CT观察奇静脉的临床应用  

CT Imaging of Azygos Vein and Its Clinical Application

作　　者：张开华[1] 唐建华[1] 阎伟伟[1] 王良文[1] 

机构地区：[1]复旦大学附属中山医院分部放射科,上海200052

出　　处：《临床放射学杂志》2004年第7期577-580,共4页Journal of Clinical Radiology

摘　　要：目的　观察奇静脉的CT影像表现 ,评价奇静脉异常的临床意义。资料与方法　随机抽取 10 0名正常人胸部的CT扫描资料 ,行增强扫描者均由上肢浅静脉注入对比剂 ,观察测量奇静脉的正常大小和强化特点 ,选择不同的层面分别测量奇静脉弓、奇静脉干和半奇静脉的血管直径 ,同时对比增强后奇静脉系统与主动脉的强化程度。回顾对照 9例奇静脉异常的影像变化 ,其中门脉高压 4例 ,上腔静脉梗阻 4例 ,1例系左侧头臂干静脉梗阻。结果　正常人奇静脉CT测量血管直径为 6～ 10mm ,奇静脉弓部最粗可达 12mm。增强 4 5s后扫描见轻度或中度均匀强化 ,CT值略低于同层面主动脉。奇静脉直径 >10～ 12mm者可视为异常增粗 ,增强时CT值超过同层面主动脉者即为异常强化。结论　奇静脉增粗常见于奇静脉与门静脉或上下腔静脉之间形成侧支回流 ,而异常强化则因上腔静脉系统血液回流受阻 ,由上肢注入的对比剂直接经侧支回流至奇静脉。观察奇静脉的变化有助于临床确诊血管性疾病的部位和程度 ,了解病变与门静脉、上下腔静脉之间的关系。Objective To discuss CT manifestations of azygos vein and to evaluate the clinical significance of azygos vein abnormalities.Materials and Methods One hundred normal thoracic CT exams (study group) were randomly selected. The diameter and enhanced pattern of the azygos vein were measured and observed. Nine patients with abnormal signs of azygos vein, including portal hypertension (n=4), occlusion of SVC (n=4) and obstruction of left brachiocephalic vein trunk (n=1), were used as control group. Results In study group, the diameter of azygos vein was 6～10mm, displaying mild to moderate enhancement at 45 seconds after contrast injection, with CT values slightly lower than that of the aorta at the same level. The diameter of azygos vein over 10～12mm should be regarded as abnormal dilatation. When the enhanced CT value of azygos vein was larger than that of the aorta, it should be taken as a sign of abnormal enhancement. Conclusion Dilated azygos vein is commonly seen in the presence of collateral formation between the azygos vein and the portal vein, SVC or IVC. Abnormal enhancement of azygos vein is usually due to the obstruction of SVC, which leads to an abundant flow of contrast media directly into azygos vein. The observation of azygos vein is helpful for judging the site and extent of vascular disease, for assessing the involvement of the portal vein, SVC and IVC, and for early detecting the occult diseases.

关 键 词：CT 奇静脉 临床应用 侧支循环 

分 类 号：R816.2[医药卫生—放射医学]