Artikel
Anatomical study of the quadrigeminal cistern in the living with three-dimensional MR cisternography
Anatomische Untersuchung der Cisterna laminae quadrigeminae am Lebenden mittels drei-dimensionaler Magnetresonanzzisternographie
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Autoren
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W. O. Lüdemann
- International Neuroscience Institute Hannover, Department of Neurosurgery, Germany
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L. Columbano
- Seconda Universita'degli Studi di Napoli, Department of Neurosurgery, Italy
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L. H. Stieglitz
- International Neuroscience Institute Hannover, Department of Neurosurgery, Germany
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K. H. Wrede
- International Neuroscience Institute Hannover, Department of Neurosurgery, Germany
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A. Samii
- International Neuroscience Institute Hannover, Department of Neurosurgery, Germany
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M. Samii
- International Neuroscience Institute Hannover, Department of Neurosurgery, Germany
| Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: The purpose of this study was to demonstrate the anatomy of the quadrigeminal cistern, to define anatomical landmarks within the cistern and to measure the extension and variability of the cistern in the living using MR cisternography with 3D reconstruction.
Methods: The quadrigeminal cistern was examined in 38 adult patients, 13 females and 25 males, using MR cisternography. Measurements were made on sagittal, axial and coronal planes. We focused on: measurements of the superior, posterior and lateral limits of the cistern; measurements of the anterior and posterior maximal rostro-caudal diameter; measurements of the distance between the right and left superior colliculus and the right and left inferior colliculus; measurements of the angle between the quadrigeminal plate and the pineal gland.
Results: The highest variability is observed for the maximal posterior rostro-caudal diameter with a standard deviation of 3,1 mm and a range from 8 to 21,1 mm, followed by the maximal anterior-posterior diameter with a standard deviation of 2,8 mm and a range from 6,4 to 16,5 mm. The distance between the right and left superior colloculus is in 100% of the cases longer than the distance between the right and left inferior colliculus; the distance between the right and left inferior colliculus ranged from 9,1 to 14,3 mm (11,4±1,3 mm; Mean ± SD) and the distance between the right and left superior colliculus ranged from 9,6 to 17,4 mm (13,3±1,8 mm; Mean ± SD). We classified two different types of cisterns: closed cisterns with angles between the quadrigeminal plate and the pineal gland ranging from 39° to 63° and open cisterns with angles ranging from 63° to 76°. The analysis of the variability by age and sex showed no significant differences.
Conclusions: The MR cisternography with 3D reconstruction is a simple and non invasive tool providing detailed anatomical information in the living. It was helpful to define anatomical landmarks to measure the amazing high variability of the shape of the quadrigeminal cistern. We classified two different types of cisterns: open cisterns and closed cisterns; this could be helpful in the choice of the surgical approach to lesions in this area.
