目的 探讨MSCTA对颅底及上颈椎 椎弓根解剖结构的研究价值。方法 选择 51例怀疑或确诊为上颈椎病变患者行颈部 CTA检查，扫描范围从颅底至颈根部。搜 集CTA原始数据在AW4.4工作站上进行后处 理重建，在MPR图像上测量C1、C2、C3椎 弓根的基本参数和枕骨的厚度作为临床置 钉的钉道数据，包括椎弓根长度(PL),椎 弓根宽度(PW)，椎弓根高度(PH),内倾角 (PMA),头倾角(PSA),枕骨正中左右各1cm 层面自颅底向上1cm、2cm、3cm、横窦交 汇处枕骨板的厚度及最大高度。术后通过 VR、减影VR、MIP和MPR等方式显示螺钉置 入情况，并且对术后症状进行随访。对双 侧椎弓根的长度、宽度、高度、内倾角、 头倾角及枕骨钉道数据进行均值统计分 析，并对左、右两侧钉道数据采用配对样 本t检验。结果 MPR法测得的钉道数据统 计采用(χ- ±s)来表示，C3左、右两侧椎 弓根宽度PW经配对t检验有统计学差异， 其他数据均无统计学差异。结论 MSCT能 客观准确反映颅底及上颈椎椎弓根解剖结 构特点，为影像解剖学研究及临床手术提 供参考。

Objective To explore the study value of multi-slice CT angiography(MSCTA) in the anatomical structure of basicranial and upper cervical vertebrae pedicle screw. Methods 51 patients suspected or conformed upper cervical disease were collected, which perform cervical CTA, choose the artery phase data to perform reconstruction at GEAW4.4, including Volume Rendering(VR), Maximum Intensity Projection(MIP) and Multi-planar Reformation(MPR) to show the courser and anatomy variation of vertebra artery, Measure the pedicle screw data of C1,C2,C3 and occipital in MPR images, including pedicle length(PL), pedicle width(PW),height(PH), pedicle median angle (PMA), pedicle superior angle (PSA), occipital thickness of 1cm, 2cm, 3cm and transverse sinus interchange plane to skull base. SPSS-19.0 statistical packages were used for data entry and statistical analysis and pair sample t-test statistical analysis for the difference between left and right side. Results Both of MIP and VR can observe courser and nearby space relationship of cervical artery. Pair sample t-test statistical analysis for the difference of left and right side: there was marked difference only between two sides of C3-PH. Conclusion MSCTA can reflect the morphology of upper cervical vertebral pedicle screw and skull base, also can provide an accurate reference for imaging anatomy research and clinical surgery.