The anatomy and CT imaging study of bony tunnel in the middle meningeal groove
Li Shihong*, Jiang Shize#, Lu Fang, Ji Ming, Lin Guangwu, Ye Chuntao, Sun Yibo, Qian Haizhen, Hu Jie, Tan Deyan, Hua Yanqing.
Department of Radiology, Huadong Hospital, Fudan University , Shanghai 200040, China; #Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
Abstract：Objective To investigate the anatomical features and performance of the bony tunnel in the middle meningeal artery groove using anatomy specimens and high resolution CT(HRCT) imaging technique, in order to provide a more reliable information on clinical application anatomical data and CT evaluation and to protect the middle meningeal artery in neurosurgery.Methods (1) Fifteen wet skull specimens were used for craniotomy to detect the characteristics of the bony tunnel and its adjacent structures. The length of bony tunnels were measured using calipers, the results were compared with the bonny tunnel CT reconstruction images which marked with metal aluminum wire before undergoing CT scanning. (2) The CT data from 200 selected patients who experienced head scanning were retrieved for the retrospective analysis of the in vivo findings of bonny tunnel. Two radiologists assessed whether the bonny tunnel exist among the examined 400 sides of sulcus for middle meningeal artery, the results were subjected to Kappa test. We used multiple planar reconstruction (MPR) and curved planar reformation (CPR) to display the morphology of bonny tunnel.Results (1) Seven bony tunnels were found among 15 specimens, in which 6 sides were continuous bonny tunnels, but one appeared to be intermittent type. The average physical length of the bony tunnels was 2.05 cm (max 3.06 cm, minimum 0.94 cm), which was correlated with the measurement results on CT curved reformation images (the averaged length is 2.10 cm), there was no significant difference between these two measurements(P＞0.05). The mean vertical distance between the top of the bony tunnels to the zygomatic arch of temporal bone was 4.67 cm, the average horizontal distance to the zygomatic process was 4.32 cm, the low point to zygomatic arch was 2.99 cm on average, to the zygomatic process was 3.24 cm on average. (2) The axial raw data in vivo can clearly show the bony tunnel, but MPR and CPR images can directly display the whole length of the bonny tunnels. The evaluation of the existence of the bony tunnel between our two radiologists achieved a high degree of consistency (Kappa=0.96).Conclusions HRCT in combination with MPR/CPR is a noninvasive method to display the bonny tunnel, with potential applications for pterion approach neurosurgery and other fields of neurovascular research.
李仕红,姜时泽,陆芳,嵇鸣,林光武,叶春涛,孙奕波,钱海珍,胡杰,谭德炎,滑炎卿. 脑膜中动脉沟骨管的解剖学与CT成像研究[J]. 中华解剖与临床杂志, 2015, 20(4): 316-320.
Li Shihong, Jiang Shize, Lu Fang, Ji Ming, Lin Guangwu, Ye Chuntao, Sun Yibo, Qian Haizhen, Hu Jie, Tan Deyan, Hua Yanqing.. The anatomy and CT imaging study of bony tunnel in the middle meningeal groove. Chinese Journal of Anatomy and Clinics, 2015, 20(4): 316-320.
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