| BackgroundStrabismus was an eye of a kind of common disease,serious impact on the patient's appearance and visual function,caused the larger to psychology and study,work pressure.It lead to the cause of strabismus clinically was more often associated with cisternal segment of abducent nerve of its adjacent vascular structures,such as the oppression and cisternal segment of abducent nerve of feeding artery blood supply reduction.Magnetic resonance imaging(MRI)of the three-dimensional fast imaging employingsteady state acquisition(3D-FIESTA)reconstruction of the sequence combined with the multi-planar reformation(MPR)image post-processing technology,the high signal of cerebrospinal fluid background,could be clearly showed low signal of cerebrovascular,cranial nerve and its relation to each other.ObjectiveUsing anatomical specimens and MRI combined with MPR reconstruction of3D-FIESTA sequence images,the observation of different ages show cisternal segment of abducent nerve length,width,thickness,angle and the degree of contact with the surrounding the position relationship between cerebrovascular,and to improve the exhibition nerve imaging diagnostic rate of cisternal segment of abducent nerve of paralysis in strabismus and blood vessels in the brain decompression success rate,reduce the complications after the operation,such as to provide morphological basis.Materials and methods20 cases of the adult head specimens were selected,it was 10 cases of male and 10 cases of female.Along the superciliary arch horizontal sawing skull,it was revealed andobservated show the cisternal segment of abducent nerve length length,width,thickness,angle,nourish the artery origin,and its relationship with the adjacent to the location of the blood vessels and the degree of contact.Collected the implementation of cerebral ministry of 3D-FIESTA sequence MRI inspectors in 140 cases(280 sides)during in June 2014 to June 2016,including all the 70 cases of men and women,7 ~ 68 years age.Inspectors according to the age divided into seven groups: <10 years old group,11 ~ 20 years old group,21 ~ 30 years old group,31 ~40 years old group,41 ~ 50 years old group,51 ~ 60 years old group,>60 years old group,each group was 20 cases,10 cases of men and women respectively.The MRI image data input GE workstation,using ADW 4.2 image post-processing system,based on the cisternal segment of abducent nerve and MPR reconstruction technology,in oblique tranverse section and oblique sagittal section reconstruction by MRI respectively.Observation the cross and shape of the cisternal segment of abducent nerve and its surrounding the position relationship between cerebral arteries and the degree of contact,measurement the different ages length,width,thickness and angle of the cisternal segment of abducent nerve.Statistical processing of the measured data by SPSS 17.0 software,there are significant differences with P < 0.05.Results1.The anatomical specimens length,width,thickness of the cisternal segment of abducent nerve,there was no significant difference between the left and right side,the male and female(P>0.05),it were(15.26±1.35)mm,(1.72±0.17)mm,(1.22±0.14)mm respectively.The cisternal segment of abducent nerve under the feeding arteries mainly comes from pontine artery,anteroinferior cerebellar arteries,basal artery,posteroinferior cerebellar artery and vertebral artery,the nourishing arteries source were 47.5%(19/40),27.5%(11/40),17.5%(7/40),5.0%(2/40),2.5%(1/40)respectively.2.In the 3D-FIESTA sequence MPR reconstruction image,the length,width,thickness of the cisternal segment of abducent nerve,there was no significant difference between the left and right side,the male and female,the different age groups(P>0.05),it were(16.88±16.88)mm,(1.44±0.18)mm,(1.03±0.13)mm respectively.It was significant difference between the MRI and anatomical specimens(P<0.05),the MRI reconstruction image length was greater than that of the anatomical specimens,the width and thickness was less than that of the anatomical specimens.The <10 years old group,11 ~ 20 years old group,21 ~ 30 years old group,31 ~ 40 years old group,41 ~ 50 years old group,51 ~ 60 years old group and >60 years old group cisternal segment of abducent nerve with brainstem dorsal angle,and the median sagittal angle,there was no significant difference between the left and right side,the male and female(P>0.05).There was significant difference between the <10 years old group,11 ~ 20 years old group,21 ~ 30 years old group and the 51 ~ 60 years old group,>60 years old group with brainstem dorsal angle MRI reconstruction image of the cisternal segment of abducent nerve(P<0.05),the <10years old group,11 ~ 20 years old group,21 ~ 30 years old group less than the 51 ~ 60 years old group,>60 years old group,there was no significant difference between all every age group cisternal segment of abducent nerve with the median sagittal angle(P>0.05).3.In the 3D-FIESTA sequence MPR reconstruction images,the anteroinferior cerebellar arteries,posteroinferior cerebellar artery,labyrinth artery,pontine artery,vertebral artery and basilar artery were course in cisternal segment of abducent nerve with the ventral,dorsal and throughout adjacent rate,there was no significant difference between the left and right side,the male and female(P>0.05),and there was no significant difference between the MRI reconstruction image and anatomical specimens(P>0.05).The anteroinferior cerebellar arteries with cisternal segment of abducent nerve of the location of relationship between the most closely,it was 72.1%(202/280),7.5%(21/280),0.0%(0/280)rate ventral,dorsal and throughout adjacent rate.The anteroinferior cerebellar arteries,posteroinferior cerebellar artery,labyrinth artery,pontine artery,vertebral artery and basilar artery were contact,oppression,interbank rate,there was no significantdifference between the left and right side,the male and female(P>0.05),there was significant difference between the contact,oppression,interbank rate(P<0.05),it was24.3%(68/280),4.6%(13/280),50.4%(141/280)oppression,contact an inter-bank rate of the anteroinferior cerebellar arteries.There was no significant difference between MRI reconstruction imaging and anatomical specimens of the cisternal segment of abducent nerve(P>0.05),there was significant difference between contact and inter-bank rates with the anatomical specimens(P<0.05),the MRI contact rate was less than that of the anatomical specimens,MRI inter-bank rates were greater than that of the anatomical specimens.Conclusion1.There were differences between the anatomy and MRI of cisternal segment of abducent nerve on the length,width,thickness and its contact with cerebrovascular rate,interbank rate,so the clinical MRI diagnostic cisternal segment of abducent nerve lesions could not existing anatomical measurements as the basis,MRI measurements should be as a reference.2.The brainstem dorsal angle size had relationship with the person's age of different age groups on cisternal segment of abducent nerve,and along with the age growth,the angle also increases gradually,therefore the diagnosis for cisternal segment of abducent nerve lesions should be considering the age factors on the brainstem dorsal angle with cisternal segment of abducent nerve. |
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