摘要
目的采用MSCT评价环主动脉型左肾静脉(circumaortic left renal vein,CLRV)变异,提高对该种左肾静脉变异及其临床意义的认识。方法回顾性分析1000例患者常规腹部动态增强CT资料,于动脉期和静脉期观察左肾静脉的解剖结构,采用MPR、MIP和VR等重建技术,分析CLRV变异的CT征象并进行分类。结果 960例患者CT图像清晰显示肾血管中,发现CLRV变异32例,发生率为3.3%(32/960)。男女性CLRV发生率的差异无统计学意义(P>0.05)。根据不同CT表现CLRV可分为4型,其中Ⅰ型20例,CT表现为单根左肾静脉分前后两支环绕主动脉注入下腔静脉;Ⅱ型4例,CT表现为两根左肾静脉分别走行于主动脉前方和后方注入下腔静脉;Ⅲ型2例,CT表现为CLRV前后支存在吻合或后支在向右行走过程中再发出分支注入下腔静脉;Ⅳ型6例,CT表现为CLRV前支走行正常,后支向下斜行注入左侧髂总静脉。结论 MSCT能够准确评价CLRV变异,在肾移植和腹膜后大血管病变术前评估有重要意义,有助于减少血管损伤和大出血等并发症。
Objective To assess the manifestation of variations of circumaortic left renal vein （CLRV） with MSCT and to improve the knowledge of variations of CLRV and its clinical significance.Methods Abdominal contrast enhanced MSCT data of 1000 patients were analyzed retrospectively.The anatomy of left renal veins on MSCT arterial and venous phase were observed.Three kinds of post-processing reconstruction methods including MPR, MIP and VR were used for analysis.The variations of CLRV were summarized and discussed according to the category.Results In 960 cases with clearly CT images of renal blood vessels, thirty-two cases（32/960, 3.3%）with CLRV were found.The difference of variation incidence of CLRV was not significant statistically between male and female （P〉0.05）.Thirty-two cases were classified into four types, including typeⅠ, one left renal vein splitting into two branches, a preaortic and a retroaortic, draining into inferior vena cava （IVC）;type Ⅱ, two different left renal veins, the one preaortic and the orther retroaortic, draining into IVC;type Ⅲ, either anastomoses between the preaortic and retroaortic vein, or multiple retroaortic renal veins without anastomoses;and type Ⅳ, the preaortic passing at the usual level, the retroaortic running downward and medially and draining into the left iliac vein.In these patients,the amoumt category typeⅠ, type Ⅱ , type Ⅲ and type Ⅳ was 20, 4, 2 and 6.Conclusion MSCT can be used to assess the circumaortic renal collar＇s morphology exactly, which has clinical value in preoperative evaluation of renal transplantation and retroperitoneal vascular lesions.And it could help prevent vascular injury and hemorrhage during surgery.
出处
《医学影像学杂志》
2017年第7期1281-1283,1287,共4页
Journal of Medical Imaging
基金
上海市嘉定区科委医学科研课题(编号:2014-KW-13)
