下腔静脉起始处解剖位置影响因素的CT研究

doi:10.13418/j.issn.1001-165x.2026.4.04

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中国临床解剖学杂志 ›› 2026, Vol. 44 ›› Issue (4) : 395-400. DOI: 10.13418/j.issn.1001-165x.2026.4.04

断层影像解剖

下腔静脉起始处解剖位置影响因素的CT研究

公海瑞^1,2，赵浩文^1,2，李玉伟 ^1,2，倪广茂¹，董鹏^1,2*

作者信息 +

A CT based-on study on factors affecting the anatomical location of the origin of the inferior vena cava

Gong Hairui^1,2, Zhao Haowen^1,2, Li Yuwei^1,2, Ni Guangmao¹, Dong Peng^1,2*

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文章历史 +

摘要

目的基于CT图像探讨下腔静脉起始处解剖位置的影响因素及其临床意义。方法回顾性分析132 例正常成人的 CT 及临床资料，测量DBIL3V、椎体参数（L3高度、L2横径）、脂肪组织分布（腹内/皮下脂肪组织面积及厚度）、腰大肌参数（面积及径线）等指标。分析DBIL3V 与各指标的相关性。结果 DBIL3V平均值为（5.39±1.21） cm，与腹内脂肪组织面积（L2水平r=0.216，脐水平r=0.212）、腹内/皮下脂肪组织面积比值（L2水平r=0.323，脐水平r=0.200）、腰大肌面积（r=0.226）及斜前后径（r=0.258）呈正相关（P均<0.05），且男性DBIL3V显著大于女性（r=0.257，P=0.003），但与年龄、椎体参数及皮下脂肪无相关性。结论 DBIL3V受腹内脂肪组织含量、腰大肌发育程度及性别影响，明确这些影响因素对临床诊疗操作具有重要参考价值。

Abstract

Objective To explore the influencing factors of the anatomical location of inferior vena cava origin and its clinical significance based on CT images. Methods CT and clinical data of 132 normal adults were retrospectively analyzed. Parameters including DBIL3V, vertebral body measurements (L3 height, L2 transverse diameter), fat tissue distribution (visceral/subcutaneous fat tissue area and thickness), and psoas major muscle parameters (area and diameter) were measured. The correlation between DBIL3V and these indicators was analyzed. Results The mean value of DBIL3V was (5.39±1.21) cm. It showed positive correlations with visceral fat tissue area (L2 level: r=0.216, umbilical level: r=0.212), visceral-to-subcutaneous fat tissue area ratio (L2 level: r=0.323, umbilical level: r=0.200), psoas major muscle area (r=0.226), and oblique anteroposterior diameter (r=0.258) (all P<0.05). DBIL3V was significantly greater in males than in females (r=0.257, P=0.003), but no correlation was observed with age, vertebral parameters, or subcutaneous fat. Conclusions DBIL3V is influenced by visceral fat tissue content, psoas major muscle development, and gender. Clarifying these factors provides important reference value for clinical diagnosis and treatment procedures.

导出引用

公海瑞, 赵浩文, 李玉伟, 倪广茂, 董鹏. 下腔静脉起始处解剖位置影响因素的CT研究[J]. 中国临床解剖学杂志. 2026, 44(4): 395-400 https://doi.org/10.13418/j.issn.1001-165x.2026.4.04

Gong Hairui, Zhao Haowen, Li Yuwei, Ni Guangmao, Dong Peng. A CT based-on study on factors affecting the anatomical location of the origin of the inferior vena cava [J]. Chinese Journal of Clinical Anatomy. 2026, 44(4): 395-400 https://doi.org/10.13418/j.issn.1001-165x.2026.4.04

