의학과/석사[한글]
경 두부 병변의 진단방법으로 외경동맥 조영촬영은 임상적으로 중요한 이용가치를 가지고 있다. 특히 경 두부의 종양의 조기진단 치료의 적절을 기하는데 큰 역할을 하게 된다. 이를 위하여는 먼저 외경동맥의 정상분포 상태가 정확히 파악되야 할 것이다.
저자는 총경동맥 천자술로 내 외경동맥이 동시 조영된 106예를 선택하여 외경동맥과 주 분지의 기시와 형상변형, 전시율 및 외경동맥 기시부로부터 주 분지의 기시부까지 거리를 계측하여 다음과 같은 결과를 얻었다.
1. 외경동맥의 기시분는 제3 및 제4 경추사이가 가장 많아 52.8%의 비율이고 주행상은 연령에 따라 상당한 변화를 보이고 있었다.
2. 상갑상선동맥은 외경동맥으로부터 기시하는 경우가 49.5%로 가장 많았다.
3. 상갑상선동맥, 설동맥 및 안면동맥은 외경동맥 기시부로부터 공히 1cm 이상 2cm 미만 거리의 외경동맥에서 기시하나 서로 다른 부위로부터 기시하는 경우가 78.3%로 가장 높은 빈도를 보였다.
4. 상행인두동맥은 59.8%에서 전시되었고 외경동맥과 후두동맥으로부터 기시하는 경우가 가장 많았다.
5. 안면횡동맥은 72.1%에서 전시되었고 외경동맥과 천측두동맥으로부터 기시하는 경우가 가장 많았다.
6. 상악동맥은 외경동맥 기시로부터 5cm 이상 7cm 미만 거리의 외경동맥 종지가 되는 경우가 69%로 가장 많고 주행상은 대부분 수평으로 놓은 "S"상을 하고 있었다.
7. 부중경뇌막동맥은 18%에서 전시되었다.
8. 후이개동맥과 천측두동맥의 두개부 전시율은 각각 69.5% 및 72.1%로 나타났다.
9. 중경뇌막동맥은 상악동맥 기시부로부터 0.5cm 이상 1cm 미만 거리의 상악동맥으로부터 기시하는 경우가 57.6%로 가장 많고 두개부 전시율은 29.5%정도에 불과하였다.
[영문]
The external carotid arteriogram is useful in the diagnosis of head and neck disease, however, clinically has not been widely used in contrast with the internal carotid anteriogram of intracranial lesion.
It is due to the shape of branches of external carotid artery being variable according to underlying mechanical factors in the normal condition and is the diagnosis of head and neck lesion has been established easily by other clinical methods.
Recently the external carotid arteriogram is valuable for the detection, location and extension of the head and neck lesion, especially in case of early and small malignant lesion. For these reasons the normal distribution and variation of branches of external carotid artery should be analysed to fulfill these purposes.
In this study the selected external carotid arteriogram of 106 cases which had been performed by puncture of common carotid artery, was conjoined. Therefore, the purpose of this study is an analysis of shape and origination of the main branches of external carotid artery, visualization rate of the branches of external carotid artery and direct distance measurement from the root of external carotid artery to the main branches by common carotid artery injection.
The results were as follows:
1. The bifurcation level of common artery is C^^3 - C^^4 in 52.8%, C^^2 - C^^3 in 34.9% and C^^4 - C^^5 in 10.4%(range: C^^2 - C^^6).
2. The shape of external carotid artery is variable and frequently appears straight and curved in the young adult before 4th decade, whereas appears waved and arch in the older age group. This fact suggest the arteriosclerotic changes of blood vessel by aging process.
3. The superior thyroidal artery arises from the external carotid artery in 49.5% and from the common carotid artery in 23.8%.
4. The variable originations of superior thyroidal, lingual and facial artery are the normal origination in 78.3%, the lingofacial common trunk in 16.1%, the thyroilingual common trunk in 3.7% and the thyrolingofacial common trunk in 1.9%.
5. The ascending pharyngeal artery arises from the external carotid artery in 24.6%, from the occipital artery in 23.5%, from the root of occipital artery in 9.8%, and from the internal carotid artery in 1.9%.
6. The transverse facial artery arises from the external carotid artery in 27.9%, from the superficial temporal artery in 21.2%, and from the maxillray artery in 10.5%.
7. The roentgen-anatomical shape of maxillary artery is divided by three part; 1st part of mandibular, 2nd part of pterygoid and 3rd part of spheno-maxillary. The most frequent shape of each part of maxillary artery is convex in 78.4% of mandibular, oblique straight in 45.8% and oblique convex in 35.2% of pterygoid and ill-defined variable shapes of sphenomaxillary.
8. The visualization of main branches of external carotid arteriogram by the common carotid artery injection is in 69.5% of posterior auricular, 70.5% of the cranial part of superficial temporal, 29.5% of the cranial part of middle meningeal and 72.1% of transverse facial artery.
9. The accessory middle meningeal artery observed in 18% of total 105 cases.
10. The distance from the root of external carotid artery to the origination of main branches is 1) in the range of 5-6cm in 33%, 6-7cm in 26% of the maxillary artery, 2) in the range of 1-2cm in 47.2% and 2-3cm in 25.2% of the occipital artery. 3) in the range of 1-2cm in 54% and 2-3cm in 30.6% of the facial artery and 4) in the range of 1-2cm in 55.6% and 0-1cm in 24.7% of the lingual artery in order frequency. (range; 0-7cm).
11. The origination of middle meningeal artery is in the range of 0.5-1cm in 57.6% from the root of maxillary artery in the most frequency and arises from the root of maxillary artery in 10.2%.restrictio