维解剖位置。结果：面动脉距下颌角点的距离为下颌角周围相关动脉走行CTA定位探究［摘要］目的：应用CTA影像测量下颌角周围动脉与下颌角手术的解剖关系，为避免手术中损伤下颌角周围动脉提供指导。方法：选择30名正常成人下颌角及周围血管CTA扫描图像，应用ADW4.2图像处理软件测量面动脉距下颌角点；颈外动脉距下颌角点、颈外动脉距下颌骨升支后缘各点的三>z<在下颌角点上30mm处距下颌骨升支后缘的距离为(28.26±8.34)mm;颈外动脉据下颌角点的距离为(18.66±6.34)mm;颈外动脉在下颌角点上10mm处距下颌骨升支后缘的距离为(12.28±5.12)mm;在下颌角点上20mm处距下颌骨升支后缘的距离为(9.58±5.42)mm;(6.38±4.12)mm，在下颌角点上40mm处距下颌骨升支后缘的距离为(3・46±2.56)mm,左右侧无显著差异。结论：在下颌角截骨或磨削手术时应注意面动脉和颈外动脉的损伤，位置越高颈外动脉距下颌升支边缘越近。手术安全范围应控制在距下颌角点上30mm以内的位置。［关键词］下颌角手术；CTA;面动脉；颈外动脉；下颌角［中图分类号JR322R782［文献标识码］A［文章编#］1008-6455(2012)02-0238-03ThemeasurementpositionstudyofexternalcarotidarteryandfacialarterywithCTAinthemandibularangleplastyWANGYan,HUAZe-quan,LIUWen-yuan,WANGJin-bao,LIShu・hua(DepartmentofOralandMaxillarySurgery,DepartmentofRadiology,ShenyangMilitaryGeneralHospital,Shenyang110016,Liaoning,China)Abstract:ObjectiveTheaimofthisstudywastoinvestigatethepositionandcourseofexternalcarotidarteryandfacialarterywithCTAinthemandibularangleplasty,andtherelationshipwithmandiableangleofthesetwovascularusingcomputedtomographicangiography(CTA)imaging,toprovideguidanceinthemandibularangleplasty,andavoidaseriescomplicationscausedbybleedingbecausedamagingthesevascular.MethodsMulti-detectorrowhelicalCTAmeasurementwasperformedonthirtyadult.WithADW4.2software,thedistancesfromthefacialarterytomandibularangle,fromtheexternalcarotidarterytomandibularangleandmandibleborderwereanalyzed・ResultsThedistaneefromtheexternalcarotidarterytothegonionisgonionintheedgeofmandibularborderis(9.58±5.42mm),andtoabove30mmfromthepointofgonionintheedgeofmandibularborderis(6.38±4.12)mm,andtoabove40mmfromthepointof(18.66±6.34)mm,andtoabove10mmfromthepointofgonionintheedgeofmandibularborderis(12.28±5.12)mm,andtoabove20mmfromthepointofKeywords:mandibulerangleplasty;CTA;gonion;externalcarotidartery;facialgonionintheedgeofmandibularborderis(3.46±2.56)mm.thedistancefromthefacialarterytothegonionis(28.26±8.34)mm・ConclusionThestudyistoprovidefurtherunderstandingoftheexternalcarotidarteryandfacialarteryinrelationtothedesignofthemandibulerangleplasty,thehigheroftheoperatingposition,thecloserofthedistancefromexternalcarotidarterytomandible,andthemorelikelydamagetheartery,Inaccordingtothedataobtained,wecancontroltheclinicalsafetyguidelinesin30mmabovethegonion.artery;facialartery下颌角肥大成型术易引起下颌角周围血管损伤，导致术中出血，术后血肿口・3],甚至窒息死亡，已得到口腔颌面外科和整形外科医师的重视。血管损伤的原因除手术操作外，主要是对下颌角周围血管的解剖位置了解不够。本文应用CTA影像对下颌角手术相关的面动脉，颈外动脉的解剖位置进行了测量研究，为临床行下颌角成型术提供解剖指导。1材料和方法选出30名成人，应用CTA在下颌角截骨位置扫描。体位:仰卧，平行听眦线固定患者。通过肘正中静脉注射欧乃派克350mg/ml,注射速度4.5~5.2nd/s,CT型号:philips:LightSpeed256排螺旋CT扫描仪(256-MSCT)，动脉显影时限25so利用ADW4.2软件120KV,350mA,层厚0.625,动脉静脉三维重建应用VRT(VolumeRenderingTechnique),MPR(MultiplanarReconstruction),MIP(MaximumIntensity>z<Projection),CPR(curvedPlanar...