临床发展需要是解剖学科研选题的源泉

人体解剖学是一门古老的医学基础学科，随高新技术发展起来的新兴分支学科相继形成后，这个传统学科应开拓新的研究方向，密切结合临床发展需要是人体解剖学研究选题的主要源泉。临床外科是应用解剖学研究的主战场，我国的解剖学都是已为显微外科的创新发展奠定了基础，正在为创伤和骨科开拓生物力学的新研究领域。人体解剖学跨学科培养外科博士的探索，为以人才培养提供了前景良好的新模式。     

Computed tomography analysis of acetabular anteversion and abduction

Purpose The purpose of this study is to define the normal range of acetabular abduction and anteversion in relation to pelvic anatomy as depicted on conventional CT scan.Methods We retrospectively reviewed 100 pelvic CT scans performed on patients presenting for evaluation of non-orthopaedic pathology. The study group consisted of 58 women and 42 men, aged between 18 and 88 years. Standard imaging protocol included an anteroposterior (AP) topogram with contiguous 5-mm thick axial images from the superior margin of the iliac crest to the lesser trochanter of the femur. The acetabular abduction was measured from the AP topogram by obtaining the angle between a line drawn from the acetabular teardrop to the lateral acetabular margin and a horizontal line between the ischial tuberosities. Acetabular anteversion was measured on axial images at the level of the mid-femoral head.Results We found the mean acetabular abduction to be 39 degrees (standard deviation 4 degrees, range 27 to 51 degrees) and the mean acetabular anteversion to be 23 degrees (standard deviation 5 degrees, range 12 to 39 degrees). Data suggests that acetabular anteversion may average 2.7 degrees lower in males than females and increase slightly with age, while abduction may tend to decrease with age. Ninety percent of patients had acetabular abduction between 31 and 46 degrees; the 90% central range for acetabular anteversion was estimated to be from 14 to 31 degrees.Conclusion CT scanning is useful in accurately defining the normal range of acetabular abduction and antiversion. Knowledge of this normal anatomy will allow accurate assessment of acetabular component position as delineated on conventional CT scanning.     

Computed tomography imaging of the temporal bone--normal anatomy

This review describes the fundamental anatomical structures of the temporal bone as depicted on high-resolution computed tomography, and the clinical significance of these structures. It is not an encyclopaedic atlas, but provides the junior radiology/otorhinolaryngology resident with sufficient knowledge for interpretation of most of the imaging studies encountered in daily clinical practice.     

NMR anatomy of the brain using inversion-recovery sequences

Summary The use of NMR inversion-recovery (IR) sequences to demonstrate brain anatomy is illustrated. The high level of grey-white matter contrast is of value in localising anatomical structures and demonstrating myelination during childhood. While the resemblance of IR scans to gross anatomical sections in different planes is close, it is limited by the spatial resolution of the NMR scanner, artefacts and partial volume effects.     

Anatomic Relationship of the InternalJugular Vein and the Common Carotid Artery Applied to Percutaneous Transjugular Procedures

Purpose To demonstrate the anatomic relationship of the internal jugular vein (IJV) with the common carotid artery (CCA) in order to avoid inadvertent puncture of the CCA during percutaneous central venous access or transjugular interventional procedures.Methods One hundred and eighty-eight consecutive patients requiring either central venous access or interventional procedures via the IJV were included in the analysis. The position of the IJV in relation to the CCA was demonstrated by portable ultrasonography. The IJV location was recorded in a clock-dial system using the carotid as the center of the dial and the angles were measured. Outcomes of the procedure were also recorded.Results The IJV was lateral to the CCA in 187 of 188 patients and medial to the CCA in one patient. The left IJV was at the 12 oclock position in 12 patients (6%), the 11 oclock position in 17 patients (9%), the 10 oclock position in 142 patients (75%) and at the 9 oclock position in 17 patients (9%). The right IJV was at the 12 oclock position in 8 patients (4%), the 1 oclock position in 31 patients (16%), the 2 oclock position in 134 patients (71%) and the 3 oclock position in 17 patients (9%). In one patient the left IJV was located approximately 60° medial to the left CCA; this was recorded as 2 oclock on the left since it is opposite to the 10 oclock position.Conclusion Knowledge of the IJV anatomy and relationship to the CCA is important information for the operator performing an IJV puncture, to potentially reduce the chance of laceration of the CCA and avoid placement of a large catheter within a critical artery, even when ultrasound guidance is used.     

