盆腔动脉造影解剖学研究及其临床意义  

Pelviarteriographic anatomy and its the clinical significance

作　　者：李春海[1] 李彩霞[1] 

机构地区：[1]山东大学齐鲁医院医学影像学中心,山东济南250012

出　　处：《山东大学学报（医学版）》2005年第9期818-822,共5页Journal of Shandong University:Health Sciences

摘　　要：目的:探讨盆腔动脉造影解剖及其最佳投照体位,指导超选择盆腔血管插管,提高介入治疗的成功率。方法:收集正常成人腹主动脉及髂总动脉造影资料51例,测量其双侧髂总动脉间的夹角、双侧髂内动脉开口的高度和髂总动脉长度;观察髂内动脉及其分支正位、对侧斜位、同侧斜位造影片上显示程度;分析髂内动脉及分支的血管造影表现及其造影解剖类型。结果:①正常成年男性双侧髂总动脉夹角均数为57.22°±8.39°,正常成年女性双侧髂总动脉夹角均数为66.41°±7.99°,女性髂总动脉夹角大于男性(P<0.01);右侧髂内动脉开口高于左侧,左侧髂总动脉长于右侧;②对侧斜位是显示髂内动脉及分支的最佳体位;③本组正常成人髂内动脉造影可分为四种解剖类型。结论:对盆腔血管介入治疗的患者,应根据其性别及其髂内动脉血管造影解剖类型、髂总动脉的主干长度,选择最佳投照体位,实行个体化介入手术操作和治疗。Objective： To study the pelviarteriographic anatomy and find the best projected position for interventional catheterization so as to improve its successful rate. Methods：Aortography （ in level of lumber 4） and bilateral common iliac arteriography were taken in 51 normal adults.The common iliac arteriographs were observed and the angles between bilateral common iliac arteries were measured respectively in male and female group, the arising altitude of internal iliac arteries were compared. Three projected positions （posteroanterior, ipsilateral oblique and contralateral oblique view） were taken and the aspects of internal iliac arteries were observed.The angiographic manifestations and arteriographic anatomical types were analyzed and concluded. Results： （1） The average angle between bilateral common iliac arteries was （57.22± 8.39）° in normal male adults, and （66.41±7.99）° in normal female adults; there was significant difference between male and female groups （P〈0.01）. The angle of bilateral common iliac arteries was larger in female than that in male. Arising of the internal iliac arteries in right was higher than that in left; （2） Contralateral oblique view was the best projected position to show the opening and route of the internal iliac artery; （3） internal iliac arteries had four anatomic types in normal adult. Conclusion： （1） Because of the female patients＇ larger angle between bilateral common iliac arteries, it is recommended that direct catheterization and Cobra or Headhunter catheter be used with percutaneous femoral artery puncture technique for contralateral iliac procedures, while in male patients, loop catheterization and Simmons ,Yashiro or RH catheter be much better; （2） contralateral oblique position is helpful for superselective catheterization of internal iliac arteries;（3） according to patients＇ sex and anatomic types of internal iliac arteriography, the characteristic interventional procedures and therapy would better be carried

关 键 词：髂动脉 血管造影术 数字减影 解剖学 

分 类 号：R813[医药卫生—放射医学]