中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (9): 1593-1596.doi: 10.3969/j.issn.1673-8225.2012.09.017

• 骨髓干细胞 bone marrow stem cells • 上一篇    下一篇

影像学测量锁骨与周围血管毗邻关系：置钉的安全区和危险区**★

季航宇1，潘功茂2，谢友扬2，骆宇春3，夏云宝2，于长春4，王诗波3   

  1. 1江苏大学临床医学院，江苏省镇江市  212000；解放军第101医院，2放射科，3骨科，4信息科，江苏省无锡市  214044
  • 收稿日期:2011-12-08 修回日期:2012-01-17 出版日期:2012-02-26 发布日期:2012-02-26
  • 通讯作者: 王诗波，副主任医师，硕士生导师，解放军第101医院骨科，江苏省无锡市 214044 wang_shibo@ yahoo.com.cn
  • 作者简介:季航宇★，男，1979年生，江苏省无锡市人，满族，江苏大学毕业，硕士，主要从事创伤骨科研究。ji_hang_yu@yahoo.cn
  • 基金资助:

    南京军区医学科研重点课题(08Z004)；江苏大学科技发展基金课题(JLY2010100)。

Imaging study of the relationship between clavicle and adjacent peripheral vessels: Safe area and hazardous area of screw insertion  

Ji Hang-yu1, Pan Gong-mao2, Xie You-yang2, Luo Yu-chun3, Xia Yun-bao2, Yu Chang-chun4, Wang Shi-bo3   

  1. 1Clinical Medicine College of Jiangsu University, Zhenjiang  212000, Jiangsu Province, China; 2Department of Radiology, 3Department of Orthopedics, 4Department of Information, the 101 Hospital of Chinese PLA, Wuxi  214044, Jiangsu Province, China
  • Received:2011-12-08 Revised:2012-01-17 Online:2012-02-26 Published:2012-02-26
  • Contact: Wang Shi-bo, Associate chief physician, Master’s supervisor, Department of Orthopedics, the 101 Hospital of Chinese PLA, Wuxi 214044, Jiangsu Province, China wang_shibo@yahoo.com.cn
  • About author:Ji Hang-yu★, Master, Clinical Medicine College of Jiangsu University, Zhenjiang 212000, Jiangsu Province, China ji_hang_yu@yahoo.cn
  • Supported by:

    Key Topic of Nanjing Military Medical Research, No. 08Z004*; Science and Technology Development Foundation of Jiangsu University, No. JLY2010100*

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摘要：

背景：锁骨周围血管与锁骨之间毗邻关系的数据大都来自人体标本解剖的观察和测量，测量结果与人体实际略有出入。
目的：对活体锁骨周围血管与锁骨解剖结构进行观察和分析，以期发现锁骨外固定置钉的安全区和危险区。
方法：通过对44例颈胸部冠状动脉血管造影检查患者进行颈胸部增强CT扫描，将采集的锁骨区断层图像利用ADW4.4工作站重建出完整的锁骨及锁骨周围血管的三维图像，在图像上观察和测量锁骨及锁骨周围血管的毗邻关系。
结果与结论：锁骨下动、静脉紧邻锁骨，由后、上、内向前、下、外方走行，与锁骨下缘间形成的夹角，左侧为(53.75±10.64)°，右侧为(52.85±11.41)°，如将锁骨全长分为5等份，锁骨下动、静脉在锁骨表面的投影范围大约在其由内向外的第2个1/5段，左侧头臂静脉距锁骨最短距离为(4.81±1.66) mm，右侧无名动脉距锁骨最短距离为(5.09±2.60) mm。活体的影像学测量数据更接近于正常人体，锁骨外固定置钉的危险区为锁骨由内向外的第2个1/5段以及锁骨的胸骨端，掌握其解剖学特点可最大程度避免医源性锁骨周围血管损伤。

关键词: 锁骨周围血管, 锁骨, 三维重建, 影像学, 置钉, 安全区与危险区

Abstract:

BACKGROUND: The adjacent data between clavicle and the subclavian vessels mostly come from human observation and measurement of anatomical specimens. The measurement results slightly differ from the actual body.
OBJECTIVE: To observe and analyze the relationship between the clavicle peripheral vascular in vivo and anatomy of collarbone for finding the safe area and hazardous area of screw external fixation.
METHODS: Totally 44 patients were conducted chest and neck enhanced CT scanning to examine coronary angiography. The collected CT image of clavicle area were used to reconstruct three-dimensional images of intact clavicle and clavicle peripheral vascular using ADW4.4 workstation. The adjacent relationship between the clavicle and clavicle peripheral vascular was observed and measured on the images.
RESULTS AND CONCLUSION: Subclavian vein and artery near the clavicle, clavicle angle formed between the lower edge of the left was (53.75°±10.64°), the right side was (52.85±11.41)°. If the length of the clavicle was divided into five equal parts, the clavicle artery and vein at the surface of the clavicle in its projected range from the inside out about the second 1/5 of the left brachiocephalic vein from the clavicle shortest average distance (4.81±1.66) mm, the right innominate artery shortest distance from the average of the clavicle was (5.09±2.60) mm. In vivo imaging measurements are closer to the normal human body, clavicle surgery is likely to damage the site of the subclavian vessels from the inside out of the second 1/5 of the sternum and clavicle end, to grasp the anatomical characteristics of the source can be maximum avoided health peripheral vascular injuries of the clavicle.

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