MSCTA观察肾动脉起源、形态及变异

MSCTA in observation of origins,morphologies and anatomic variations of renal artery

目的采用MSCTA观察肾动脉起源、形态及变异情况。方法回顾性分析MSCTA检查未见异常的308例患者的影像学资料,观察肾动脉开口位置、两侧肾动脉开口高度差、肾动脉开口距腹主动脉分叉的距离、肾动脉与腹主动脉夹角(α夹角)、肾动脉形态及肾动脉变异情况。结果 97.73%(301/308)肾动脉开口位于L1椎体上1/3至L2椎体下1/3;48.70%(150/308)右肾动脉开口高于左肾动脉,42.53%(131/308)右肾动脉开口与左肾动脉开口持平,8.77%(27/308)右肾动脉开口低于左肾动脉开口。左侧肾动脉开口与腹主动脉分叉的距离[(9.79±1.11)cm]小于右侧[(10.23±1.09)cm,P<0.001]。左侧α夹角[(63.74±13.24)°]大于右侧α夹角[(52.54±13.82)°,P<0.001]。肾动脉形态以下斜型最常见,左、右侧分别占35.71%(110/308)和52.60%(162/308)。以研究对象为单位,肾副动脉及过早分支发生率分别为36.04%(111/308)和34.42%(106/308);以肾脏为单位则分别为20.78%(128/616)和20.29%(125/616)。结论肾动脉起源及走行具有一定规律;MSCTA可为肾脏相关手术,尤其是肾动脉介入治疗提供解剖学参考。

Objective To observe the origin, morphology and anatomic variation of renal artery with MSCTA. Methods MSCTA data of 308 patients with normal renal artery were retrospectively analyzed. The ostium location of renal artery, the height deviation of left and right renal artery, the distance from bifurcation of abdominal aorta （AA） to ostium of renal artery, the angle between renal artery and abdominal aorta （a angle）, as well as the morphologic feature and variation of renal artery were observed. Results There were 97.73% （301/308） ostium of both sides renal artery located between the upper third of L1 vertebra and the lower third of L2 vertebra. There were 48.70% （150/308） cases with higher ostium of right renal artery, 42.53% （131/308） cases with equal ostium location between right and left renal artery and 8.77% （27/ 308） cases with higher ostium of left renal artery, The distance from the bifurcation of AA to ostium of right and left renal artery was （10. 23±1.09）cm and （9.79±1.11）cm （P〈0. 001）. The a angles of the left renal artery （63.74±13.24） were significantly larger than those of the right renal artery （52.54± 13.82）° （P〈0. 001）. There were 35.71% （110/308） of the left and 52, 60% （162/308） of the right renal arteries were downward-sloping type, which was the most common type. The incidence of accessory renal artery was 36.04% （111/308） with the subject as unit, and 34.42% （106/308） with the renal artery as unit. The incidence of early branching was 20. 78% （128/616） with the subject as unit and 20. 29% （125/616） with renal artery as unit. Conclusion There are certain rules in the origins and the line feed of renal arteries. MACTA can provide anatomic references for renal operations, especially interventional procedures.