双下腔静脉的MSCT表现及临床意义

doi:10.13418/j.issn.1001-165x.2022.2.07

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中国临床解剖学杂志 ›› 2022, Vol. 40 ›› Issue (2) : 154-158. DOI: 10.13418/j.issn.1001-165x.2022.2.07

断层影像解剖

双下腔静脉的MSCT表现及临床意义

程诚^{1, 2}，　赵明泽³，　江岷芮^1,2，　张春来^{1, 2}，　王毅^{1, 2}*

作者信息 +

MSCT manifestation and clinical significance of double inferior vena cava

Cheng Cheng^1,2, Zhao Mingze³, Jiang Minrui^1,2, Zhang Chunlai^1,2, Wang Yi^1,2*

Author information +

文章历史 +

摘要

目的　探讨双下腔静脉（inferior vena cava，IVC）的多层螺旋CT（multi-slice spiral CT，MSCT）表现及临床意义。方法　收集经腹部MSCT多期增强扫描发现的18例双IVC患者，采用MPR、MIP和VR等血管成像技术显示IVC解剖，回顾性分析患者临床及影像学资料，结合文献讨论双IVC影像学特征、胚胎学机制及临床意义。结果　18例双IVC的MSCT表现为3种类型。Ⅰ型83.33%（15例）表现为左侧IVC上行至左肾静脉汇入，再以左肾静脉正常方式经主动脉前方右行，汇入正常的右侧IVC。Ⅱ型11.11%（2例）表现为右侧IVC上行达腰2椎体平面，经腹主动脉后方左行汇入左侧IVC，后者再上行延续为半奇静脉，然后经奇静脉和上腔静脉汇入右心房；右肾静脉主要汇入右侧肾上段IVC，但存在侧支与右侧肾下段IVC相连。Ⅲ型5.56%（1例）表现为右侧IVC全程行径正常，左侧IVC垂直上行接收左肾静脉汇入后，于主动脉后方向右上走行与奇静脉连接。结论　双IVC有多种复杂的变异类型，对于腹膜后手术及下半身静脉血栓治疗具有重要的临床意义。

Abstract

Objective　To explore the multi-slice spiral CT (MSCT) manifestation and clinical significance of double inferior vena cava (IVC).　Methods　Eighteen patients with the double IVC found by multi-phase enhanced abdominal MSCT scans were collected. Three kinds of post-processing reconstruction methods including MPR, MIP and VR were used for analysis IVC variation . Their clinical and radiological data were analyzed retrospectively and the double IVC’ imaging features, embryological mechanisms and clinical significance were discussed in combination with literature.　Results　There were 3 types of MSCT manifestation in the 18 patients with the double IVC. 15 patients (accounting for 83.33%) of type I showed as that the left-sided IVC ascended vertically to the position where the left renal vein merged into, then travelled to the right in front of the aorta in a normal way of the left renal vein and merged into the normal right-sided IVC. Two patients (accounting for 11.11%) of type II showed as that the right-sided IVC ascended to the second lumbar level, then crossed the aorta posteriorly to drain into left-sided IVC, and next connected with the hemizygous vein and eventually drained into the right atrium via the azygos vein and superior vena cava. Right renal vein mainly drained into the right suprarenal IVC, but there were collateral branches connecting to the right infrarenal IVC. One patient (accounting for 5.56%) of type III showed as that the right-sided IVC travelled normally all the way, after the left IVC ascended vertically to the position where the left renal vein merged into, then it travelled right and upward behind the aorta and connected to the azygos vein.　Conclusions　Double IVC has many complex variant types, which has important clinical significance for retroperitoneal surgery and treatment of venous thrombosis of the lower body.

导出引用

程诚, 赵明泽, 江岷芮, 张春来, 王毅. 双下腔静脉的MSCT表现及临床意义[J]. 中国临床解剖学杂志. 2022, 40(2): 154-158 https://doi.org/10.13418/j.issn.1001-165x.2022.2.07

Cheng Cheng, Zhao Mingze, Jiang Minrui, Zhang Chunlai, Wang Yi. MSCT manifestation and clinical significance of double inferior vena cava[J]. Chinese Journal of Clinical Anatomy. 2022, 40(2): 154-158 https://doi.org/10.13418/j.issn.1001-165x.2022.2.07

中图分类号： R445.3 R322.1 R816.2

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