202例无下肢静脉疾病者左髂总静脉受压的MSCTA研究

MSCTA findings in left common iliac vein compression among 202 asymptomatic patients

目的运用MSCTA分析无下肢静脉疾病症状人群左髂总静脉受压率。方法对202例无下肢静脉疾病者的盆腔增强扫描进行分析,在右髂总动脉跨越左髂总静脉水平,采用多平面重建等方法,显示、测量两侧髂总静脉正交断面上的短径及面积,并分别计算左髂总静脉短径受压率及面积受压率。用t检验分析短径受压率与面积受压率的差异以及性别差异,卡方检验或确切概率法分析受压率大于50%患者中不同性别发病率的差异。结果①在正交断面上,左髂总静脉短径受压率为27.06%±2.23%,面积受压率为9.59%±1.63%,短径受压率明显高于面积受压率(t=8.980,P=0.000);②对左髂总静脉面积受压率进行统计分析,平均受压程度为9.59%,受压率≥50%占3.96%(n=8);在受压率≥50%的8例受试者中,7例为女性,女性发生率高于男性(P=0.03)。将202例研究对象分成小于40岁组(1)、40～60岁组(2)、大于60岁组(3)三个组别,分别进行两两比较,结果显示男女患者均无显著年龄差异(女性:p1～2=0.249,p1～3=0.669,p2～3=0.293;男性:p1～2=0.401,p1～3=0.459,p2～3=0.841)。在三个年龄组别内,分别统计分析性别差异,结果均无明显性别差异(小于40岁组:t=0.492,P=0.627;40～60岁组:t=0.238,P=0.813;大于60岁组:t=1.597,P=0.113);③对左髂总静脉短径受压率进行统计分析,结果显示受压率≥50%占16.34%(n=33),在受压率≥50%的33例受试者中,22例为女性,女性的发生率高于男性(P=0.019)。男女患者均无显著年龄差异(女性:p1～2=0.262,p1～3=0.086,p2～3=0.870;男性:p1～2=0.307,p1～3=0.156,p2～3=0.875)。在三个年龄组别内,均无明显的性别差异(小于40岁组:t=0.941,P=0.356;40～60岁组:t=1.437,P=0.156;大于60岁组:t=1.883,P=0.062)。结论左髂总静脉受压率在正常人群中无明显年龄、性别差异,但在左髂总静脉受压大于50%的无症状者中,女性较男性多。

Objective To study the incidence rate of left common iliac vein compression among asymtomatic patients using MSCTA. Methods 202 patients without lower extremity diseases underwent enhanced CT. Using multiplanar reformation technique, the anteroposterior diameter and area of bilateral common iliac veins were mesured in orthogonal crosssectional planes at the point where the right common iliac artery crossed, to get the compression rate in diameter and area.Independent sample t test was used to compare the differences between the rates in diameter and area,as well as in male and female. AVONA test was used to compare the differences within groups of age. Comparing the rates between maleand female among, the rates were bigger than 50% using Chi-square test and fisher＇s test. Results ① In the orthogonal cross-sectional planes, the mean compression extent on anteroposterior diameter of left common iliac veins was 27.06 % ±2.23 %, on area of left common iliac veins was 9.59 %±1.63 %. The extent on anteroposterior diameter of left common iliac veins exceeded the extent on area obviously （ t = 8. 980, P = 0. 000）; ② Statistically,the mean compression extent onarea of left common iliac veins was 9.59 %. The extent of greater than 50 % of compression on left common iliac vein was found in 3.96 % （n= 8） of the patients, and 7 of which were female, so the extent of greater than 50 % in female was largerthan in male （ P =0.03）. All the patients were divided into three groups according to age, group 1 were younger than 40 years old,group 2 was between 40 to 60, group 3 was older than 60. There were no statistically significant differences inage both among male and female （female：p1～2=0. 249, p1～3=0. 669, p2～3=0. 293; male： p1～2=0. 401, p1～3= 0. 459, p2～3=0. 841）. Within the three groups, there were no statistically significant differences in sex （group 1： t=0. 492, P =0. 627; group2： t =0. 238, P =0. 813; group 3： t =1. 597, P =0. 113） ; ③ Statistically,analysising the data of compression extent on anteroposterior diameter of left common iliac veins, the extent of greater than 50% was found in16.34%（n=33）, and 7 of which were female,also the extent of greater than 50% in female was larger than in male （ P = 0. 019）. There were no statistically significant differences in age both among male and female （female： p1～2=0. 262, p1～3：0.086, p2～3：0.870; male：p1～2=0. 307, p1～3：0. 156, p2～3=0.875）. Within the three groups, there were no statistically significant differences in sex （group 1： t =0.941, P=0.356; group 2： t =1.43, P=0.156; group 3： t= 1. 883, P =0. 062）. Conclusion In asymptomatic individuals, there were no statistically age and gender differences, but in those patients whose extent was greater than 50%, more women exist.