多层螺旋CT血管成像对肾动脉解剖变异的评价

Multi-slice Spiral CT Angiography in the Evaluation of Renal Artery Anatomical Variations

目的 应用多层螺旋CT血管成像技术（CTA）研究肾动脉解剖变异类别、部位及数目,为肾脏手术术前提供指导。资料与方法 选择2014年10月—2015年3月间在南昌大学第一附属医院影像科因腹部不适行肾动脉增强及全腹部CT增强扫描的1074例患者。回顾性分析研究对象的肾血管CTA,统计肾动脉变异即肾动脉提前分支和副肾动脉的情况,并比较不同性别与不同侧发生率之间的差别。结果 肾动脉变异分别占病例数和肾脏数的53.4%和45.1%,其中提前分支变异率为38.9%,副肾动脉变异率为33.4%。变异肾动脉从肾门入肾最常见,占67.1%;变异数目以1支型最多见,占66.3%。单侧、双侧变异率分别为38.4%、14.9%。男性变异率显著高于女性,差异有统计学意义（χ^2=17.693,P〈0.01）。右侧肾动脉变异发生率显著高于左侧,差异有统计学意义（χ^2=6.490,P〈0.05）。结论 多层螺旋CT血管造影可清晰显示肾动脉的解剖变异,能够作为肾脏手术术前检查的重要方法。

Purpose To discuss the category, location and number of anatomical variations of renal artery using multi-slice spiral CT angiography（CTA）, and to provide guidance for kidney surgery. Materials and Methods A retrospective review of renal artery CTA and contrast enhanced abdominal CT in 1074 patients examined for abdominal discomfort in the First Affiliated Hospital of Nanchang University to analyze renal artery variants including early branching and accessory renal artery. The differences of incidence in males and females, and between the right and left kidneys were compared. Results Renal artery variation was found in 53.4% of all patients and 45.1% of the kidneys, including early branching in 38.9% and accessory artery in 33.4%. The most common location of the variants was the hilum（67.1%）. Most patients had only one variant（66.3%）. Unilateral and bilateral incidence was 38.4% and 14.9%, respectively. There was significantly higher incidence in males than in females（χ^2=17.693, P0.01）. The incidence of anatomical variants was higher in the right kidney than in the left kidney（χ^2=6.490, P0.05）. Conclusion Multi-slice spiral CTA can demonstrate anatomical variants of renal artery and can be an important imaging modality prior to kidney surgery.