下腔静脉滤器置入术后倾斜和穿孔的CT随访结果

Follow-up of of Filter Tilting and Caval Perforation of Patients with Inferior Vena Cava Filter Placement with CT

目的 CT(computed tomography)评估下腔静脉滤器(inferior vena cava filter,IVCF)置入后滤器倾斜和穿孔的临床价值。方法 2010年1月至2012年10月对行IVCF置入术后的78例患者予CT随访,回顾性评估IVCF置入期间随访滤器异常的CT表现。结果 78例患者滤器置入时间为12天—16年,滤器发生倾斜的共22例,17例倾斜角大于15°。滤器侧方倾斜的平均倾斜角为9°±2°,15例大于15°;前后方倾斜的平均倾斜角为10°±3°,10例大于15°;9例滤器仅表现在一个方向上倾斜角度大于15°;8例滤器双向倾斜角度均大于15°。CT图像发现下腔静脉穿孔0-1级共71例,3-4级共7例,其中0级,68例,1级3例;2级3例;3级4例。结论 CT能够较清晰地呈现下腔静脉滤器全貌并检测异常,可作为对滤器置入术后并发症及随访的有效方法。

Objective To assess the clinical value of filter tilting and caval perforation after the inferior vena cava filter （inferior vena cava filter, IVCF） placement with CT （computed tomography）. Methods Seventy-eight patients with IVCF placement were followed up with CT from January 2010 to October 2012. The abnormal of IVCF on CT imaging findings were evaluated retrospectively. Results The dwell time of Seventy-eight patients filter placement were Twelve days - Sixteen years. Twenty-two filters tilted at CT, Sev- enteen filters was tilted higher than 15a.The mean tilt angle in the mediolateral direction was 9° ± 2° , and fifteen filters had a tilt angle higher than 15° . The mean tilt angle in the anteroposterior direction was 10°± 3°, and ten filters had an tilt angle higher than 15°. nine filters with a tilt angle higher than 15ain only one direction .eight filters with a tilt angle higher than 15° both in the mediolateral and anteroposterior directions. CT images found that the nttmber of IVC perlbration with 0-1 grade and 2-3 grade were Seventy-one cases and seven cases respectively. The degree of perforation was distributed as follow exactly： grade 0, Sixty-eight filter; grade 1, three filters： grade 2, three filters; grade 3, four filters. Conclusion CT can show an overview of the inferior vena cava filter and detect anomalies clearly, can be used as an effective way to filter placement for postoperative complications and follow-up.