中文摘要：

目的探讨经前外侧倾斜入路行颈2椎体穿刺路径的影像解剖及其能否对实际穿刺有指导意义。方法新鲜尸体10具分别于双侧颈总动脉内注入对比剂后行CT扫描，通过二维重建建立双侧模拟穿刺路径，分别测量穿刺点距中线的旁开距离（AC）、模拟路径与矢状面间夹角（AOB）及与颈动脉壁和喉咽侧壁间距离。根据所得参数于透视下行颈2椎体前外侧倾斜穿刺，成功后再行CT扫描，通过二维重建显示实际针道并测量相关数据。组间数据比较采用配对t检验。结果10具尸体均获得双侧CT模拟穿刺路径。透视导向下颈2椎体10节共20侧分别穿刺均获成功，且CT重建均显示实际针道。左模拟路径AC、AOB、与颈动脉距离及与喉咽侧壁的距离分别为（4．7±1．0）cm、（33±8）°、（6．7±2．6）mm、（6．6±2．8）mm，右侧为（5．2±1．3）cm、（36±8）°、（7．5±2．2）mm、（7．2±2．5）mm；左实际针道AC、AOB、与颈动脉距离以及与喉咽侧壁的距离分别为（4．5±1．1）cm、（33±9）°、（6．7±3．0）mm、（7．1±3．9）mm，右侧为（5．1±1．5）cm、（35±10）°、（7．4±2．1）mm、（7．2±2．6）mm，对各项数据分别行左右以及模拟与实际的比较，差异均无统计学意义（t=0．104-1．882，均P〉0．05）。结论CT重建可模拟经前外侧颈2椎体倾斜穿刺路径，并与实际针道具有较好的一致性；CT模拟路径可指导经前侧倾斜穿刺颈2椎体，并提高实际穿刺的准确性和安全性。

英文摘要：

Objective To determine the anatomical relation between the carotid artery or laryngopharynx and the needle path via anterolateral oblique approach to C2 vertebral body, and whether the simulated path can direct the actual procedure. Methods Contrast agent was injected into bilateral carotid arteries of 10 fresh cadavers （20 sides ）, and then CT scans were performed on each subject. Bilateral simulated puncture paths were simulated on the image of two-dimensional reconstruction CT. The distance between the puncture site and middle line （ AC ）, the angle between the simulated puncture paths and the median sagittal plane （AOB）, the distance between the simulated puncture paths and the side wall of hypopharynx, or the carotid artery was measured respectively. Under the guidance of fluoroscopy, oblique puncture via anterolateral to C2 was performed according to the simulated parameters, and then CT was done. The actual needle path was measured on the image of two-dimensional reconstruction CT. The outcomes were compared by using paired t test between groups. Results Bilateral simulated puncture paths in all 10 cadavers were achieved on the image of CT. The bilateral punctures via anterolateral to C2 were successfully performed under fluoroscopic guidance in 10 cadavers, and the actual needle path could be showed on the image of two-dimensional reconstruction CT. The AC, angle AOB, the distance to carotid artery and side wall of laryngopharyngeal of the left simulated path was （4. 7 ± 1.0） cm, （ 33 ± 8 ）°, （ 6. 7 ± 2. 6） mm, （ 6. 6 ± 2. 8 ） mm, respectively ; and those in the right side was （5.2 ± 1.3 ） cm, （ 36 ± 8 ）°, （7.5 ± 2. 2） mm, （7.2 ± 2. 5） mm, respectively. The AC, angle AOB, the distance to carotid artery and side wall of laryngopharyngeal of the left actual needle was （4. 5 ± 1.1 ） cm, （ 33 ± 9 ）°, （6. 7 ± 3.0） mm, （7.1 ±3.9） mm, respectively; and those in the right side was（5.1 ± 1.5） cm, （35 ± 10）°, （7.4 ±2.1） mm, ?