3DCE-MRA对颈部静脉系统的影像解剖分析及临床意义

Anatomic Analysis and Clinical Significance of 3D CE-MRA of Jugular Vein

目的通过三维对比增强磁共振血管成像（3DCE—MRA）对颈部静脉系统的解剖进行观察分析，为临床应用及相关研究提供基础。方法搜集行颈部动脉3DCE-MRA的受检者，对静脉显影良好、无病变的中老年人108例，男、女各54例，分40—55岁、56—70岁和〉70岁3个年龄组，每组36例，年龄40—82岁。利用工作站后处理技术进行血管三维成像，观察横窦（Ts）及颈内静脉（UV）的引流优势、颈内静脉球（JB）的走行形态、正常UV影像解剖测量，分析侧别、性别和年龄因素在IJV各部位内径测值差异性以及其他相关统计学分析。结果（1）108例受检者中，右侧JB62例为隆起型，占57．4％，46例为平坦型，占42．6％；左侧JB55例为隆起型，占50．9％，53例为平坦型，占49．1％；（2）随着年龄增长，IJV内径值逐渐增大；UV内径多数右侧宽于左侧，男性宽于女性居多，左右两侧IJV各部位内径测值中除了最小值，其余均有显著性差异（P〈0．05）；不同年龄组间差异比较均无显著意义（P〉0．05）；性别间比较无差异（P〉0．05）；（3）108例受试者中，59例为TS右优势型，占54．6％，17例为左优势型，占15．7％，32例为对称型，占29．6％；65例为UV右优势型，占60．2％，18例为左优势型，占16．7％，25例为对称型，占23．1％。（4）右侧JB走行形态与IJV的引流优势有关联性（P〈0．05），左侧JB走行形态与IJV的引流优势无关联性（P〉0．05），TS与UV优势引流相关联（P〈0．05）。结论3DCE—MRA可以清晰显示IJV的解剖学全貌．此项技术府用于中老年人群．为疾病诊断、临床席用及介入或手术治疗根供可靠依据。

Objective Using three dimensional contrast-enhanced MRA to observe and analyze the anatomy of the diag- nosis of jugular vein, which provide anatomic basis for clinical application and related research. Methods The subjects of cevical arteries by 3D CE-MRA, the imaging data of 108 cases without vasculopathy and blood flow abnormalities, were di- vided into three groups according to their ages： 40 -55 years,56-70 years, 〉70 years, with 36 cases in each group,54 cases for each gender, the age range 40 -82 years old. Images were taken to the workstation with 3D post processing tech- niques, the drainage dominance of TS and IJV and the course of the Jugular bulb were observed respectively. The imaging anatomical of the normal IJV was measured and the statistical comparisons was made between the bilateral, sex and age groups, and related to others statistically analyzed. Results 1, In the 108 subjects, 62 cases were right JB eminence type, accounting for 57.4%, 46 were flat type, accounting for 42.6% ;55 cases were left JB eminence type, accounting for 50.9%, 53 were flat type, accounting for 49.1% ; 2, Internal diameter in IJV increased with the age, the internal diame- ter in IJV of right was broader than left one, that in males was broader than in female. There was statistically significant dif- ferent between the left and right side except the minimum （ P 〈 0.05 ）, and there are no statistically significant different between male and female groups, young and older groups of the common IJV（ P 〉 0.05 ） in these measurements. 3 ,In the 108 subjects, 59 cases were right side advantages TS, accounting for 54.6%, 17 cases were left side advantages TS, ac- counting for 15.7% , 32 cases were symmetrical TS, accounting for 29.6% ;65 cases were right side advantages IJV, ac- counting for 60.2%, 18 cases were left side advantages IJV, accounting for 16.7%, 25 cases of symmetrical IJV, ac- counting for 23.1%. 4,The process and morphology of the right JB is closely related to IJV drainage dominance （ P 〈 0.05 ）, The process and morphology of the left JB were decreased with IJV drainage dominance （ P 〉 0.05 ） , TS drainage dominance is related to IJV drainage dominance （P 〈 0.05）. Conclusion 3D CE-MRA images can display the anatomy of the IJV satisfactorily. This technology can be applied in the middle and elderly population, as disease diagnosis, clinical application and interventional or surgical treatment to provide a reliable basis.