脑表面成像方法应用

目的　探讨脑表面成像技术在脑外科的应用。方法　对 2 4例在我院行头颅MRI扫描者加行脑表面成像扫描 ,其中 5例为健康查体 ,10例为胶质瘤 ,4例为转移瘤 ,3例为脑膜瘤 ,1例海绵状血管瘤 ,1例脑梗塞。结果　 5例正常扫描均能清楚地显示中央沟、外侧裂等大脑半球的主要沟回。 19例病变中 ,14例病变可以清楚地辨认出来 ,病灶与脑沟、脑回的位置关系十分清晰直观。 5例病变因周围水肿严重而显示欠佳。结论　脑表面成像技术可用于皮层及皮层下病变的定位及脑沟脑回异常的诊断 ,可部分代替神经导航的功能     

高原红细胞增多症的病理观察（附12例尸检报告）

本文报告高原红细胞增多症１２例尸体解剖材料。由于慢性长期缺氧，病理损害十分广泛，累及全身各脏器。文章总结了本病的临床病理特点，旨在为临床提供病理基础。     

Multiplanar reconstruction recovers morphological cartilage assessment reproducibility from maloriented coronal MRI scans

The study's purpose was to assess the effect of multiplanar reconstruction on precision of weight‐bearing medial and lateral femoral cartilage (cMF, cLF) morphometry in maloriented coronal MR images. Twenty knees were scanned four times with a 1.0 Tesla extremity imager using a fat‐suppressed T1‐weighted three‐dimensional spoiled gradient recalled echo sequence; twice with “best as” double bull's‐eye orientation of the femoral condyles, and once each with 5° internal and external rotation. Multiplanar reconstruction was applied to maloriented scans to recover double bull's‐eye orientation. Medial and lateral femoral cartilages were segmented and precision of bone area, cartilage volume and thickness (ThCtAB) evaluated for all scans. Test‐retest precision (RMSCV%) of the double bull's‐eye scans was 1.1% for total bone area and 4.1% for cartilage volume. Differences in precision between double bull's‐eye and maloriented images were assessed. Higher precision errors were observed in malorientated images for all outcomes (1.7–4.8% for internally rotation scans; 1.7–4.8% for external rotation scans). Precision generally improved with multiplanar reconstruction correction (1.7–5.6% for internally rotated scans; 1.2–3.5% for external rotation scans). Precision of femoral cartilage morphometry is generally reduced when maloriented images are acquired. Multiplanar reconstruction can correct malorientated scans and recover precision losses. Measurements are affected in a rotationally and compartmentally dependent manner. Magn Reson Med, 2011. © 2010 Wiley‐Liss, Inc.     

Clinical biomechanics of the patellofemoral joint

Anatomic variations of the knee extensor mechanism may result in predisposition to maltracking or instability ofthe patella and quadriceps mechanism. In addition to these anatomic variations, individuals may subject their knees to a wide variety of activities and stresses. Each case of patellofemoral dysfunction, which may range from only anterior knee pain to patellar dislocation, must be considered individually. In the presence of maltracking or patellar instability that is recalcitrant to rehabilitation, there is no single structure which can be surgically altered, repaired, or reconstructed in each case to expect a satisfactory result. The purpose of this article is to describe recent work on the anatomy and biomechanics of the patellofemoral joint to aid the reader in understanding, assessing, and determining the method of treatment most likely to result in improvement in symptoms associated with patellofemoral dysfunction.     

Aspects of the anatomy of the cerebellum on computed tomography

Summary The salient features of the normal CT anatomy of the various lobules of the cerebellar hemispheres and vermis are described. The subdivisions of the vermis were found to be most constant. The surface appearance of the hemisphere lobules was also relatively constant; however, at CT these fissures are imaged at depth and this constancy is not reflected in CT images because folia cross the depths of the major sulci from one lobule to the other in a highly variable manner. The flocculus has been confused with the anterior angle of the cereellum, and the cerebellar tonsils with the biventral lobule.     

