左侧髂总静脉与下腔静脉延长线夹角的大小与左侧髂总静脉压迫的相关性研究

Study on the Correlation between the Size of the Angle between the Left Common Iliac Vein and the Inferior Vena Cava Extension Line and the Left Common Iliac Vein Compression

目的探究左侧髂总静脉与下腔静脉延长线夹角的大小与左侧髂总静脉受压程度的相关性并检验夹角对左侧髂静脉压迫综合征（IVCS）的诊断效能。方法回顾性分析60例行髂静脉CT静脉造影（CTV）检查患者的临床及影像学资料。利用多平面重组技术对原始数据进行冠状位重组,测量并记录左侧髂总静脉与下腔静脉延长线的夹角;测量左侧髂总静脉的受压率,对左侧髂总静脉受压率（变量a）及左侧髂总静脉与下腔静脉延长线的夹角（变量b）进行相关性检验。最后通过受试者工作特征（ROC）曲线检验夹角对左侧IVCS的诊断效能。结果左侧髂总静脉最小内径（5.40±3.69）mm,右侧髂总静脉平均内径（11.87±2.18）mm,左侧髂总静脉受压率（55.22±17.51）%,左侧髂总静脉与下腔静脉延长线夹角（44.97±15.29）°。经检验变量a的检验统计量P=0.035〈0.05;变量b的检验统计量P=0.18〉0.05,可见变量a为非正态性分布。对两个变量进一步行Spearman相关性检验,变量a与变量b的相关系数r=0.56,t检验得P=0.037〈0.05,差异有统计学意义。ROC曲线下面积为0.714,渐进显著性P=0.032〈0.05,差异有统计学意义。结论随着左侧髂总静脉与下腔静脉延长线夹角的增大,左侧髂总静脉受压率也增大;左侧髂总静脉与下腔静脉延长线夹角对IVCS具有一定的诊断价值。

Objective To investigate the correlation between the size of the angle between the left common iliac vein and the inferior vena cava extension line and the left common iliac vein and test the angle＇s Diagnostic efficacy of the left iliac vein compression syndrome. Methods The clinical and imaging data of 60 patients with iliac vein CT venography（ computed tomography venography,CTV） were retrospectively analyzed. Coronal reconstruction of raw data was performed using multiplanar reconstruction technique,and the angle between the left common iliac vein and the inferior vena cava was measured and recorded; To measure the compression ratio of the left common iliac vein with the method of Cheng Feng et al,The correlation between the left iliac vein compression ratio（ variable a） and the angle between the left common iliac vein and the inferior vena cava（ variable b） was examined. Finally,the ROC curve was used to test the diagnostic effect of the angle on the left IVCS. Results LCIV minimum internal diameter（ 6. 02 ＋ 3. 69） mm,the average diameter of the right common iliac vein（ 11. 87 ± 2. 18） mm,LCIV compression rate（ 55. 22 ＋ 17. 51） %,the left common iliac vein and the inferior vena cava extension line angle（ 44. 97 ± 15. 29） °. The test statistic of variable a P = 0. 035 is less than 0. 05,the test statistic variable b P = 0. 18 is greater than 0. 05,and the distribution of the variable a is non-normal. The Spearman correlation test was carried out on two variables,the correlation coefficient of variable a and b r = 0. 56,t test was P = 0. 037 0. 05,the difference was statistically significant. The area under the ROC curve was 0. 714,the significant difference of P =0. 032 was 0. 05 is less than 0. 05,the difference was statistically significant. Conclusion With the increase of the angle between the extension line of the left common iliac vein and the inferior vena cava,the compression rate of the left common iliac vein was also increased. The angle between the left common iliac vein and the inferior vena cava extension line had certain diagnostic value for IVCS.