| Objectives Applying 256 slice spiral CTA to intravital measure facial artery and structure of the mandibular in order to farther identify anatomical structure of mandibular region.Analysis of gender differences and differences between left and right sides of the facial artery, masseter and mandibular growth characteristics of different ages provide theoretical basis in order to avoid damage facial artery in the operation and matters needing attention.Methods There is 240 people to be study object had been screened from north China university of science and technology affiliated hospital CT room for head and neck artery combined CTA imaging examination of patients between 2014 and 2015. With 256 CT scan: voltage 120 kv, the current 800 ~ 1000 m As, rotation speed of 0.27 s, scan time about5 ~ 8s. Establishing venous pathway, injected with 20 ml saline, velocity of 4 ml/s, then injecting iodine sea alcohol(350mg I/ml) 50 ml and normal saline 50 ml. Sending images into the workstation, according to the different gender, different side measure items following: mandibular branch height, facial artery across the lower jaw studded in the distance to the mandibular angle, the mandibular angle, the distance between facial artery starting point to the common carotid artery bifurcation and so on. Making statistical description with SPSS23.0, measurement data(mean ± standard deviation), the qualitative data case, compared between group by t test and chi-square test and variance analysis, the relationship between the two variables determine the Pearson correlation analysis method.Results 1 The type of facial artery origin, male:Ⅰ46.25%,Ⅱ 10.0%,Ⅲ 1.25%;female:Ⅰ37.5%,Ⅱ3.75%,Ⅲ1.25%。AmongⅠ,Ⅱ,Ⅲ,male and female distribution is the same( X~2=3.70,P>0.05). Among Ⅰ, Ⅱ, Ⅲ,left and right distribution is the different( X~2=13.4,P<0.05). Among male, Ⅰ, Ⅱ, Ⅲ distribution of left and right is statistically significant( X~2=9.16,P<0.05). Among female, Ⅰ,Ⅱ,Ⅲ distribution of left and right is statistically significant( X~2=27.2,P<0.05). 2 Facial artery end position also is different,2.5% ending in angular artery; 30% ending in nasal; 28.7% in the upper lip artery; 23.8%ending in the lower lip artery; 15.0% ending in the mandibular area. 3 Facial artery wavy and spiral growth, a total of 51 cases, 70.6% for wavy, 29.4% for spiral. The right is more than left of wavy and spiral facial artery with statistically significant(X~2=3.99,P<0.05). At the edge of the chin area and mandibular body undulating in the facial artery and the distribution of the spiral is not the same, the difference was statistically significant( X~2=3.99,P<0.05). 4 Mandibular branch height, male(66.06±4.43)mm, female(59.46±3.79)mm, left(62.61±5.43)mm, right(63.90±5.12)mm; mandibular angle: male(117.83±6.62)°, female(123.55±6.66)°, left(120.34±7.71)°, right(120.18±6.69)°; facial artery across the edge of mandible place(across) the distance to the mandibular angle:male(26.71±6.22)mm, female(23.02±5.23)mm, left(25.22±6.15)mm, right(25.06±6.05)mm;facial artery beginning of pipe diameter: male(2.57±0.55)mm, female(2.39±0.55)mm,left(2.48±0.53)mm, right(2.50±0.51)mm; the distance between facial artery starting point to the common carotid artery bifurcation: male(22.81±8.23)mm, female(27.39±9.23)mm,left(23.79±9.70)mm, right(25.73±8.04)mm. There was statistically significant difference of male and female in every item(P<0.05). There was no statistically significant difference of left and right, among female, of facial artery beginning of pipe diameter(t=0.02,P>0.05). There was no statistically significant difference of left and right, among male, of facial artery across the edge of mandible place(across) the distance to the mandibular angle(t=1.32,P>0.05). 5 Mandible rises height and angle of mandible is degree has significant negative correlation(r=-0.488,P<0.01). In female, facial artery across the edge of mandible place(across) the distance to the mandibular angle and the distance between facial artery starting point to the common carotid artery has significant correlation(r=0.627,P<0.01). In female, the edge of mandible place(across) the distance to the mandibular angle and mandible rises height has significant correlation(r=0.546,P<0.05). 6The measured values are men and women of different ages, the period has the difference:mandible rises height: male(F=33.14,P<0.05), female(F=3.08,P<0.05); mandibular Angle:male(F=3.91,P<0.05), female(F=29.61,P<0.05); the edge of mandible place(across) the distance to the mandibular angle: male(F=41.83,P<0.05), female(F=4.29,P<0.05); facial artery beginning of pipe diameter: male(F=24.2,P<0.05), female(F=16.8,P<0.05); the thickness of the masseter: male(F=5.95,P<0.05), female(F=2.85,P<0.05).Conclusions 1 256 slice spiral CT shows various types of facial artery and artery circuity surface structure and the characteristics of maxillofacial skin flap design and help to avoid complications such as bleeding. 2 Male and female facial artery anatomical differences can be reasonable for clinical trauma and orthopedic surgery preoperative design, choice of operative methods to provide the anatomical reference and related data, so as to provide help to improve the effect of surgery. 3 Young period is peak of facial artery and mandibular growth, female adulthood will stop growing, the male adulthood can still grow,what understand the characteristics of male and female patients with different age, can provide reference for trauma and orthopedic surgery. |
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