腹腔干缺如的MSCT血管成像表现

Multi-Slice Spiral CT Angiographic Features of Absence of the Celiac Trunk

目的探讨腹腔干缺如的多层螺旋CT（MSCT）血管成像表现,以提高对这种先天动脉发育变异的认识。方法搜集行腹部MSCT增强扫描及血管成像发现的5例腹腔干缺如患者的临床资料,回顾性分析其影像学特征,并结合文献讨论其临床意义。结果 5例腹腔干缺如患者均无与血管变异相关的腹部临床症状和体征。MSCT血管成像均表现为胃左动脉、肝总动脉、脾动脉和肠系膜上动脉分别独立起源于腹主动脉,肝总动脉和脾动脉分别起源于腹主动脉的右前壁和左前壁,而胃左动脉和肠系膜上动脉分别起源于其上、下方的腹主动脉前壁,其中1例合并胃十二指肠动脉变异起源于脾动脉。结论腹腔干缺如是一种罕见的先天发育变异,腹部MSCT血管成像发现腹腔干缺如将有可能改变临床介入治疗或手术方案。

Objective To explore the Multi-Slice spiral CT（ MSCT） angiographic findings of absence of the celiac trunk,in order to improve the understanding of this congenital arterial variation. Methods Clinical data of 5 patients with absence of the celiac trunk found by abdominal MSCT angiography from Jan 2011 to Dec 2015 were collected. Their imaging features were analyzed retrospectively and the clinical significances of this variation were discussed by combining the literature. Results There were 4 males and 1 female in the 5 patients with absence of the celiac trunk,and all 5 patients had no abdominal clinical symptoms and signs associated with the arterial variation. MSCT angiography showed that the celiac trunk was absent and that the left gastric artery（ LGA）,splenic artery（ SA）,common hepatic artery（ CHA） and superior mesenteric artery（ SMA） arose independently from the abdominal aorta. The CHA and SA originated respectively from the right and left anterior wall of the abdominal aorta,and the LGA and SMA arose from the anterior wall of the abdominal aorta at the above and below the CHA and SA,respectively. In addition,in 1 patient of them the gastroduodenal artery was also a variant originating from the SA. Conclusion Absence of the celiac trunk was a rare congenital developmental variation and the findings of this variation in the abdominal MSCT angiography would be likely to change clinical interventional procedures or surgical approach.