腰动脉CT血管成像的影像解剖学研究

Imaging Study on the Anatomy of Lumbar Arteries with the MSCT Angiography

目的探讨多层螺旋CT血管成像(MSCT-CTA)对腰动脉的显示情况,分析腰动脉的影像学解剖特点。方法采用64层螺旋CT扫描仪和静脉注射碘对比剂,对100例患者进行腹主动脉CT血管成像,使用容积再现(VRT)、最大密度投影(MIP)进行血管三维重建,观察腰动脉起源、与腹主动脉的交角、腰动脉间距以及追踪腰动脉的细小分支Adamkiewicz动脉(AKA)、第5对腰动脉的显影率及起源与走行。结果 100例患者CTA共检出778支腰动脉,其中,752支腰动脉起源于腹主动脉背侧,26支腰动脉共干;腰动脉与腹主动脉夹角:374支腰动脉以直角发出,再向上向后行走于腰椎两侧缘(<20o);194支呈正常型;210支例呈垂直型。相邻腰动脉的间距分别为:(30.88±5.76)mm、(28.74±5.65)mm、(24.42±3.88)mm。结论 MSCTA能够准确地、非损伤地显示腰动脉的解剖特点。

Objective To explore visualization of lumbar arteries with the multi-slice computerized tomography angiography（MSCTA） so as to study its anatomic features.Methods With the application of 64-slice spiral CTA and intravenous injection of an iodinated contrast material,a total of 100 patients underwent CT angiography on their abdomen.Then,volume rendering technique（VRT） and maximum intensity projection（MIP） were used for three-dimensional reconstruction of the blood vessel,based on which the origin of lumbar arteries and the distance and angle between lumbar and abdominal arteries were observed,the subtle branches of lumbar arteries-Adamkiewicz arteries（AKA）,the visualization ratio,origin and flow direction of the fifth lumbar arteries were traced.Results Among 778 lumbar arteries that were scanned with MSCTA in 100 patients,752 were originated from the dorsal part of the abdominal aorta;26 were found with common trunks.In view of the angle between the abdominal aorta and the lumbar artery,374 lumbar arteries arose at a right angle and then went in the up and back directions between two lateral margins of lumbar vertebrae（20o）;194 lumbar arteries were identified to be normal;210 cases were considered as the vertical type.The distances between neighboring lumbar arteries were（30.88±5.76） mm,（28.74±5.65） mm,（24.42±3.88） mm,respectively.Conclusion Anatomic features of lumbar arteries are displayed in an accurate way through the application of MSCTA.