CT血管成像在脾动脉及其分支检查中的应用研究

Role of CT Angiography in the Examinations of Splenic Artery and Its Branches

目的探讨应用CT血管成像(CTA)检查脾动脉及其分支的可行性。方法分析2008年1月—2010年3月我院115例患者脾动脉CTA检查的影像学资料,三维重建脾动脉,分析脾动脉及其分支解剖特点及分布规律。选取行腹腔镜脾切除术(LS)的患者18例,术前脾动脉CTA检查结果与术中所见进行对比分析。结果 115例患者集中型脾动脉38例(占33.0%),分散型脾动脉77例(占67.0%)。脾动脉在胰尾上方81例(占70.4%),脾动脉在胰尾后方23例(占20.0%),脾动脉在胰尾内11例(占9.6%)。脾叶动脉一支型3例(占2.6%),二支型97例(占84.3%),三支型11例(占9.6%),多支型4例(占3.5%)。脾动脉末段内径与脾指数呈正相关(r=0.4997,P=0.02),脾叶动脉内径与脾指数呈正相关(r=0.4568,P=0.03)。18例患者均顺利完成LS手术。患者术前CTA检查脾动脉解剖类型、脾动脉与胰尾关系、脾叶动脉分支数及有无副脾与术中所见比较,差异均无统计学意义(P>0.05)。结论脾动脉CTA检查是在活体具有正常生理功能的条件下进行测量的,方法先进,数据真实,可用于脾动脉及其分支应用解剖学指标的研究。

Objective To explore the feasibility of using CT Angiography（CTA） for the examinations of splenic artery and its branches.Methods The CTA data of 115 patients who received imaging examinations in our hospital from January 2008 to March 2010were retrospectively analyzed.The three dimensions of splenic artery were re-constructed to analyze the characteristics and distribution of splenic artery and its branches.Among 18 cases who underwent laparoscopic splenectomy（LS）,their CTA results of splenic artery and its branches were compared with the intra-operative findings.Results Of these 115 patients,the distribution of splenic artery and its branches was as follows：compact type in 38 cases（33.0%）,distributed type in 77 cases（67.0%）.In addition,the splenic artery was above the tail of pancreas in 81 cases（70.4%）,behind the tail of pancreas in 23 cases（20.0%）,and inside the tail of pancreas in 11 cases（9.6%）.One branch of splenic lobial artery was noted in 3 cases（2.6%）,two branches in 97 cases（84.3%）,three branches in 11 cases（9.6%）,and multibranch in 4 cases（3.5%）.The internal diameter of the end segment of splenic artery was positively correlated with spleen index（r=0.4997,P=0.02）.and the internal diameter of splenic lobial artery was positively correlated with spleen index（r=0.4568,P=0.03）.Surgical operations were successful in all the 18 patients who underwent LS.There were no significant differences between pre-operative CTA and intra-operative findings in terms of anatomy of splenic artery,relationship between splenic artery and the tail of pancreas,number of the branches of splenic lobial artery,and the existence of splenculus（allP〉0.05）.Conclusion Splenic artery CTA can be performed when a living body has normal physiological functions.With advanced technology and accurate results,this method can be used for the anatomic analysis of splenic artery and its branches.