在预测视交叉位置时视神经长度与视间角之间的关系。

Reyhan Kasab, Selcuk Yilmazlar, Oguz Altunyuva, Recep Fedakar
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引用次数: 0

摘要

导言和目标:蝶鞍区位于颅底,是中枢神经系统肿瘤最常见的部位之一。目前通过不同的途径进行手术干预。在 70% 的人群中,视丘会占据预期的位置,但也有可能偏离这一位置。在这种情况下,由于已知的手术路径变窄,涉及该区域的手术变得更加困难。预先了解这些变异有助于外科医生确定最佳路径,从而在蝶鞍区进行安全的手术干预。通过对视神经的长度和它们之间的角度进行简单测量,外科医生可以预测视交叉的位置:对从布尔萨法医学院的尸体解剖中收集的 20 个标本进行了检查,以确定视交叉的类型和周围视交叉下结构之间的关系:在 20 个标本中,我们发现了 2 个前固定型(10%)、10 个常固定型(50%)和 8 个后固定型(40%)视丘。平均虹膜间角度为 81.03 (±17.41)⁰ 。固定前的虹膜夹角范围为 115.36⁰-124.76⁰(平均值为 120.06 [±6.65]⁰ ),固定后的虹膜夹角范围为 83.11⁰-97.53⁰(平均值为 86.07 [±6.73]⁰),后固定驰束角介于 53.01⁰-78.71⁰(平均值为 69.20 [±9.13]⁰)之间。右侧视神经的长度在 6.95-13.83 毫米(平均 10.25 [±1.81] 毫米)之间,左侧视神经的长度在 7.25-12.51 毫米(平均 10.40 [±1.47] 毫米)之间。钝角表示脊柱前凸,锐角表示脊柱后凸。视神经长度与视间角之间存在很强的负相关;因此,随着视神经长度的增加,视间角会变得更尖锐:我们提出了一种简单的视神经长度和视神经间夹角测量方法,用于预测视交叉的相对位置,这种方法在核磁共振成像上很容易实现。
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Relationship between optic nerve length and interoptic angle in the prediction of optic chiasm location.

Introduction and objectives: The sellar region is an area in the base of the skull that is among the most common sites for tumors of the central nervous system. Surgical interventions are currently performed via different routes. While the optic chiasm occupies its expected position in 70% of the population, it can deviate from this position. In such cases, surgery involving this region becomes more difficult as the known surgical routes are narrowed. Advance awareness of these variations can help surgeons to identify the optimal route for safe surgical intervention in the sellar region. By performing simple measurements of both the lengths of the optic nerves and the angle between them, a surgeon can predict the location of the chiasm.

Materials and methods: Twenty specimens collected from autopsies performed at Bursa Forensic Medicine İnstitute were examined to determine the optic chiasm types and the relationships between the surrounding subchiasmal structures.

Results: Among the 20 specimens, we found two prefixed (10%), 10 normo-fixed (50%), and eight postfixed chiasms (40%). The mean interoptic angle was 81.03 (±17.41)⁰. Prefixed chiasms had angles in the range 115.36°-124.76 ° (mean 120.06 [±6.65]⁰), normo-fixed chiasm angles were between 83.11° and 97.53 ° (mean 86.07 [±6.73]⁰), and postfixed chiasms ranged between 53.01 ° and 78.71 ° (mean 69.20 [±9.13]⁰). The length of the right optic nerve ranged between 6.95 and 13.83 mm (mean 10.25 [±1.81] mm), and the length of the left between 7.25 and 12.51 mm (mean 10.40 [±1.47] mm). Obtuse angles indicated that the chiasm was prefixed, and acute angles were indicative of a postfixed chiasm. There was a strong negative correlation between optic nerve lengths and the interoptic angle; thus, as the length of the nerves increases, the interoptic angle becomes more acute.

Conclusions: We have proposed a simple measurement of the optic nerve lengths and the angle between them to predict the relative location of the OC, which can be done easily on MRI.

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