Research and Clinical Application of Three-Dimensional Location of Amygdaloid Body.

Accurately representing the spatial location of the amygdaloid body can lay an anatomical basis for the neurosurgery operation for amputation of the amygdaloid body through lateral fissure approach. As we know, there are a number of nerve nucleuses and essential structures locating around amygdaloid body in our brain, especially optic tract. However, only few research had been done to protect these tissues or nerve nucleuses. Thus, we reconstructed the three-dimensional images of the amygdaloid body of the human brain and established a coordinate system. The morphological parameters of the amygdaloid body and the three-dimensional coordinate data were measured. The spherical coordinates (R, θ, ϕ) were constructed by calculating the azimuth angle, elevation angle, and the distance from the coordinates origin to each amygdaloid body centroid. Sixty people brain MRI images without any visible organic disease were used in our research to investigate the average level of related parameters. The authors selected a proper coordinate origin and measured the value of anteroposterior diameter, right-and-left diameter, vertical diameter of the amygdaloid body, and the distance from the optic tract to amygdaloid body. The authors also measured the three-dimensional coordinate data of each centroid of the amygdaloid body in order to provide anatomical suggestion for surgery. The authors confirmed the nearest point from the foremost edge of the brain ventricle temporal horn to the lateral fissure, then viewed it as the coordinate origin. By means of coordinate translation, the authors got various morphological parameters and the coordinate values of each centroid of the amygdaloid body. Spherical coordinates were calculated from the three-dimensional coordinate values. The distances between the different layers of the amygdaloid body and the optic tract were also measured. The reconstruction of the three-dimensional coordinates of amygdaloid body is part of the digital engineering of the human body. The measurement of the parameters provides an important theoretical basis for the clinical amygdaloid body destruction surgery. Finally, the authors get conclusions as follows. There are no significant differences in the measured values of r1, r2, and r3 between the upper and lower diameters, the left and right diameters, the anteroposterior diameter of the amygdaloid body. The measured values of men and women are not statistically significant (P > 0.05). Spherical coordinates (R, θ, ϕ) calculated from the three-dimensional coordinate values and values from different sexes of the amygdaloid body are not statistically significant, either (P > 0.05). The distance between the different levels of the amygdaloid body and the optic tract (h1, h2, h3, h4, h5, h6, and h7) are not statistically significant (P > 0.05).

Three-Dimensional Radiologic Study on Index Measurement of Endonasal Endoscopic Optic Nerve Decompression.

OBJECTIVE: To provide the radiologic basis for the clinical application of endonasal endoscopic optic nerve decompression (EEOND). METHODS: CTA images were used to observe the optic canal (OC) and related structures of 60 patients (120 sides) with normal nasal, paranasal sinuses, OC, and other related structures. RESULTS: Optic canal could be classified as: the canal (10 sides, 8.33%), the semicanal (25 sides, 20.83%), the impression (49 sides, 40.83%), and the nonimpression (36 sides, 30%). According to its relationships with the sinuses, OC could be further typed as: ethmoid sinus (22 sides, 18.3%), sphenoid sinus (38 sides, 31.7%), ethmoid and sphenoid sinus (60 sides, 50%). The thickness of OC medial wall is about 1.11 ±â€Š0.24 mm at orbital mouth, 0.87 ±â€Š0.25 mm at middle part and 1.19 ±â€Š0.27 mm at cranial mouth. The arc length of OC bone wall which can be opened from the sinus cavity is about 7.18 ±â€Š0.76 mm at orbital mouth, 8.27 ±â€Š0.93 mm at middle part, and 6.98 ±â€Š0.89 mm at cranial mouth. The length of the OC medial wall is 12.18 ±â€Š1.35 mm. In the three-dimensional Cartesian coordinate system that origined with the last point of middle turbinate root and oriented by temporal side, front side, and superior side, the coordinates of midpoints of OC medial wall are: (3.64 ±â€Š1.11, 8.48 ±â€Š1.65, 23.14 ±â€Š2.67) at orbital mouth, (0.16 ±â€Š1.21, 3.99 ±â€Š1.80, 24.85 ±â€Š2.67) at middle part, and (-3.59 ±â€Š1.22, 0.77 ±â€Š2.13, 26.39 ±â€Š2.68) at cranial mouth. One length unit on the axes is a millimeter. CONCLUSION: Computed tomography (CT) scanning technique can measure the data of the OC in EEOND. It has great guiding significance for clinical operation.

Relative Projective Location of Three Bottom Apexes of Petrous Bone on Skull.

The complex anatomy of petrous part of temporal bone makes the craniotomy around this area challenging. To avoid damaging the interior structures of petrous part of temporal bone, the authors used computed tomography to get the projection of the petrous part of temporal bone on skulls, making the external contours of petrous part clear, thus protecting its interior structure as a reference in craniotomy. The objective of this study was to find out the three-dimensional location of 4 points of petrous part of temporal bone. Parameters of 120 patients (240 observations) between 25 and 65 years who were free of abnormalities and pathological changes in temporal bone were measured on high-resolution spiral multiple slice computed tomographic multiple planar reconstruction images that were parallel to the base plane. The data were analyzed by SPSS, statistical software with the comparison between sides and sexes. The authors found the accurate locations that 4 points of petrous part of temporal bone with mastoidale as the origin. Then the authors connect the 3 vertexes of underside and the petrous apex and lengthen it until intersect with skulls to get the external landmarks. In the end, the authors get the safe range that can be applied to the clinical surgery.

Morphologic Study of Superior Temporal Sulcus-Amygdaloid Body and Lateral Fissure-Amygdaloid Body Surgical Approach by Using Magnetic Resonance Imaging Volume Rendering.

In this research, 83 patients were measured by magnetic resonance imaging volume rendering technique. The authors acquired the curve length of the superior temporal sulcus and the lateral fissure on the cerebral hemisphere, the shortest distance from the superior temporal sulcus and the lateral fissure to the center of amygdaloid body separately, the vertical diameter, the transversal diameter, and the anteroposterior diameter of the amygdaloid body and the 2 approach angles between the median sagittal plane and the shortest segment from the superior temporal sulcus to the center of amygdaloid body and the shortest segment from lateral fissure to the center of the amygdaloid body. At the same time, we preliminarily oriented the 2 points of the superior temporal sulcus and the lateral fissure, which are closest to the center of amygdaloid body, aimed at finding out the best entrance points of surgical approach through the superior temporal sulcus and the lateral fissure to the amygdaloid body and reducing the damage to the nerve fibers or blood vessels during the operation. The results indicate that the point at the front side 1/4 of the superior temporal sulcus may be the ideal surgical approach entrance point and the point at the front side 1/3 of the lateral fissure. There is no difference between 2 cerebral hemispheres (P < 0.05).