64层螺旋CTA对变异肾动脉与主肾动脉和对应肾脏的研究

Study of variation renal artery and main renal artery and the corresponding kidney by 64-slice CTA

目的：分析变异肾动脉的特点及其与主肾动脉和对应肾脏的关系,为临床诊断及手术方案提供参考。方法：回顾性分析518例疑有肾血管性高血压或肾脏病变患者的64层螺旋CT血管影像资料,其中210例患者存在肾动脉变异（40.5%）,主要观察变异肾动脉的特点及其与同侧主肾动脉的位置关系、双侧主肾动脉管径及肾脏结构形态的对比。结果：单侧肾动脉变异141例,占67.1%,双侧肾动脉变异69例,占32.9%;肾脏形态结构、位置异常178例,正常32例;变异侧主肾动脉管径小于无变异侧主肾动脉管径112例,占79.4%（112/141）;195支变异肾动脉开口于腹主动脉,其与同侧主肾动脉距离范围为0~112mm,其中0~20mm共130支,占66.7%;高于同侧主肾动脉72支,占36.9%,低于同侧主肾动脉118支,占60.5%,与主肾动脉等高5支,占2.6%;入肾上极130支,入肾门113支,入肾下极100支;开口于腹主动脉的变异肾动脉起源于T12~L5椎体段范围,其中L1上缘至L2椎体下缘范围149支,占76.4%（149/195）。结论：64层螺旋CTA可直观、准确地显示变异肾动脉的起源、数目及其与相应主肾动脉、肾脏的关系。

Objective：To analyzc the feature of variation renal artery and the relation of main renal artery and the corresponding kidney,and to provide reference for clinical diagnosis and surgical scheme.Methods：The vascular image data of 518 patients with renovascular hypertension or renal lesions were reviewed retrospectively,including 210 patients with renal artery variation（40.5%）.The feature and the location relation of variation renal artery and main renal artery were observed.The diameter of double main renal artery and the morphology structure of double kidney were compared.Results：Single-side renal artery variation was foud in 141 patients（67.1%）,bilateral renal artery variation in 69 patients（32.9%）.The morphology and position of kidney were abnormal in 178 patients,the kidney was normal in 32 patients.The diameter of main renal artery with variation renal artery was smaller than that of main renal artery without variation renal artery in 112 patients（79.4%）;195 branches of variant renal artery opened in the abdominal aorta,the distance between the variant renal artery and the main renal artery was 0～112 mm,130 branches in the range 0～20 mm（66.7%）;The position of the variant renal artery was highter than the main renal artery in 72 branches（36.9%）,and lower than the main renal artery in 118 branches（60.5%）,at a same level in 5 branch（2.6%）;130 entered into the upper kidney pole,113 entered into the renal hilus,100 entered into the lower kidney pole;variation renal artery were found originated from T12 to L5 vertebrae,among them,149（76.4%） were originated from the upper of L1 and the lower of L2 vertebrae.Conclusion：64-slice spiral CT angiography can accurately show the origin,number,and the relationship of main renal artery and the corresponding kidney.