. Methods A total of 169 Chinese adult head-neck CT angiography (CTA) imaging data were analyzed in the software of Horos using a personal computer as working station. There were 119 males and 50 females. The V2 segment that firstly running the transverse foramen of C5 or C4 was defined as the running variations and the difference between different sides and genders was analyzed. The distance between the inner wall of the artery and the midline was measured and the variation was defined as inner-migration when the distance was less than 1 cm, and the difference between different sides and genders was analyzed also. Results Among the 169 patients with bilateral vertebral arteries (338 sides), 32 sides had the variation of running variations, in which 4 sides had vertebral artery dysplasia. The vertebral artery firstly run through C4 or C5 transverse foramen in 5 and 23 sides respectively. Both sides of 4 patients firstly passed through the C5 transverse foramens. The variations occurred in 16 sides in the left and 16 cases in the right. There was no statistically significant difference between the sides (P＞0.05). The incidence was 16.81% (20/119) in males and 16.00% (8/50) in females respectively, and there was no significant difference between the genders (χ2=0.017, P=0.898). There were 11 cases of vertebral arteries that were less than 1 cm to the midline, including 8 (8/169, 4.73%) in the left sides and 3 (3/169, 1.78%) in the right sides, and there was no statistically significant difference between different sides (χ2=1.503, P=0.221). Also in these cases, 3 (3/119, 2.52%) cases were men and 8 (8/50, 16.00%) were women, and there was significant difference between genders (χ2=8.413, P=0.004). Conclusion There are variations of the V2 segment that running through the transverse foramens, in which there are no significant differences in this variation between sides or genders. The distance between the inner wall of vertebral arteries and the midline can be less than normal range. And there is no significant difference between sides. But the incidence of this variation in females is higher than males. Examinations should be proceeded to avoid the risks caused by these variations before cervical surgery, especially the puncture operations associated with minimally invasive surgeries. |
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