中图分类号： R322.123 R814

参考文献

[1] 林立夫, 黎琼岚, 谭学渊, 等. 多层螺旋CT对下腔静脉发育异常的影像学诊断[J]. 广东医科大学学报, 2023, 41(1):75-78. DOI: 10.3969/j.issn.1005-4057.2023.01.016.
Lin LF, Li QL, Tan XY, et al. Imaging Diagnosis of Developmental Anomalies of the Inferior Vena Cava Using Multi-slice Spiral CT[J]. Journal of Guangdong Medical University, 2023, 41(1): 75-78.DOI: 10.3969/j.issn.1005-4057.2023.01.016.
[2] 李玉伟, 陈华成, 高峻, 等. 腹膜后间隙和盆腔腹膜外间隙连通性肿瘤性病变的CT和MRI诊断[J]. 临床放射学杂志, 2025, 44(1): 170-174. DOI:10.13437/j.cnki.jcr.2025.01.033.
Li YW, Chen HC, Gao J, et al. CT and MRI Diagnosis of Tumorous Lesions with Communication between the Retroperitoneal Space and Extraperitoneal Pelvic Space[J]. Journal of Clinical Radiology, 2025, 44(1):170-174. DOI: 10.13437/j.cnki.jcr.2025.01.033.
[3] 李维. L5/S1节段前路腰椎椎体间融合术的神经解剖学分析[J]. 局解手术学杂志, 2024, 33(7): 592-595. DOI:10.11659/jjssx.06E023085.
Li W. Neuroanatomical Analysis of Anterior Lumbar Interbody Fusion at the L5/S1 Segment[J]. Journal of Regional Anatomy and Operative Surgery, 2024, 33(7): 592-595. DOI:10.11659/jjssx.06E023085.
[4] 王东, 张追阳, 胡春洪. 正常成人下腔静脉的CT测量[J]. 南京医科大学学报（自然科学版）, 2009, 29(7): 1017-1021.DOI:10.7655/njmu. 2009.07.023.
Wang D, Zhang ZY, Hu CH. CT Measurement of the Inferior Vena Cava in Normal Adults[J]. Journal of Nanjing Medical University (Natural Science Edition), 2009, 29(7): 1017-1021.DOI:10.7655/njmu.2009.07.023.
[5] 高峻, 李玉伟, 吴航, 等. 腹主动脉与左侧腰大肌距离影响因素CT解剖学研究[J]. 中国临床解剖学杂志, 2024, 42(5): 595-600. DOI: 10.13418/j.issn.1001-165x.2024.5.19.
Gao J, Li YW, Wu H, et al. CT Anatomical Study on the Influencing Factors of the Distance Between the Abdominal Aorta and the Left Psoas Major Muscle[J]. Chinese Journal of Clinical Anatomy, 2024, 42(5): 595-600. DOI: 10.13418/j.issn.1001-165x.2024.5.19.
[6] 张源亮, 王可读, 李人光, 等. 国人下腔静脉起始端与左、右髂总静脉的初步调查[J]. 泰山医学院学报, 1982, 2(1): 4, 11.
Zhang YL, Wang KD, Li RG, et al. Preliminary Investigation on the Origin of the Inferior Vena Cava and Left/Right Common Iliac Veins in the Chinese Population[J]. Journal of Taishan Medical College, 1982, 2(1): 4, 11.
[7] 张朝晖, 赖佳明, 梁力建, 等. 腹膜后侵袭性纤维瘤病包绕下腔静脉一例[J]. 中华普通外科学文献(电子版), 2016, 10(1):74-76. DOI: CNKI:SUN:ZHPD.0.2016-01-018.
Zhang ZH, Lai JM, Liang LJ, et al. Retroperitoneal Aggressive Fibromatosis Surrounding the Inferior Vena Cava: A Case Report[J]. Chinese Journal of General Surgery (Electronic Edition), 2016, 10(1): 74-76. DOI: CNKI:SUN:ZHPD.0.2016-01-018.
[8] 伍宇轩, 包贝西, 闫辉, 等. 基于腰椎MRI L5～S1节段斜前方腰椎融合术操作通道可行性分析[J]. 中国骨与关节杂志, 2025, 14(1): 16-21. DOI: 10.3969/j.issn.2095-252X.2025.01.004.
