256层螺旋CT血管成像对正常与变异胃周动脉的显示情况及临床意义

Clinical significance and demonstration of gastric arterial anatomy and variation with SCTA

目的观察256层螺旋CT血管成像(MSCTA)对胃周动脉的显示情况,了解胃周动脉的正常解剖及变异,并探讨其临床意义。方法回顾性分析2015年1月至2017年10月150例非胃部疾病者行腹部CT血管成像的图像,观察胃供血动脉的显示情况并统计显示率,分析胃供血动脉起源及变异情况。结果胃左动脉、胃网膜右动脉显示150例,显示率为100%,胃右动脉显示117例(78. 0%),胃网膜左动脉显示94例(62. 7%),胃短动脉显示74例(49. 3%),胃后动脉显示71例(47. 3%)。胃右动脉的起源变异最大,117例胃右动脉起源于肝固有动脉92例,起源于肝左动脉13例、肝总动脉7例、胃十二指肠动脉5例,以起源于肝固有动脉最多。胃网膜右动脉起源于胃十二指肠动脉147例,起源于肠系膜上动脉3例;胃左动脉起源于腹腔干148例,其余2例起源于腹主动脉。另发现副胃左动脉2例(1. 3%),起源于肝总动脉、肝固有动脉各1例; 4例胃左动脉发出副肝左动脉。结论 MSCTA能直观、立体显示胃周动脉的空间解剖结构与变异,手术前充分了解胃周血管解剖变异,能减少术中盲目探查,缩短手术时间,减少并发症。

Objective To observe the displays of gastric arteries with the 256-slice spiral CT angiography,and to investigate the clinical significance of nomal anatomy and variations in gastric peripheral arteries. Methods A total of 150 cases of non-gastric diseases from January 2015 to October2017 underwent abdominal CT angiography images,the display of gastric artery was observed and the display rate, analyze the origin of gastric artery and variation rate were retrospective analyzed.Results The left gastric artery and the right gastroepiploic artery were 100%（ 150/150） displayed. A total of 117 cases（ 78. 0%） of right gastric artery were displayed,accounting for 94 cases（ 62. 7%） of left gastroepiploic artery were displayed; and 74 cases of short gastric arteries was displayed,accounting for 49. 3%; there were 71 cases for arteria gastrica posterior,which accounting for 47. 3%. The right gastric artery origins changed much greater. Among all the 117 cases in this group,92 right gastric artery were starting from proper hepatic artery,13 cases were starting from left hepatic artery,5 cases were starting from gastroduodenal artery,7 cases were starting from common hepatic artery. There were 147 cases of right gastroepiploic artery starting from gastroduodenal artery and 3 cases starting from superior mesenteric artery. There were 148 cases of left gastric artery starting from celiac axis and 2 cases starting from abdominal common iliac artery. There were 2 cases（ 1. 3%） of accessory left gastric artery,of which 1 case for common hepatic artery and proper hepatic artery respectively. Besides,there were 4 cases of accessory left hepatic artery starting from left gastric artery. Conclusions The 256-slice Spiral CT can display the space anatomical structure and variations of gastric artery in a direct and threedimensional way. The accurate displays of MSCTA in gastric artery can provide rich information to clinical diagnosis and treatment.