肾上腺静脉MSCT影像解剖研究

Multi-slice computed tomography imaging anatomy study of adrenal vein

目的利用MSCT准确显示肾上腺静脉正常解剖结构及变异,为临床提供影像解剖数据。方法回顾分析上腹部CTA患者108例。薄层MIP/MPR评估测量肾上腺静脉管径、长度及走行路径。结果 1右侧:显示率64.81%(70/108),变异5.71%(4/70);汇入下腔静脉7点至8点间占优势42.42%;其管径Rr(2.19±0.56)mm,腺外段长度RD1(5.02±1.82)mm,汇入下腔静脉距右肾静脉汇入距离RD2(40.69±12.96)mm,汇入口开口向下角度RA(60.25±17.85)°。2左侧:显示率97.22%(105/108);变异14.29%(15/105);肾上腺静脉管径Lr(2.39±0.56)mm,腺外段长度LD1(7.28±4.01)mm,膈-肾上腺静脉干管径LR(3.65±0.93)mm,膈-肾上腺静脉的共干段长度LD2(14.07±6.77)mm,膈-肾上腺静脉汇入左肾静脉点至下腔静脉左侧缘距离LD3(32.89±4.85)mm,膈-肾上腺静脉汇入左肾静脉开口向内的角度LA1(118.06±18.49)°,肾上腺静脉与膈静脉共干段开口向下的角度LA2(156.15±13.81)°。结论 MSCT可显示大部分右侧肾上腺静脉及绝大部分左侧肾上腺静脉正常走行及变异,测量相关影像解剖数据,为AVS等手术方案提供影像数据。

Objective Using MSCT to display the normal anatomic structure and variation of the adrenal vein accurately and to provide image anatomy data for clinical application. Methods 108 patients with abdominal examination of CTA were retrospectively analyzed. A thin layer of MIP and MPR technique was applied to evaluate and measure the adrenal vein diameter, length and line path. Results ① Display rate and variation rate in the right side was 64.81% （70/108） and 5.71% （4/70）. The adrenal vein drained directly into the inferior vena cava in 7 o＇clock to 8 o＇clock direction, accounting for a majority of 42.42%（28/66）. The diameter of adrenal vein was （2.19±0.56） mm, the length of vein outside the gland was （15.02± 1.82） mm, the distance between the sites where the right and left the adrenal veins joint the inferior vena cava was （240.69 ± 12.96） mm; the inferiorly-oriented angel of adrenal vein into the inferior vena cava was （60.25 ± 17.85）° . ② Display rate and variation rate on the left side was 97.22% （105/108） and 14.29% （15/105）;adrenal vein was （2.39±0.56） mm, the length of vein outside the gland was （17.28±4.01） mm, the shared trunk between the diaphragmatic-adrenal veins was （3.65 ± 0.93） mm, the distance from the point of diaphragmatic-adrenal vein draining into the left renal vein was （14.07 ± 6.77） mm, the distance from the point of the diaphragmatic-adrenal vein draining into the left renal vein to the left side of the inferior vena cava was （32.89 ± 4.85） mm, the inward angel of the diaphragmatic-adrenal vein drainging into the left renal vein was （118.06±18.49）°,the inferiorly-oriented angel of the adrenal vein draining into the diaphragmatic-adrenal vein （156.15 ± 13.81）° . Conclusion MSCT can display most of the right adrenal vein and the vast majority of the left adrenal vein in normal and abnormal passageway. Measurement of relevant imaging anatomy data can provide the imaging data for operation scheme such as AVS.