仰、俯卧位下肾结肠位置变化与相对位移的影像解剖学研究

Imaging study of position correlation between kidney and colon under supine and prone positions

目的:测量仰、俯卧位下肾与结肠的解剖位置变化和相对位移,探讨俯卧位是否会增加经皮肾穿刺时结肠损伤的风险。方法:回顾分析30例患者的20侧左肾和13侧右肾的肾CT+CTU影像资料(肾CT为仰卧位,CTU为俯卧位)。分别测量仰、俯卧位时,肾与结肠的水平和垂直距离、肾与结肠间的最短距离,结肠到模拟经皮肾穿刺线的距离。从影像学上测量肾与结肠的位置变化及两者间的相对位移。结果:左肾垂直距离在仰、俯卧位时分别为(8.35±14.6)mm、(-3.71±13.8)mm,左结肠垂直距离在仰、俯卧位时分别为(23.1±21.7)mm、(12.23±18.7)mm,均有统计学差异。右肾、结肠垂直距离在仰、俯卧位时无统计学差异。左侧结肠到模拟经皮肾穿刺线的距离在仰、俯卧位是分别为(15.4±16.2)mm、(11.05±14.9)mm,有统计学差异;右侧结肠到模拟经皮肾穿刺线的距离在仰、俯卧位时无统计学差异。结论:俯卧位时,双侧肾、结肠向腹侧移位,但肾与结肠间的相对位置无明显变化;俯卧位不会增加经皮肾穿刺术中结肠损伤的风险。

Objective： To explore the position relationship between kidney and colon under supine and prone positions, and judge the possibly increased risk of colon injury during percutaneous nephrostomy in prone position comparing with that in supine position. Methods： The data of CT and CTU of 20 left kidneys and 13 right kidneys from 30 patients （CT was taken in supine position, CTU in prone position） were analyzed retrospectively. The horizontal and vertical distances from kidney and colon to vertebral body, the shortest distance between ipsolateral kidney and colon, and the distance between colon and puncturing line of PCN in supine and prone positions were measured respectively. The position changes of kidney and colon, and the relative movement between them in supine and prone positions were detected. Results： Vertical distances of left kidney at supine and prone positions were （8.35±14.6） mm and （-3.71±13.8） mm, vertical distances of left colon were （23.1 ±21.7） mm and （12.23± 18.7） mm respectively, with statistical differences. Vertical distance of right kidney at supine and prone positions had not statistical differences. The distances from left colon to the puncturing line at supine and prone positions were （15.4_＋16.2） mm and （11.05±14.9） mm respectively, with statistical differences, however, it had no statistical differences on right. Conclusions： Ventral displacement appeared for both kidneys and colon in prone position, however, the relative position between two organs has no obvious changes when position changes from supine to prone. The risk of colon injury doesn＇t increase during percutaneous nephrostomy in prone position comparing with that in supine position.