Surgical and Radiologic Anatomy最新文献

Purpose: Meningohypophyseal trunk (MHT) is a small branch of cavernous part of the internal carotid artery (ICA) which trifurcates into tentorial, inferior hypophyseal and dorsal meningeal arteries. MHT often provides the feeder artery for skull-base meningiomas. Therefore, this arterial trunk is frequently chosen for preoperative embolization. Due to its clinical importance we summarized information about its anatomical variations and relevant clinical attributes pertaining to embolization procedures as reported in literature.

Materials and methods: We performed a systematic review of PubMed and Embase databases according to the PRISMA 2020 guidelines. Studies with anatomical description of the MHT or embolization of this vessel were included.

Results: From 150 identified studies, 49 full-texts were analyzed and 25 of them were included in this systematic review. Seventeen of included studies described morphological features of the MHT (origin from the ICA, complete/incomplete type) and 8 studies depicted embolization of the MHT. The most common origin of the MHT was the posterior loop of the cavernous ICA and in majority of cases complete trifurcated type of the MHT was observed. Embolization of the MHT was successful in nearly all of the patients with lower risk of complications when balloon protection was used.

Conclusions: Relevant morphological details about MHT might facilitate neurosurgeons during planning procedures involving cavernous sinus area but there is no significant correlation between anatomy of the MHT and risk of possible complications. Choice of method and embolic agent during embolization may be approached with customized perspective of the operator. This may be associated with reduced risk of complications and better outcome from clinical viewpoint.

Purpose: There have been no anatomic reports documenting the peripheral segments of the cerebral cortical veins (PSCVs). This study aimed to explore them using magnetic resonance imaging (MRI).

Methods: A total of 100 patients underwent thin-sliced coronal T2-weighted MRI, 2.0 mm in thickness, performed in both the supine and prone positions. For comparison, two cadaveric heads were dissected to observe the PSCVs.

Results: In the dissected hemispheres, the PSCVs were consistently attached to the lateral surfaces of the cerebral gyri. In 100 patients who underwent MRI, the PSCVs were attached variably to the cerebral gyri or bottom of the sulci, in subdivided cerebral areas. The length and thickness of the PSCVs showed high variability. Compared to the medial two-thirds of the middle cerebral part, the PSCVs were more frequently found in the medial two-thirds of the anterior cerebral part. Also, compared to the medial two-thirds of the posterior cerebral region, PSCVs were more frequent in the medial two-thirds of the middle cerebral region. Furthermore, the PSCVs and attached cerebral gyri did not undergo any morphological alterations or displacement in response to positional changes from the supine to the prone position.

Conclusions: PSCVs may be most frequently distributed over the anteromedial cerebral hemisphere, followed by the middle part of the hemisphere. In the cranial cavity, these veins may serve to anchor the cerebral hemisphere floating in the cerebrospinal fluid.

This study constructed a statistical shape model (SSM) of the full ankle joint-including the tibia, talus, calcaneus, and fibula-in healthy Chinese males and analyzed the variation patterns of joint space width (JSW). Computed tomography scans of 108 asymptomatic ankle joints were collected from healthy Chinese males and used to construct a statistical shape model based on principal component analysis. Anatomical variations were evaluated using spatial mapping and least-squares regression. The statistical shape model satisfied the validation criteria for accuracy, compactness, generalization, and specificity, and participants demonstrated high conformity in joint surface coverage and congruency. The first principal component explained more than 22% of the total variance. The minimum joint space widths for the tibiotalar, talofibular, and talocalcaneal joints ranged from 0.85 to 1.95 mm, 0.87 to 2.39 mm, and 0.90 to 3.32 mm, respectively, while the average joint space widths ranged from 2.81 to 3.35 mm, 1.36 to 3.36 mm, and 2.12 to 4.95 mm, respectively. Regression analysis showed that the first five principal modes of variation were strongly correlated with anatomical variations in ankle JSW. This study will provide theoretical support for the early diagnosis and personalized treatment of ankle joint diseases, as well as important morphological references for prosthesis design and biomechanical simulation research.

Purpose: The orbicularis oculi (OOc) and risorius muscles are typically regarded as distinct anatomic and functional units with no known direct muscular connections. Although rare variants of the facial musculature have been reported, their implications for facial dynamics and clinical practice remain underexplored. To the best of our knowledge, this report presents a previously undescribed direct link between the OOc and risorius muscles, highlighting their potential functional and clinical significance.

