A comparative study of thin-layer cross-sectional anatomic morphology and CT images of the basal cistern and its application in acute craniocerebral traumas

Abstract

To compare the cross-sectional morphologic features of successive thin-layers and CT images of the basal cistern and its application in the diagnosis and management of acute craniocerebral traumas. Successive thin-layer cross-sectional images of the basal cistern were retrieved from the second Chinese visible human (CVH) data set and observed. A total of 40 healthy volunteers were subjected to 64-slice spiral CT scan of the head, and CT images of the basal cistern were compared with CVH images. A total of 413 patients with acute craniocerebral traumas were subjected to 64-slice spiral CT scan of the head, CT image changes of the basal cistern were observed. Thin-layer cross-sectional images retrieved from the CVH data set clearly displayed the sectional anatomic morphology, morphologic change pattern and important adjacent structures of the basal cistern. The quadrigeminal cistern was pateriform or sellaeform; the suprasellar cistern was hexagonal or pentagonal star-shaped; the ambient cistern encircled both sides of the brainstem like an arc band. CT images of the quadrigeminal and ambient cisterns were similar with their CVH images; however, the morphology of the suprasellar cistern changed substantially. In 413 patients with acute craniocerebral traumas, the basal cistern may be normal, or presented with narrowing, obliteration, shift, hematocele, and pneumatosis. Narrowing or obliteration of the basal cistern occurred mostly at the side of dominant intracranial lesions, and frequently occurred in patients with diffuse axonal injury or combination of SDH + CONT + ICH. Thin-layer cross-sectional images of the basal cistern retrieved from the CVH data set correspond satisfactorily to CT images of the basal cistern. Comparison of the two types of images can provide a sectional anatomic basis for the image identification of acute craniocerebral traumas. A careful observation on the initial CT images of the basal cistern for anatomic morphologic changes will help diagnose acute craniocerebral traumas early, improve the management, and appropriately predict the prognosis of the condition.