Abstract：Objective To investigate the spatial interrelationship between the insular and the pyramidal tract (PT) and provide the guidance for the protection of PT and reduction of postoperative motor dysfunction during insula lesions surgery.Methods From March 2013 to October 2013, magnetic resonance images of the PT of 10 healthy volunteers were acquired by using diffusion tensor tractography (DTT). The corona radiata and internal capsule were exposured by Klingler′s white matter anatomy technique in 6 cadaveric brains. The distances from the insular landmarks to the corona radiata and internal capsule were measured on the sections of the cerebral specimens. The spatial interrelationship between the insular landmarks and the PT were analyzed by combining magnetic resonance images and anatomical results.Results Insula landmarks in brain specimens and magnetic resonance images were easily identifiable. The DTT image displayed that the PT went through the deep area of the posterosuperior part of the insular. The connecting line between the upper central insular point(UCIP) and the posterior inferior insular point(PIIP) divided the insular into the anteroinferior region and the posterosuperior region. Anatomical specimens showed there were extreme capsule, claustrum and external capsule between the posterosuperior part of the insular cortex and the PT, while the putamen and globus pallidus were absent in that area. The mean distance from the UCIP and the posterior superior insular point(PSIP)to the corona radiata was (5.0 ± 0.3)mm and (4.7 ± 0.3)mm. The mean distance from the PIIP to the posterior limbs of the internal capsule was (5.7 ± 0.5)mm.Conlusions The posterosuperior region of the insular, divided by connecting the line between UCIP and PIIP, is near to the PT and is a dangerous area in the operation. The division of the dangerous area can help to estimate the risk of operation and prognosis, protect the PT, and reduce the occurrence of postoperative motor dysfunction.
蒋辰, 牛朝诗, 邓雪飞, 韩卉. 岛叶与锥体束空间关系的影像学和解剖学研究[J]. 中华解剖与临床杂志, 2015, 20(2): 106-111.
Jiang Chen, Niu Chaoshi, Deng Xuefei, Han Hui.. Neuroanatomy and neuroimaging study of the relationship between the insular and the pyramidal tract. Chinese Journal of Anatomy and Clinics, 2015, 20(2): 106-111.
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