论文部分内容阅读
目的评价64层螺旋CT血管成像(CTA)对观察肾动脉变异及左肾静脉(LRV)解剖的价值。资料与方法回顾性分析105名正常人的64层螺旋CT肾血管影像资料,观察肾动脉变异及LRV解剖,测量肠系膜上动脉(SMA)与腹主动脉(AA)之间的夹角(α)、SMA与AA夹角间隙内LRV中心水平SMA的后缘与AA前缘之间的距离(D1)、SMA与AA夹角间隙内十二指肠中心水平SMA的后缘与AA前缘之间的距离(D2)、SMA与AA夹角间隙内LRV中心与SMA起始根部中心的距离(D3)、SMA与AA夹角间隙内十二指肠中心与SMA起始根部中心的距离(D4),同时测量LRV通过α角时的内径(a),近左肾侧最大内径(b),计算b/a值,并进行统计学分析。结果105名正常人共210只肾脏,肾动脉变异分别占病例数和肾脏数的32.4%(34/105)和17.6%(37/210),其中Ⅰ类(肾门前肾动脉分支)13只肾脏,Ⅱ类(肾副动脉)24只肾脏。α、D1、D2、D3、D4、a、b、b/a的均值分别为(51.2±18.5)°、(13.4±6.0)mm、(17.0±7.2)mm、(20.3±5.0)mm、(56.9±12.5)mm、(5.8±2.0)mm、(10.5±2.3)mm、(2.0±0.9),α角与D1、D2、a存在正相关,α角与D3、D4、b/a之间存在负相关,α角与b不存在相关性。结论64层螺旋CTA可清晰显示肾动脉变异、LRV和十二指肠的解剖关系,并准确测量SMA与AA之间的夹角,对指导肾脏手术及诊断胡桃夹综合征(nutcracker syndrome,NCS)和十二指肠淤积症有重要的临床价值。
Objective To evaluate the value of 64-slice spiral CT angiography (CTA) in observing renal artery variability and left renal vein (LRV) anatomy. Materials and Methods Retrospective analysis of 64-slice spiral CT renal angiography data of 105 normal subjects. Renal artery variability and LRV dissection were observed. The angle (α) between superior mesenteric artery (SMA) and abdominal aorta (AA) , LRV center between SMA and AA clearance Horizontal distance between the trailing edge of the SMA and the AA leading edge (D1), between the trailing edge of the SMA of the duodenum and the leading edge of AA (D2), the distance between the LRV center and the starting root center of the SMA in the clearance between SMA and AA (D3), the distance between the center of the starting duodenum and the starting root of SMA in the clearance between SMA and AA (D4) , Meanwhile, the internal diameter (a) of the LRV through the α angle and the maximum internal diameter of the left kidney (b) were measured, and the b / a value was calculated and statistically analyzed. Results A total of 210 normal subjects were included in this study. The renal artery variability accounted for 32.4% (34/105) and 17.6% (37/210) of the cases, respectively, of which 13 cases were type Ⅰ (renal branch of anterior renal artery) Kidney, class Ⅱ (renal artery) 24 kidneys. The average values of α, D1, D2, D3, D4, a, b and b / a were 51.2 ± 18.5, 13.4 ± 6.0, 17.0 ± 7.2 and 20.3 ± 5.0, 56.9 ± 12.5 mm, (5.8 ± 2.0) mm, (10.5 ± 2.3) mm and (2.0 ± 0.9) respectively. There was a positive correlation between the α angle and D1, D2, and between α and D3, D4 and b / a There is a negative correlation, α angle and b does not exist correlation. Conclusion The 64-slice spiral CTA can clearly show the anatomic relationship between renal artery variability, LRV and duodenum and accurately measure the angle between SMA and AA. It can be used to guide the operation of kidney and to diagnose nutcracker syndrome (NCS) And duodenal disease have important clinical value.