左位下腔静脉变异及相关并发症的超声诊断价值

The diagnostic value of ultrasound for left inferior vena cava malformation and related complications

目的认识左位下腔静脉变异的超声表现,分析超声诊断在左位下腔静脉变异引发的相关并发症中的应用价值。方法分析2008年1月~2019年5月在我院经超声多普勒检查发现的11例左位下腔静脉变异的超声声像图特征,以及由该疾病引发的相关并发症的超声声像图表现。结果11例左位下腔静脉变异患者中,1例左位下腔静脉伴"胡桃夹现象",1例左位下腔静脉伴左侧髂静脉血栓,2例左位下腔静脉伴右侧髂静脉血栓及右下肢静脉血栓,1例左位下腔静脉伴双侧髂静脉血栓和双下肢静脉血栓,其余6例左位下腔静脉变异患者均未发生相关并发症。结论大部分下腔静脉变异并不会引起血流动力学异常,认识并重视因下腔静脉变异血管的位置、走行、回流途径,不仅可以解释因该疾病引发的多种相关并发症的表现,同时还可对胸腹部手术具有重要的指导意义。

Objective To identify the sonographic manifestations of left inferior vena cava variation and analyze the diagnostic value of ultrasound in the diagnosis of the complications caused by the left inferior vena cava. Methods 11 cases with left inferior vena cava variation detected by ultrasound in our hospital between January 1 st 2008 and May 30, 2019 were retrospectively reviewed. The sonographic manifestations of left inferior vena cava variation and the related complications were analyzed. Results Of the 11 patients with the left inferior vena cava, "nutcracker phenomenon" was present in 1 case, venous thrombosis in the left iliac vein was detected in 1 case, venous thrombosis in the right iliac vein and the right lower extremity were identified in 2 cases, venous thrombosis in both iliac veins and both lower extremities were found in 1 case. The other 6 cases with the left inferior vena cava did not have related complications. Conclusion The left inferior vena cava does not cause hemodynamic abnormalities in most cases, but identifying the position, course and reflux route of the left inferior vena cava can not only explain the manifestations of various related complications caused by the variation, but also have important significance for thoracic and abdominal surgery.