目的 探讨浙西南地区中老年人群的肾动脉影像特征，为临床肾动脉介入手术提供影像解剖学资料。 方法 抽取浙江省丽水市10个城镇社区常住人口中45~75岁者为研究对象，收集问卷资料，行肾动脉CTA检查，采用西门子FORCE CT行腹部CT增强扫描，观察肾动脉的起源、结构，入肾位置及变异等情况，按性别及侧别进行统计分析。 结果 共纳入3090例，男1447例，女1643例，男性和女性在吸烟、饮酒、身高、腰围、舒张压、脉压、服用高血压药物、服用糖尿病药物方面存在显著性差异（P＝0.00）。男性和女性双侧肾动脉的长度和外径无统计学差异（P>0.05），肾动脉长度和平均外径左侧为（37.43±13.73）、（6.37±6.6）mm，右侧为（24.52±25.5）、（4.4±2.67）mm。肾动脉与腹主动脉夹角均以大于45 °为主，男性左72.3%，右70.9%；女性左74.8%，右71.8%。肾动脉开口位置集中在第2腰椎和第1腰椎（左L2 67.8%，L1 30.1%）；（右L2 75.9%，L1 20.4%），肾动脉开口位置均为右侧较高（男56.7%，女56.6%）。肾动脉经肾门入肾为主（男48.5%，女47.6%）。肾血管走形左侧以上斜型为主，右侧以平直型为主，两侧有统计学差异（P＝0.00）。肾动脉变异的发生率男性24.5%（95% CI 22.3% ~26.8%），女性22.3%（95% CI 20.3% ~ 24.4%）。男性副肾动脉检出率为15.4%（95% CI 13.5% ~ 17.3%），女性为11.1%（95% CI 9.7%~12.7%）。单侧副肾动脉发生率为15.0%，双侧为3.9%。 结论 运用CT可直观、准确地显示肾动脉结构及其变异情况，男性和女性肾动脉的变异差异较大，术前行肾CTA检查可明确肾动脉结构和变异，有利于肾动脉介入术的顺利开展。
Abstract
Objective To investigate the imaging characteristics of renal artery in middle-old aged people from southwest Zhejiang province, and provide the imaging data for renal artery interventional surgery. Methods Research object was collected from 45-75 years old resident population in 10 urban communities in Lishui City. CTA examination of renal artery was performed. FORCE enhanced abdominal CT was used to observe the origin, structure, location and variation of renal artery. The data collected from the questionnaire were statistically analyzed by t-test and χ 2 test according to gender and side. Results A total of 3090 subjects were included, including 1447 males and 1643 females. There were significant differences between males and females in smoking, drinking, height, waist circumference, diastolic pressure, pulse pressure, taking high blood pressure drugs and taking diabetes drugs (P＝0.00). There was no statistical difference in the length and the diameter of bilateral renal arteries between males and females. The length and average diameter of renal artery were (37.43±13.73) mm, (6.37±6.6) mm on the left side and (24.52±25.5) mm, (4.4±2.67) mm on the right side. The angle between renal artery and abdominal aorta was more than 45 ° [male (72.3% in left side, 70.9% in right side), female (74.8% in left side, 71.8% in right side)]. The opening position of the renal artery was concentrated in the left side (67.8%, 30.1%) of the second lumbar vertebrae (L2) and the first lumbar vertebrae (L1); the right side (75.9%, 20.4%), and the right side was higher than the left side (56.7%, 56.6%). The renal artery mainly entered the kidney through the hilum (male accounting for 48.5%, female 47.6%). The renal vascular deformation was mainly oblique on the left side and flat on the right side, with statistical difference between the two sides (P = 0.00). The incidence rate of renal artery variation was 24.5% (95% CI 22.3%~26.8%) in male and 22.3% (95% CI 20.3%~24.4%) in female. The detection rate of accessory renal artery was 15.4% (95% CI 13.5%~17.3%) in male, 11.1% (95% CI 9.7%~12.7%) in female, and the total physical examination rate was 26.4%. The incidence rate of unilateral accessory renal artery was 15.0% and bilateral accessory renal artery was 3.9%. Conclusions Dual source computer tomography (DSCT) can directly and accurately display the structure and variation of renal artery, and there is a great difference between male and female in the variation of renal artery. Preoperative renal CTA examination can reveal clearly the structure and variation of renal artery, which is conducive to the smooth development of renal artery intervention.
关键词
肾动脉 /
双源CT /
解剖结构 /
肾动脉变异
Key words
Renal artery /
Dual source CT /
Anatomical structure /
Variation of renal artery
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基金
浙江省基础公益技术研究计划（LGF19H020008）
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