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Abstract：
OBJECTIVE: The vertical level of carotid bifurcation (CB) is commonly indicated at the superior margin of the thyroid cartilage. Few studies observed the CB vertical topography. It was aimed at studying the vertical location of the CB as referred to vertebral and anterior cervical landmarks.
METHODS: An archived lot of 147 computed tomography angiograms was documented for the vertical level of CB referred to vertebral and anterior cervical landmarks. The topography of the CB in relation to anterior landmarks was classified into seven types: (1) at the superior margin of the thyroid cartilage; (2) between the hyoid and the thyroid cartilage; (3) at the hyoid level; (4) between the hyoid and mandible; (5) subgonial or supragonial CB; (6) lower cervical level; (7) intrathoracic.
RESULTS: The most common locations of CB were at C3 (27.21%), C3/C4 (26.19%) and C4 (25.51%). Bilateral symmetry of CB was found in 51.7%, except for C2 and C5/C6. Type 7 was not found, type 3 occurred in 39.12%, type 2 in 24.49%, type 1 in 13.95%, type 4 in 13.61%, type 5 in 6.12%, and type 6 in 2.72% (294 CBs). Bilateral symmetry of anterior types was found in 59.86%. Statistically significant correlations were found between sex and both left and right types and vertebral levels of CB.
CONCLUSIONS: The vertical topography of the CB is highly variable and has sex-related specificity. This detail should be included in the teaching of anatomy. Surgeons and interventionists should better document the carotid anatomy on a case-by-case basis.
METHODS: An archived lot of 147 computed tomography angiograms was documented for the vertical level of CB referred to vertebral and anterior cervical landmarks. The topography of the CB in relation to anterior landmarks was classified into seven types: (1) at the superior margin of the thyroid cartilage; (2) between the hyoid and the thyroid cartilage; (3) at the hyoid level; (4) between the hyoid and mandible; (5) subgonial or supragonial CB; (6) lower cervical level; (7) intrathoracic.
RESULTS: The most common locations of CB were at C3 (27.21%), C3/C4 (26.19%) and C4 (25.51%). Bilateral symmetry of CB was found in 51.7%, except for C2 and C5/C6. Type 7 was not found, type 3 occurred in 39.12%, type 2 in 24.49%, type 1 in 13.95%, type 4 in 13.61%, type 5 in 6.12%, and type 6 in 2.72% (294 CBs). Bilateral symmetry of anterior types was found in 59.86%. Statistically significant correlations were found between sex and both left and right types and vertebral levels of CB.
CONCLUSIONS: The vertical topography of the CB is highly variable and has sex-related specificity. This detail should be included in the teaching of anatomy. Surgeons and interventionists should better document the carotid anatomy on a case-by-case basis.
摘要：
目的：颈动脉分叉（CB）的垂直水平通常显示在甲状软骨的上缘。很少有研究观察到CB的垂直地形。旨在研究CB的垂直位置，即椎骨和颈椎前路标志。
方法：记录了147张CT血管造影照片，记录了椎体和颈椎前路标志的CB垂直水平。CB与前标志有关的地形图分为七种类型：（1）在甲状软骨的上缘；（2）舌骨和甲状软骨之间；（3）在舌骨水平；（4）在舌骨和下颌骨之间；（5）性腺下或性腺上CB；（6）下颈椎水平；（7）胸内。
结果：CB最常见的位置是C3（27.21%），C3/C4(26.19%)和C4(25.51%)。CB的双边对称性在51.7%中发现，除了C2和C5/C6。找不到类型7，类型3发生在39.12%，类型2占24.49%，类型1占13.95%，类型4占13.61%，类型5占6.12%，类型6占2.72%(294个CBs)。前路型双侧对称性占59.86%。性别与CB的左右类型和椎骨水平之间存在统计学上的显着相关性。
结论：CB的垂直形貌是高度可变的，并且具有与性别相关的特异性。这个细节应该包括在解剖学的教学中。外科医生和干预人员应根据具体情况更好地记录颈动脉解剖结构。
方法：记录了147张CT血管造影照片，记录了椎体和颈椎前路标志的CB垂直水平。CB与前标志有关的地形图分为七种类型：（1）在甲状软骨的上缘；（2）舌骨和甲状软骨之间；（3）在舌骨水平；（4）在舌骨和下颌骨之间；（5）性腺下或性腺上CB；（6）下颈椎水平；（7）胸内。
结果：CB最常见的位置是C3（27.21%），C3/C4(26.19%)和C4(25.51%)。CB的双边对称性在51.7%中发现，除了C2和C5/C6。找不到类型7，类型3发生在39.12%，类型2占24.49%，类型1占13.95%，类型4占13.61%，类型5占6.12%，类型6占2.72%(294个CBs)。前路型双侧对称性占59.86%。性别与CB的左右类型和椎骨水平之间存在统计学上的显着相关性。
结论：CB的垂直形貌是高度可变的，并且具有与性别相关的特异性。这个细节应该包括在解剖学的教学中。外科医生和干预人员应根据具体情况更好地记录颈动脉解剖结构。
