髌骨中心层面腘静脉多层螺旋CT解剖学研究

Anatomical study of popliteal vein at the central level of patella with multislice spiral CT scanning

目的采用多层螺旋CT静脉造影技术研究髌骨中心层面腘静脉解剖及其变异,为临床腘静脉盲探式穿刺提供影像解剖学基础。方法回顾性分析2010年9月至2015年3月在南通大学第三附属医院接受直接法CT静脉造影检查患者171侧下肢(男91侧,女80侧;左91侧,右80侧)。测量髌骨中心层面腘静脉中点至股骨内外侧髁连线中点水平距离(D1)、同层腘静脉中心至体表距离(D2)、腘静脉内径(D3、D4),对测得的指标作统计学分析。同时解剖观测同层面171侧下肢腘静脉有无畸形、数目及与腘动脉的位置的关系。结果统计学分析显示,男、女及左、右侧间数据差异均无统计学意义(P>0.05)。171侧下肢中腘静脉D1为(10.62±4.64)mm,变异系数为0.44;D2为(25.15±4.37)mm,变异系数为0.17;D3、D4分别为(10.55±2.87)mm、(10.94±2.68)mm,变异系数分别为0.27、0.24;171侧下肢中34侧为2支型腘静脉(占19.9%),1例为3支型腘静脉(占0.6%),136侧仅有1支型腘静脉(占79.5%);171侧下肢中仅5侧下肢髌骨中心层面腘动脉与腘静脉并列(内外侧),166侧腘动脉均位于腘静脉前方或前内侧。结论以上腘静脉观测结果,为临床腘静脉盲探式穿刺提供了影像解剖学基础。

Objective To study the anatomy and variation of popliteal vein at the central level of patella by using multisliee spiral CT （MSCT） venography in order to provide imaging anatomy basis for the clinical performance of blind puncturing of popliteal vein. Methods During the period from September 2010 to March 2015, direct CT venography was performed for 171 legs at the Third Affiliated Hospital of Nantong University, including 91 left legs and 80 right legs. Ninety-one diseased legs were found in males and 80 diseased legs were found in females. The clinical materials were retrospectively analyzed. The horizontal distance from the midpoint of the popliteal vein to the midpoint of the medial-to-lateral condyle line at the central level of patella （D1） , the distance from popliteal vein center to the body surface at the same level （D2）, and the inner diameters of popliteal vein （D3 and D4） were measured, and the data thus obtained were statistically analyzed. Meanwhile, the deformity and the number of popliteal vein as well as the relationship of the popliteal vein with the popliteal artery were evaluated. Results Statistical analysis showed that there were no statistically significant differences in the gender distribution and in the side distribution （P〉0.05）. D1 was （10.62＋4.64） mm, with the variable coefficient being 0.44; D2 was （25.15＋4.37） mm, with the variable coefficient being 0.17; and D3 and D4 were （10.55＋2.87） and （10.94＋2.68） respectively, with the variable c.efficienis being 0.27 and 0.24 respectively. Of 171 legs, double popliteal veins was seen in 3,1- （ 19.9% ） , three popliteal veins in one （0.6%） , and ollly one popliteal vein in 136 （79.5%）. Among the 171 legs, only in 5 legs the direr.lion of popliteal artery was parallel to the popliteal vein （medial-lateral arrangement） , and in 166 legs the poplileal artery was situated anterior to or antero-rnedial to lhe poplileal vein. Conclusion The results of this study provide hnaging allalllnly basis for the clinical performance of blind puncturing of popliteal vein.