头臂静脉的CT解剖学研究

Anatomical CT study of brachiocephalic vein

目的探讨左右侧头臂静脉的CT解剖结构差异。方法回顾性分析无纵隔、锁骨上及腋窝病变的胸部平扫及增强扫描60例,观察左右侧头臂静脉的形态,测量左侧头臂静脉横过主动脉弓或右侧头臂动脉处的短径,右侧头臂静脉汇入上腔静脉前段短径,记录静脉注射侧别、有无静脉反流。结果右侧头臂静脉短直,直行向下汇入上腔静脉(100%,60/60);左侧头臂静脉较长,跨过右侧头臂动脉前方者(Ⅰ型)占86.7%(52/60),跨过主动脉弓前方者(Ⅱ型)占13.3%(8/60)。左侧头臂静脉管径明显小于右侧,26.7%出现管腔狭窄,经左侧肘前静脉注射时,8.3%出现明显的静脉反流;右侧头臂静脉管径大于左侧,未发现静脉反流病例。结论右侧头臂静脉形态短直,管径明显大于左侧,未发现静脉反流,在CT增强时采用右侧上肢静脉注射,能达到较好的对比剂强化效应。

Objective To investigate the anatomical difference on CT between left and right brachiocephalic vein.Methods Sixty chests examining on plain and enhanced CT without disease in mediastinum,superior clavicle and axillary fossa were analyzed retrospectively.Including that the configuration and short diameter of left and right brachiocephalic vein were observed,the information of the injection site and the venous regurgitation was recorded.Results Right brachiocephalic veins were short and straight,and were directly downward to superior vena cava（100%,60/60）.The left brachiocephalic veins were long,crossing the right brachiocephalic artery at 86.7 %（52/60）,and crossing aortic arch in 13.3%（8/60）.The caliber of left brachiocephalic vein was less than right＇s,which had lumen stenosis in 26.7%,and 8.3% with venous regurgitation when injected in left superior extremitic vein.There were no venous regurgitation in right brachiocephalic vein.Conclusion Right brachiocephalic vein is short,straight and no venous regurgitation after injection,its lumen is larger than left＇s,then it would have better effective enhance by injecting right superior extremitic vein.