Wu YX, Bao BX, Yan H, et al. Feasibility Analysis of the Operative Channel for Oblique Anterior Lumbar Interbody Fusion at the L5-S1 Segment Based on Lumbar MRI[J]. Chinese Journal of Bone and Joint, 2025, 14(1): 16-21. DOI: 10.3969/j.issn.2095-252X.2025.01.004.
[9] 冒晋宇, 曹和涛. 下腔静脉MDCT测量及扁平下腔静脉在外伤患者容量状态评估中的应用[J]. 中国CT和MRI杂志, 2019, 17(11): 123-127, 131. DOI: 10.3969/j.issn.1672-5131.2019.11.039.
Mao JY, Cao HT. MDCT Measurement of the Inferior Vena Cava and Application of Flat Inferior Vena Cava in Volume Status Assessment of Trauma Patients[J]. Chinese Journal of CT and MRI, 2019, 17(11): 123-127, 131. DOI: 10.3969/j.issn.1672-5131.2019.11.039.
[10]吴航, 周陶胡, 李玉标, 等. 基于mLIVE序列对青年人腹部脂肪分布及内脏脂肪定量评估的研究[J]. 磁共振成像, 2023,14(01):77-81. DOI：10.12015/issn.1674-8034.2023.01.014.
Wu H, Zhou TH, Li YB, et al. Quantitative evaluation of abdominal fat distribution and visceral fat in young people based on mLIVE sequence[J]. Chin J Magn Reson Imaging, 2023, 14(1): 77-81. DOI：10.12015/issn.1674-8034.2023.01.014.
[11]王玲, 汪伟, 邓微, 等. 定量CT 测量腹部脂肪面积及分布的重复性研究[J]. 中国骨质疏松杂志 2012, 18(11): 999-1003.
Wang L, Wang W, Deng W, et al. Reproducibility Study on the Measurement of Abdominal Fat Area and Distribution Using Quantitative CT[J]. Chinese Journal of Osteoporosis, 2012, 18(11): 999-1003.
[12] 端木羊羊, 余永强, 程晓光, 等. 人体测量学参数与定量CT测量腹部脂肪的相关性与预测误差[J]. 重庆医学 2016, 45 (30): 4182-4185. DOI: CNKI:SUN:CQYX.0.2016-30-002.
Duanmu YY, Yu YQ, Cheng XG, et al. Correlation and Prediction Error Between Anthropometric Parameters and Abdominal Fat Measured by Quantitative CT[J]. Chongqing Medicine, 2016, 45(30): 4182-4185. DOI: CNKI:SUN:CQYX.0.2016-30-002.
[13]王猛, 罗宴吉, 蔡华崧, 等. MRI无创定量测量腹腔脂肪体积预测２型糖尿病[J]. 中国医学影像技术2017, 33 (12): 1844-1849. DOI: 10.13929/j.1003-3289.201705101.
Wang M, Luo YJ, Cai HS, et al. Non-invasive Quantitative Measurement of Intra-abdominal Fat Volume Using MRI for Predicting Type 2 Diabetes Mellitus[J]. Chinese Journal of Medical Imaging Technology, 2017, 33(12): 1844-1849. DOI: 10.13929/j.1003-3289.201705101.
[14] 陈洪群, 陈游洲, 郑梅, 等. 定量计算机断层摄影术测定中国人群多中心体脂指标与高血压水平的相关性研究[J]. 中国循环杂志, 2018, 33 (4): 341-345. DOI: 10.3969/j.issn.1000-3614.2018.04.007.
Chen HQ, Chen YZ, Zheng M, et al. Correlation Study Between Multicenter Body Fat Indicators Measured by Quantitative Computed Tomography and Hypertension Levels in the Chinese Population[J]. Chinese Circulation Journal, 2018, 33(4): 341-345. DOI:10.3969/j.issn.1000-3614.2018.04.007.
[15]马青, 刘宗芬, 孙波, 等. 髂静脉受压综合征合并急性下肢深静脉血栓形成的腔内治疗进展[J].血管与腔内血管外科杂志, 2023, 9(6): 701-704, 709. DOI: 10.19418/j.cnki.issn2096-0646.2023.06.13.