Methods: This report presents an anatomical variant in which the lateral fibers of the OOc muscle descend abnormally, running lateral to the zygomaticus major and in close proximity to the zygomatic retaining ligaments (McGregor's patch).

Results: In the mid-cheek region, several of these fibers blended with the superior fibers of the risorius muscle, forming a direct muscular connection at the lateral boundary of the facial expression muscles, and ultimately inserting into the modiolus. This bilateral anatomical variant was not accompanied by other notable anomalies in the adjacent facial structures.

Conclusion: This report presents a previously undescribed direct connection between the OOc and risorius muscles. This configuration may allow for coordinated movement between eyelid closure and mouth corner retraction, thereby facilitating complex and integrated facial expressions. Clinically, recognition of this variation is important for procedures such as botulinum toxin injection, musculo-aponeurotic system-based facial surgery, and facial reconstruction, as it may influence both functional and aesthetic outcomes.

Purpose: To demonstrate 3D volumetric computed tomography (CT) analysis of the internal auditory canal (IAC) in a large pediatric population and to evaluate the relationship between age, sex, and IAC mid-point diameters.

Methods: The study population comprised children between 0 and 16 years of age who underwent temporal bone CT. Five males and five females were included in each age group. The IAC mid-point diameters were measured, and a three-dimensional volumetric reconstruction analysis was made. The receiver operating characteristic (ROC) analysis was performed to detect thresholds for the IAC volumes.

Results: A total of 340 ears were evaluated. IAC volume increases with age, most significantly from ages 0-4 to > 4 years. A moderate and significant monotonic increase in IAC volume with age for both the left and right sides were found (r = 0.37, p < 0.001). A ROC analysis revealed that the optimal threshold for the mean IAC volume was 147 mm³. IAC volumes above this threshold indicated a child aged over four years, with an area under the curve (AUC) of 0.76. This threshold yielded a sensitivity of 90% and a specificity of 62%. No significant differences in IAC volume were observed between the right and left sides or between sexes across all age groups.

Conclusion: The current study provides normative 3D volumetric benchmarks for pediatric IAC development, underscoring its accelerated growth in early childhood and supporting anatomical precision in radiological assessment and otologic surgery.

The scapula ossifies from multiple ossification centres, with ossification in the scapular body seen at the time of birth. Ossicle inferior angle of the scapula (OIAS) is an anatomical anomaly resulting from non-fusion of the ossification centre of the inferior angle of the scapula. OIAS remains asymptomatic and is infrequently detected as a palpable and painful abnormality, leading to patient discomfort and a need for healthcare assistance. OIAS can be detected on radiography, with Computed Tomography (CT) reserved for cases with an alternative diagnosis, like in our case. A 14-year-old female patient presented with a palpable and occasionally painful bony hard swelling at the level of the anterolateral aspect of the right 5th and 6th ribs, confirmed to be OIAS on CT chest. The patient was assured of its benign nature and received no further management. OIAS is an anatomical variation to be kept in mind whenever a palpable bony hard abnormality is encountered around the inferior angle of the scapula, avoiding unnecessary medical and/or surgical management and patient apprehension.

Purpose: The aim of this study was to delineate and define, using ultrasound images, the boundaries of the different strata of the human tongue body, based on ultrasound examination of cadaveric samples.

Methods: The study was conducted using two fresh human cadavers from elderly male subjects, obtained through the Body Donation Program of the University of Chile. The tongues were dissected in sagittal and coronal planes, followed by detailed ultrasound examination using a Wisonic Piloter ultrasound equipment with a LH15-6 Hockey Stick linear probe. Metallic markers were used to demarcate the boundaries of the different strata during the ultrasound examination.

Results: Ultrasound images made it possible to distinguish between the mucosa and the underlying muscular strata of tongue. The mucosa appeared as three bands of different echogenicity, while the muscular strata exhibited varying echogenicities corresponding to their anatomical compositions. Stratum II was characterized by hypoechoic muscle fascicles with hyperechoic strands, while stratum III showed higher echogenicity with prominent hyperechoic speckles. The differentiation between stratum III and IV was clear in the central part of the tongue but less distinct laterally.

Conclusion: High-frequency ultrasound provided visualization of the detailed anatomy of the human tongue, including the delineation of its mucosal and muscular layers. This anatomical-ultrasonographic correlation could enhance the diagnostic accuracy of ultrasound for various pathological conditions affecting the tongue. Future studies should focus on evaluating variations in tongue anatomy based on age and gender to further refine ultrasound diagnostic capabilities.