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多排螺旋计算机断层摄影肾上腺静脉成像

刘炜,  薛华丹,  孙昊,  王萱,  陈钰,  苏佰燕,  张晓娜,  金征宇

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文章导航 > 协和医学杂志  > 2011 >  2(3): 233-236
刘炜, 薛华丹, 孙昊, 王萱, 陈钰, 苏佰燕, 张晓娜, 金征宇. 多排螺旋计算机断层摄影肾上腺静脉成像[J]. 协和医学杂志, 2011, 2(3): 233-236. doi: 10.3969/j.issn.1674-9081.2011.03.009
引用本文: 刘炜, 薛华丹, 孙昊, 王萱, 陈钰, 苏佰燕, 张晓娜, 金征宇. 多排螺旋计算机断层摄影肾上腺静脉成像[J]. 协和医学杂志, 2011, 2(3): 233-236. doi: 10.3969/j.issn.1674-9081.2011.03.009
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Wei LIU, Hua-dan XUE, Hao SUN, Xuan WANG, Yu CHEN, Bai-yan SU, Xiao-na ZHANG, Zheng-yu JIN. Adrenal Venography Using Multi-slice Spiral Computed Tomography[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(3): 233-236. doi: 10.3969/j.issn.1674-9081.2011.03.009
Citation: Wei LIU, Hua-dan XUE, Hao SUN, Xuan WANG, Yu CHEN, Bai-yan SU, Xiao-na ZHANG, Zheng-yu JIN. Adrenal Venography Using Multi-slice Spiral Computed Tomography[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(3): 233-236. doi: 10.3969/j.issn.1674-9081.2011.03.009
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多排螺旋计算机断层摄影肾上腺静脉成像

doi: 10.3969/j.issn.1674-9081.2011.03.009

  • 中国医学科学院 北京协和医学院 北京协和医院放射科, 北京 100730

详细信息
    通讯作者:

    金征宇 电话:010-65295441, E-mail:jin_zhengyu@163.com

  • 中图分类号: R814.42;R445.3

Adrenal Venography Using Multi-slice Spiral Computed Tomography

  • Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

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    摘要
  • 摘要:   目的  探讨多排螺旋计算机断层摄影(multi-slice spiral computed tomography, MSCT)静脉成像显示双侧肾上腺静脉的图像质量, 并对肾上腺静脉解剖及变异进行形态学观察。  方法  回顾性分析100例双侧肾上腺形态大致正常的患者腹部增强CT图像, 用最大密度投影(maximum intensity projection, MIP)或多平面重建(multi-planar reconstruction, MPR)显示双侧肾上腺静脉, 评价图像质量, 并分别描述肾上腺静脉解剖位置、变异及与左肾静脉和下腔静脉的关系。  结果  以MIP或MPR技术评价图像质量, 左肾上腺静脉97例(97%)为1级, 1例(1%)为2级, 2例(2%)为3级; 右肾上腺静脉52例(52%)为1级, 19例(19%)为2级, 29(29%)例为3级。左肾上腺静脉均为1支; 91%与膈下静脉汇合后汇入左肾静脉; 左肾上腺静脉平均直径(3.6±0.6)mm(2.4~4.5 mm); 左肾上腺静脉与左肾静脉形成交角, 平均为(121.9±16.0)°(150~58°)。2例发现右侧双支肾上腺静脉; 67例(94%)右肾上腺静脉汇入下腔静脉, 4例(6%)汇入右副肝静脉; 右肾上腺静脉平均直径(3.2±0.5)mm(1.9~4.0 mm); 右肾上腺静脉与下腔静脉形成交角, 平均为(75.3±16.6)°(90~35°)。  结论  多排螺旋CT双侧肾上腺静脉成像结合MIP和MPR技术可清晰显示大部分肾上腺静脉, 尤其是左肾上腺静脉。
    Abstract:   Objective  To assess the image quality of multi-slice spiral computed tomography (MSCT) for adrenal venography and describe the anatomic and morphologic features of adrenal veins.  Methods  The abdominal MSCT images of 100 patients (M:F=54:46, 55.7±15.7 yrs old) with normal adrenal morphologies were retrospectively reviewed. The bilateral adrenal veins were displayed using maximum intensity projection (MIP) or multi-plannar reformation (MPR) software and the image quality was assessed using a 3-point grading scale (excellent, sufficient and non-diagnostic). The anatomical location, anomalies and spatial interrelationships of the renal veins and inferior vena cava (IVC) were also described.  Results  In the evaluation of image quality with MIP or MPR images, the left adrenal vein was excellent in 97% patients, sufficient in 1%, and non-diagnostic in 2%. For the right adrenal vein, 52% were excellent, 19% were sufficient, and 29% were non-diagnostic. The left adrenal vein was always a single one, 91% of which joined the inferior phrenic vein and then drained into the left renal vein. The diameter of the left adrenal vein ranged 2.4 mm to 4.5 mm (mean:3.6±0.6 mm). The angle of the left adrenal vein and left renal vein ranged 150° to 58° (mean:121.9±16.0°). Two patients were found to have double right adrenal veins. The right adrenal vein drained into the IVC in 67 of 71 patients (94%) and into the right accessory hepatic vein in 4 patients (6%). The average diameter of the right adrenal vein ranged 1.9 mm to 4.0 mm (mean:3.2±0.5 mm). The angle of the right adrenal vein and IVC ranged 90° to 35° (mean:75.3±16.6°).  Conclusion  MSCT venography, together with the application of MIP and MPR permits satisfying visualization of the bilateral adrenal veins, especially the left one, in most cases.
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  • 图  1  左肾上腺静脉冠状位CT图像

