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.
Key words
Renal artery /
Dual source CT /
Anatomical structure /
Variation of renal artery
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] 缪晓帆, 唐立钧, 徐怡,等. MSCTA观察肾动脉起源、形态及变异[J]. 中国介入影像与治疗学, 2014, 11(6):377-380. DOI: 10.13929/j.1672-8475.2014.06.010.
[2] 蔡东升, 沈珈谊, 韦铁民. 副肾动脉与高血压相关性的临床研究进展[J]. 临床心血管病杂志, 2019, 318(12): 94-91. DOI: 10.13201/j.issn.1001-1439.2019.12.020.
[3] 王占宇, 李小娟, 袁曙辉, 等. 256层螺旋CT肾动脉成像的三维解剖学[J]. 解剖学杂志, 2012, 35(4): 489-492. DOI: 10.11817/j.issn.1672-7347.2016.01.007.
[4] 韩雪, 王青. MSCTA对活体肾移植供肾血管评估的应用价值[J]. 国际医学放射学杂志, 2010, 33(4): 332-335. DOI: 10.3784/j.issn.1674-1897.2010.04.Z0407.
[5] 王晓梅, 李长江, 边杰. MSCT在肾动脉CTA成像的临床应用价值[J]. 中国医药导报, 2008, 5(6): 87-88. DOI: 10.3969/j.issn.1673-7210. 2008. 06.056.
[6] 赵青, 赵昶, 崔复霞, 等. 彩超对腹主动脉夹层肾动脉及肾段间动脉血供的检测[J].心肺血管病杂志, 2014, 33(3): 422-424, 428. DOI: 10.3969/j.issn.1007-5062.2014.03.029.
[7] 范明霞, 周康荣, 王佩芬, 等. 肾动脉动态增强磁共振血管造影[J]. 实用放射学杂志, 2002, 18(7): 595-597. DOI: 10.3969/j.issn.1002-1671.2002.07.018.
[8] 王莹, 王亚红, 张怡璇, 等. 肾动脉支架置入术后支架内再狭窄的影像学研究进展[J]. 中华医学超声杂志(电子版), 2018, 15(10): 741-743. DOI: 10.3877/cma.j.issn.1672-6448.2018.10.001.
[9] 赵修义, 孙奔, 田军, 等. 血管成像评估活体肾移植供者肾动脉变异的准确性及其误判原因分析[J]. 中华器官移植杂志, 2014, 35(5): 277-281. DOI: 10.3760/cma.j.issn.0254-1785.2014.05.006.
[10] Diao KY, Zhao Q, Gao Y, et al. Prognostic value of dual-source computed tomography (DSCT) angiography characteristics in anomalous coronary artery from the opposite sinus (ACAOS) patients: a large-scale retrospective study[J]. BMC Cardiovasc Disord, 2020, 20(1): 25. DOI: 10.1186/s12872-019-01285-3.
[11] Schicchi N, Fogante M, Pirani PE, et al. Third generation dual source CT with ultra-high pitch protocol for TAVI planning and coronary tree assessment: feasibility, image quality and diagnostic performance[J]. Eur J Radiol, 2020, 122: 108749. DOI: 10.1016/j.ejrad.2019.108749.
[12] Yu Y, Wang QS, Wang XF, etal. Diagnostic value of echocardiography on detecting the various types of anomalous origin of the left coronary artery from the pulmonary artery[J]. J Thorac Dis, 2020, 12(3): 319-328. DOI: 10.21037/jtd.2020.01.28.
[13] Jin L, Gao YY, Shan YQ, et al. Qualitative and quantitative image analysis of 16 cm wide-coverage computed tomography compared to new-generation dual-source CT[J]. J Xray Sci Technol, 2020, 28(3): 527-539. DOI: 10.3233/XST-190624.
[14]Lauder L, Ewen S, Tzafriri AR, et al. Renal artery anatomy assessed by quantitative analysis of selective renal angiography in 1,000 patients with hypertension[J]. EuroIntervention, 2018, 14(1): 121-128. DOI: 10.4244/EIJ-D-18-00112.
[15]李文省, 王震寰, 李成, 等. MSCTA三维重建技术对肾动脉的解剖学研究及临床应用价值[J]. 蚌埠医学院学报, 2018, 43(4): 440-443. DOI: 10.13898/j.cnki.issn.1000-2200.2018.04.006.
[16]Ozkan U, Oğuzkurt L, Tercan F, et al. Renal artery origins and variations: angiographic evaluation of 855 consecutive patients[J]. Diagn Interv Radiol, 2006, 12(4): 183-186. PMID: 17160802.
[17]王真. 肾动脉造影的解剖学分析及其与临床的关系[D]. 上海: 上海交通大学, 2014.
[18]Lee CH, Seo BK, Choi YC, et al. Using MRI to evaluate anatomic significance of aortic bifurcation, right renal artery, and conus medullaris when locating lumbar vertebral segments[J]. AJR Am J Roentgenol, 2004, 182(5): 1295-1300. DOI: 10.2214/ajr.182.5.1821295.
[19]Beregi JP, Mauroy B, Willoteaux S, et al. Anatomic variation in the origin of the main renal arteries: spiral CTA evaluation[J]. Eur Radiol, 1999, 9(7): 1330-1334. DOI: 10.1007/s003300050843.
[20] Chen ZD, FU F, Zhu HD. Relationship between the existence of an accessory renal artery and the diameter of the renal artery: CT angiographic evaluation[J]. Journal of Medical Imaging, 2011, 34(6): 1151-1164. DOI: 10.1007/s00270-011-0202-2.
[21] 邵亚军, 田宏哲, 薛红强, 等. CTA在副肾动脉诊断中的应用价值[J]. 实用放射学杂志, 2017, 33(5): 765-768.DOI:10.3969/j.issn.1002-1671.2017.05.031.
[22] 仇剑. 肾动脉多排CTA的相关解剖学研究[D]. 长春: 吉林大学, 2014.
[23] 杨絮, 牟焕晨, 许传斌. 多层螺旋CT对肾动脉起始及解剖变异的研究[J]. 黑龙江医药科学, 2011, 34(5): 20-21. DOI: 10.3969/j.issn.1008-0104.2011.05.012.
[24] Gulas E，Wysiadecki G，Cecot T, et al. Accessory(multiple) renal arteries-differences in frequency according to population, visualizing techniques and stage of morphological development[J]. Vascular, 2016, 24(5): 531-537. DOI: 10.1177/1708538116631223.
[25] Palmieri BJ, Petroianu A, Silva LC, et al. Study of arterial pattern of 200 renal pedicle through angiotomography[J]. Rev Col Bras Cir, 2011, 38(2): 116-121. DOI: 10.1590/s0100-69912011000200009.
PDF(1410 KB)
