下腔静脉先天畸形MSCT表现及临床意义

目的 探讨下腔静脉(IVC)先天畸形的MSCT表现及其临床意义。方法 回顾性分析960例患者中48例IVC先天畸形的腹部增强CT影像资料,观察MSCT动脉期和静脉期IVC后处理图像及其属支的解剖结构。结果 IVC先天畸形的发生率为5.00%(48/960)。左IVC 4例(4/48,8.33%),CT示肾下段IVC位于腹主动脉左侧;双IVC 5例(5/48,10.42%),CT示腹主动脉两侧上行的IVC;主动脉后型左肾静脉12例(12/48,25.00%),CT示左肾静脉走行于腹主动脉后方;环主动脉型左肾静脉26例(26/48,54.17%),CT示左肾静脉分两支环绕腹主动脉,在不同水平分别注入IVC;IVC伴奇静脉延续畸形1例(1/48,2.08%),增强CT示IVC向上延续为奇静脉,肝静脉直接回流至右心房。结论 MSCT可清晰、直观地显示IVC畸形,对诊断与IVC有关的疾病和防止术中血管损伤有重要临床意义。

MSCT manifestations of inferior vena cava congenital abnormalities and its clinical significance

Objective To explore the imaging manifestations of congenital abnormalities of inferior vena cava (IVC) and clinical significance with MSCT. Methods Abdominal contrast enhanced MSCT data of 48 congenital abnormalities of IVC in 960 patients were retrospectively reviewed. The anatomies of IVC on MSCT arterial and venous phase were observed. Post-processing reconstruction methods including MPR and VR were used for analysis. Results The incidence of congenital abnormalities of IVC was 5.00% (48/960); 4 cases (4/48, 8.33%) were left IVC, showing IVC left to aorta inferior to the renal hilum; 5 cases (5/48, 10.42%) were double IVC, showing two IVC besides the aorta inferior to the renal hilum; 12 cases (12/48, 25.00%) were retroaortic left renal vein, showing left renal vein crossing posterior to the aorta; 26 cases (26/48, 54.17%) were circumaortic left renal vein, showing two left renal veins around the aorta; 1 case (1/48, 2.08%) was azygos continuation of IVC, contrast-enhanced CT scan demonstrated dilatation azygos continuation of IVC and hepatic vein draining directly into right atrium. Conclusion MSCT can clearly demonstrate the congenital abnormalities of IVC, which has important clinical value in the diagnosis of some IVC related diseases and preventing vascular injury during surgery.