    左肾上腺静脉(白箭头)与膈下静脉汇合后汇入左肾静脉

    下载: 全尺寸图片 幻灯片

    图  2  右肾上腺静脉斜矢状位CT图像

    右肾上腺静脉(黑箭头)自足侧汇入下腔静脉的右侧后方，与下腔静脉的夹角为42°

    下载: 全尺寸图片 幻灯片

    图  3  右肾上腺静脉变异轴位(A)及冠状位(B) CT图像

    右肾上腺静脉(箭头)汇入右副肝静脉(黑箭)，而不是直接汇入下腔静脉

    下载: 全尺寸图片 幻灯片
    • 参考文献(8)
  • [1] Kempers MJ, Lenders JW, van Outheusden L, et al. Systematic review:diagnostic procedures to differentiate unilateral from bilateral adrenal abnormality in primary aldosteronism[J]. Ann Intern Med, 2009, 151:329-337. doi:  10.7326/0003-4819-151-5-200909010-00007
    [2] 王卫庆.原发性醛固酮增多症诊治进展[J].中国实用内科杂志, 2010, 30:15-16.
    [3] Scatarige JC, Horton KM, Ratner LE, et al. Left adrenal vein localization by 3D real-time volume-rendering CTA before laparoscopic nephrectomy in living renal donors[J]. Abdom Imaging, 2001, 26:553-556. doi:  10.1007/s002610000205
    [4] Yamamoto S, Tanooka M, Ando K, et al. Diagnostic accuracy of a volume-rendered computed tomography movie and other computed tomography-based imaging methods in assessment of renal vascular anatomy for laparoscopic donor nephrectomy[J]. Int Urol Nephrol, 2009, 41:785-790. doi:  10.1007/s11255-009-9535-z
    [5] Sèbe P, Peyromaure M, Raynaud A, et al. Anatomical variations in the drainage of the principal adrenal veins:the results of 88 venograms[J]. Surg Radiol Anat, 2002, 24:222-225. doi:  10.1007/s00276-002-0021-x
    [6] 陈幽婷, 王玉兰, 刘志安, 等.左肾静脉主要属支的影像学应用解剖[J].中国解剖与临床. 2001, 6:28-29, 33. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=jiepxzz200101010
    [7] Nakamura S, Tsuzuki T. Surgical anatomy of the hepatic veins and the inferior vena cava[J]. Surg Gynecol Obstet, 1981, 152:43-50. http://www.ncbi.nlm.nih.gov/pubmed/7455890
    [8] 高江平, 王威, 郭刚, 等.腹腔镜肾上腺手术肾上腺中央静脉的应用解剖[J].中国内镜杂志, 2005, 11:632-633, 636. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgnjzz2005z1057
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出版历程
  • 收稿日期:  2011-04-25
  • 刊出日期:  2011-07-30

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