摘要目的 通过三维CT重建并测量中国正常成人侧脑室额角穿刺冠状平面的侧脑室宽度正常值范围,探讨侧脑室额角穿刺的最佳方向. 方法 收集天津医科大学总医院自2014年10月至2015年9月正常门诊体检的241例正常人的颅脑CT原始数据,并按年龄分为44岁以下组、45～59岁组、60～74岁组和75岁以上组.三维CT重建侧脑室额角穿刺冠状平面,在此平面上测量单侧侧脑室宽度.选择中线旁开2.5 cm为标准穿刺点模拟侧脑室额角穿刺过程,并将偏开角度定义为穿刺点朝向侧脑室额角穿刺方向与正中矢状面的夹角,最大偏开角度定义为穿刺点与透明隔顶点连线与正中矢状面的夹角,最小偏开角度定义为穿刺点与同侧脑室最外缘连线与正中矢状面的夹角. 结果 (1)在241例正常成人侧脑室额角穿刺冠状平而上,单侧侧脑室宽度平均为(15.68±3.66) mm,其95％置信区间为15.21～16.15mm.45～59岁组侧脑室宽度为(15.22±3.12)mm,60～74岁组为(15.92±3.42) mm,比较差异无统计学意义(P＞0.05);而44岁以下组侧脑室宽度更小[(13.51±3.46) mm],75岁以上组则更大[(18.52±2.98)mm],比较差异有统计学意义(P＜0.05).(2)241例正常成人模拟侧脑室额角穿刺的最大偏开角度平均为17.67°±1.69°,且不同年龄组间差异无统计学意义(P＞0.05);最小偏开角度平均为6.07°±3.66°,其中44岁以下组最大(8.02°±3.32°),75岁以上组最小(3.21°±3.42°),比较差异有统计学意义(P＜0.05). 结论 正常成人的侧脑室宽度随年龄增大而增大,偏开角度随年龄增大而减小.保障侧脑室额角穿刺成功的最优化偏开角度范围是6.07°～17.67°.

abstractsObjective To measure the normal width of the lateral ventricle of normal Chinese adults on CT-based forehead horn puncture coronal plane,and explore the optimal puncture direction through the forehead horn of the ventricle.Methods Original brain CT data of 241 Chinese adults,admitted to our hospital from October 2014 to september 2015,were collected and divided into 4 groups based on their ages,which were groups of less than 44 years old,45 to 59 years old,60 to 74 years old and more than 75 years old.The coronal planes were reconstructed on the CT images based on the puncture routes of forehead horn of the ventricle.The width of ventricle on the puncture side in this plane was measured.The standard puncture point was 2.5 cm aside from the midline of the head.On the reconstructed coronal plane,the angle between the line of the standard puncture point to forehead horn of the ventricle and the sagittal plane was named as lateral opening angle (LOA).The angle between the line of standard puncture point to the septum vertices and the sagittal plane was named as maximal lateral opening angle (maxLOA).The angle between the line of standard puncture point to the outermost edge of the lateral ventricle and the sagittal plane was named as minimum lateral opening angle (minLOA).Results (1) In the coronal plane,the average width of one side of the lateral ventricle was 15.68±3.66 mm,with 95％ confidence interval of 15.21-16.15 mm.The width of one side of lateral ventricle in the 45 to 59 years old group was (15.22±3.12) mm and that in the 60 to 74 years old group was (15.92±3.42) mm;no significant difference was noted between the two groups (P＞0.05);that in the group of lees than 44 years old had the minimal width of one side of lateral ventricle ([13.51 ±3.46] mm) and the group of more than 75 years old had the maximal one ([18.52±2.98] mm),and the difference was significant between the two groups (P＜ 0.05).(2) The maxLOA was 17.67°±1.69° without a statistical difference between different age groups (P＞0.05);the minLOA was 6.07°±3.66° showing a decreasing trend when the age increased (the group of less than 44 years old:8.02°±3.32°;group of more than 75 years old:3.21 °±3.42°).Conclusions The normal ventricle width increases with the age changes,while the LOA decreases with the age increases.The optimal LOA ranging from 6.07°-17.67° will ensure the successful puncture to the ventricle forehead horn.