| BackgroundSellar region was small scope, structure, adjacent relation more complex, was a good location of pituitary tumor lesions. Sellar region nerve lesions often easy to hit the saddle weeks depending on the cross structure, such as to cause around the optic chiasma and its adjacent to the location of the structure and morphology change. Constitute a brain artery ring before the traffic artery and the joint of the anterior cerebral artery was a good location of the aneurysm, hemangioma oppression sellar region structure, cause nerve compression, et al. The corresponding clinical symptoms, familiar with sellar region saddle weeks anatomy of nerves, blood vessels and their relations with neighbours, diagnosis and surgical treatment of the lesions was of great significance.ObjectiveMicroanatomy and section and imaging techniques, was used to collect the sellar region saddle weeks nerves, blood vessels and the surrounding adjacent anatomic data structure, for the pathological changes of imaging diagnosis of optic chiasma and its surrounding structure, as well as to provide morphological basis for surgical minimally invasive surgery.MethodsSelected by the 10% formalin liquid fixed adult wet head specimens of 20 cases, with microanatomy method of sellar region saddle weeks nerves, blood vessels and the surrounding adjacent to the structure of anatomical observation. Selected 20 cases of adult body wet head specimens made of continuous transection, sagittal and coronal specimens, observe the sellar region saddle weeks nerves, blood vessels in the signs on the fault samples were typical performance, structure, position and adjacent relation, and measure the related data. Selection of ZhengZhou city people’s hospital image division, come into force as of July 2013 to June 2014, the sellar region MRI scans the inspectors images of 100 cases,50 cases of men and women 50 cases, aged 23 to 61 years old, and observed the sellar region saddle weeks nerves, blood vessels, image data. Using SPSS13.0 software for statistical data from processing, use the mean ± standard deviation (x±s).Results1. The optic chiasm was located in the suprasellar, was "X" shape; normal type was 75%, anterior type was 15% and posterior type was 10%, optic chiasma left and right diameter (12.75 ± 1.85) mm, anteroposterior diameter (8.07 ± 1.58) mm, the upper and lower size (3.17 ± 0.62) mm, anterior angle was (70.4°± 9.0°), the left angle was (123.4°± 11.4°) and right angle was (121.7°± 112°), posterior angle was (74.4°± 7.4°). The optic chiasm blood supply mainly from the anterior cerebral artery, superior hypophyseal artery and posterior communicating artery, the dual type was 5%, multi-source type was 95%.2. The left and right optic nerve of intracranial section was symmetrical, with no significant difference between them (P> 0.05). The length, diameter and vertical diameter were (10.53 ± 2.44) mm, (4.91 ± 0.80) mm, (3.42 ± 0.67) mm respectively.3. After the initial part of the traffic section to the optic chiasm and the lateral angle of the horizontal distance was (3.36 ± 1.03) mm, the vertical distance was (2.91 ± 0.85) mm. At the beginning of the A1 segment of anterior cerebral artery to the optic chiasm shortest distance to the left was (3.48 ± 0.75) mm, the right side was (3.66 ± 1.03) mm, anterior communicating artery to the visual vertical distance was (2.90 ± 1.11) mm.4. Transverse section can also display the intracranial part of the optic nerve, optic chiasm and optic tract section start; optic recess and the infundibular recess as the floor of the third ventricle coronary sectional cross separated, the above was Al segment of anterior cerebral artery, below the adjacent to the pituitary stalk and tuber cinereum, on both sides of the C2 segment of internal carotid artery. The transverse diameter of the optic chiasm was (13.20 ± 2.14) mm, anteroposterior diameter was (7.90 ± 1.23) mm, the upper and lower size was (3.48 ± 0.64) mm. As the anterior angle was (68.8°± 8.4°), the left angle was (120.2°± 12.3°), right angle was (122.3°± 13.0°), the posterior angle was (73.5°± 7.1°), anatomical data through statistical analysis of sectional data and microanatomy, no significant difference between them (P> 0.05).5. Clearly show the optic chiasma and its adjacent structures MRI images, there were no significant differences between the left and right side, men and women, the MRI image and sectional specimens (P> 0.05). Cross transverse optic MRI image diameter, anteroposterior diameter, vertical diameter were (13.41 ± 2.75) mm, (7.68 ± 1.83) mm, (3.58 ± 0.41) mm respectively, bilateral optic nerve, bilateral optic bundles, optic nerve and optic tract were (65.85°± 5.31°), (71.11°± 6.93°), (111.52°± 10.34°) respectively.6. Al segment of anterior cerebral artery was different shapes, can be divided into levels shaped 22% (44/200 side), superior oblique shaped 19% (38/200 side), inferior oblique shaped 46% (92/200 side), wavy or spiral shaped 13% (26/200 side). The anterior communicating artery go for to see above 86% (86/100 side), walking in front of optic chiasma 8% (8/100 side), the optic chiasm lateral 3% (3/100 side) and the optic chiasm posterior 3% (3/100 side).Conclusion1. Anatomical structure of the nerves and blood vessels around the sella and its mutual position relations, provides the reference for the clinical different suprasellar tumor surgical options.2. Clinical application of operation sellar region, in addition to avoid damage the perforator of the internal carotid artery, anterior cerebral artery, anterior communicating artery and posterior communicating artery, prevent the emergence of decreased visual acuity, visual field defect after operation.3. Serial transverse, sagittal, coronal sectional and imaging anatomy, was obtained the qualitative and quantitative data of optic chiasm and with the surrounding structure relation, and provided morphological basis for visual lesion cross and surrounding structures imaging diagnosis and surgery minimally invasive surgery. |
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