Software tools for interactive instruction in radiologic anatomy

RATIONALE AND OBJECTIVES: To promote active learning in an introductory Radiologic Anatomy course through the use of computer-based exercises. MATERIALS AND METHODS: DICOM datasets from our hospital PACS system were transferred to a networked cluster of desktop computers in a medical school classroom. Medical students in the Radiologic Anatomy course were divided into four small groups and assigned to work on a clinical case for 45 minutes. The groups used iPACS viewer software, a free DICOM viewer, to view images and annotate anatomic structures. The classroom instructor monitored and displayed each group's work sequentially on the master screen by running SynchronEyes, a software tool for controlling PC desktops remotely. RESULTS: Students were able to execute the assigned tasks using the iPACS software with minimal oversight or instruction. Course instructors displayed each group's work on the main display screen of the classroom as the students presented the rationale for their decisions. The interactive component of the course received high ratings from the students and overall course ratings were higher than in prior years when the course was given solely in lecture format. CONCLUSIONS: DICOM viewing software is an excellent tool for enabling students to learn radiologic anatomy from real-life clinical datasets. Interactive exercises performed in groups can be powerful tools for stimulating students to learn radiologic anatomy.     

Retention of radiographic anatomy of the chest by 4th-year medical students

RATIONALE AND OBJECTIVES: The authors performed this study to assess the ability of medical students to retain their knowledge of radiographic anatomy into the 4th year. MATERIALS AND METHODS: One hundred ninety-four 4th-year medical students were quizzed on their ability to (a) identify 10 anatomic structures on chest radiographs and (b) search an abnormal radiograph to identify two important findings. Frontal and lateral views were used. The students had learned about radiographic anatomy of the chest and plain radiography search techniques in 1st- and 2nd-year courses and had proved their ability to perform these tasks, during their 2nd year of medical school, by achieving grades of 84% or more (average grade, 90%) on individual oral examinations administered by radiologists. RESULTS: The mean test score was 4.47 out of 12. Only 10 students (5%) were able to identify the main pulmonary artery on the frontal view, and only nine (4%) identified the main bronchi on the lateral view. Of the 194 students, 192 failed to detect a collapsed vertebral body on the lateral view of a patient who had previously undergone a mastectomy. CONCLUSION: Specific radiologic anatomy facts and search techniques are poorly retained by 4th-year medical students. Preclinical teaching of imaging probably should stress principles rather than specific details.     

Trends in radiological anatomy teaching in the U.K. and Ireland

AIM: To determine the prevalence of radiological anatomy teaching in modern medical curricula. MATERIALS AND METHODS: The present paper details a survey carried out amongst 21 medical schools in the U.K. and Ireland to determine the variability of the inclusion of radiological anatomy in their different curricula. RESULTS: In all the institutions surveyed teaching of anatomy as revealed by radiological techniques was delivered by anatomy departments. There was considerable variation, however, in the way in which it was delivered, by whom and in the range of radiological material available. Most anatomy departments had links with radiology departments, though the precise arrangements of these also varied. CONCLUSION: This study highlights the need for standardization between anatomy departments with regard to the content and level of radiological anatomy taught to ensure that an appropriate basis for clinical undergraduate training is provided.     

胰腺的血管系统

胰腺的血管是上腹部内脏血管系统非常重要而又复杂的组成部分之一。来自腹腔动脉干的胃十二指肠动脉与脾动脉、肠系膜上动脉一道，构成了胰腺丰富的动脉血管网，作为肝外门静脉系统最重要的两大静脉属支环路之一的胰头静脉弓和来自脾静脉，肠系膜上静脉的属支组成了组成了引流胰腺血液的静脉框架，正确认识胰腺的血管解剖并熟悉其影像学表现，有助于识别胰腺血管系统在形态学及血流动力学方面的异常状况，为相关疾病的全面而准确的诊断及预后评价提供重要的影像学依据。     

Clinical anatomy, histology, & pathomechanics of the elbow in sports

The elbow is an integral link in the athlete's upper extremity function transferring force, position, and load-bearingcapability to the hand. This paper focuses upon the salient clinical anatomy and biomechanics of the elbow relative to specific athletic skills. First, the pertintent anatomy of the elbow will be discussed emphasizing those aspects that are clinically relevant. In the second section, the pathomechanics of the elbow will be reviewed using the throwing motion as the representative athletic skill. An understanding of the functional anatomy and pathomechanics of the elbow will aid in developing a rational approach to the evaluation, treatment, and rehabilitation of sports-related injuries.     

正常垂体高度的解剖与MRI测量对比研究

目的对正常成人垂体高度MRI与解剖测量进行比较.方法采用1.5超导磁共振系统,对垂体连续薄层自旋回波T1加权成像,测量1400例成人垂体正中矢状位高度,并与国内外资料相对比.结果国内正常成人垂体高度均值为6.6±2.1mm,明显大于多数国内外解剖测量资料,统计具有非常显著性差异.结论解剖测量垂体的高度值小于MRI测量的高度值.