Ma Q, Liu ZF, Sun B, et al. Progress in Endovascular Treatment of Iliac Vein Compression Syndrome Complicated with Acute Lower Extremity Deep Venous Thrombosis[J]. Journal of Vascular and Endovascular Surgery, 2023, 9(6): 701-704, 709. DOI: 10.19418/j.cnki.issn2096-0646.2023.06.13.
[16]Aringhieri G, Di Salle G, Catanese S, et al. Abdominal Visceral-to-Subcutaneous Fat Volume Ratio Predicts Survival and Response to First-Line Palliative Chemotherapy in Patients with Advanced Gastric Cancer[J]. Cancers (Basel). 2023, 15(22): 5391．DOI: 10.3390/cancers15225391. DOI: 10.3390/cancers15225391.
[17]黄露, 王哲涛, 罗凤鸣. 腹部脂肪分布与肺通气功能的关系研究[J]. 华西医学, 2022, 37(1): 27-32.
Huang L, Wang ZT, Luo FM. Study on the Relationship Between Abdominal Fat Distribution and Pulmonary Ventilatory Function[J]. West China Medical Journal, 2022, 37(1): 27-32.
[18]Timothy T, Richard A, Daniel A, et al. Retroperitoneal oblique corridor to the L2-S1 intervertebral discs in the lateral position: an anatomic study[J]. J Neurosurg Spine, 2014, 21(5): 785-793. DOI: 10.3171/2014.7.SPINE13564.
[19]李宇轩, 张铁亮, 刘文亚. 腰大肌及侧腹肌相关CT参数评价肝硬化肌少症[J].中国医学影像技术, 2021, 37(9): 1391-1395. DOI: 10.13929/j.issn.1003-3289.2021.09.027.DOI:10.3171/2014.7.SPINE13564.
Li YX, Zhang TL, Liu WY. CT-Related Parameters of Psoas Major and Lateral Abdominal Muscles for Evaluating Hepatic Cirrhosis-Related Sarcopenia[J]. Chinese Journal of Medical Imaging Technology, 2021, 37(9): 1391-1395. DOI: 10.13929/j.issn.1003-3289.2021.09.027.
[20]邢桂枚, 谢璞, 李敏, 等. 探讨腰大肌指数对重症急性胰腺炎病人营养风险评估及预后判断价值[J]. 肠外与肠内营养, 2022, 29(2):110-115. DOI: 10.16151/j.1007-810x.2022.02.010.
Xing GM, Xie P, Li M, et al. Exploration of the Value of Psoas Major Muscle Index in Nutritional Risk Assessment and Prognosis Evaluation of Patients with Severe Acute Pancreatitis[J]. Parenteral & Enteral Nutrition, 2022, 29(2):110-115.DOI:10.16151/j.1007-810x.2022.02.010.
[21] 娄朝晖, 梁碧玲, 吴卓, 等. 国人腰椎椎体性别差异的分析[J]. 中国组织工程研究与临床康复, 2010, 14(13): 2416-2420. DOI: 10.3969/j.issn.1673-8225.2010.13.034.
Lou ZH, Liang BL, Wu Z, et al. Analysis of Gender Differences in Lumbar Vertebral Bodies Among the Chinese Population[J]. Chinese Journal of Tissue Engineering Research and Clinical Rehabilitation, 2010, 14(13): 2416-2420. DOI: 10.3969/j.issn.1673-8225.2010.13.034.
[22]青思含, 常云峰, 董晓爱, 等. 基于腰椎高度X线测量技术推断四川汉族女性身高[J]. 法医学杂志, 2013, 29(5): 344-347. DOI: 10.3969/j.issn.1004-5619.2013.05.007.
Qing S H, Chang Y F, Dong X A, et al. Estimation of Stature in Sichuan Han Females Based on Lumbar Vertebra Height X-ray Measurement Technology[J]. Journal of Forensic Medicine, 2013, 29(5): 344-347. DOI: 10.3969/j.issn.1004-5619.2013.05.007.