MSCT动态增强膈下段下腔静脉形态与改良肝尾/右叶比值的关系  

The Relationship Between the Morphology of Subdiaphragmatic Inferior Vena Cava and the Ratio of Modified Caudate Right Lobe

作　　者：曹和涛[1] 黄虹[1] 苏海[1] 

机构地区：[1]江苏省南通大学附属医院影像科,226001

出　　处：《临床放射学杂志》2013年第11期1589-1593,共5页Journal of Clinical Radiology

摘　　要：目的探讨膈下段下腔静脉(SIVC)形态与改良肝尾/右叶比值(C/RL-r)的关系。方法随机搜集100例患者腹部MSCT动态增强资料,测量C/RL-r,以其值1为界将100例分为A(C/RL-r≤1)、B(C/RL-r>1)两组。在冠状位测量SIVC平均长度、出孔处与离肝处左右径比值(R)及与人体矢状面夹角即倾斜度,组间差异采用t检验;在横断位观察其断面形态,组间分布及两组临床影像肝硬化诊断率差异采用χ2检验。结果 100例中,A组70例,B组30例;两组SIVC平均长度和倾斜度依次分别为(0.45±0.46)cm、(0.95±0.52)cm(P=0.000)和(7.14±5.14)°、(10.34±5.95)°(P=0.007)。断面形态大致分为圆形类和非圆形类两类,A、B两组依次分别为46例、24例和12例、18例(P=0.017)。两组R值平均为1.23±0.83和2.21±1.33(P=0.024)。临床影像诊断为肝硬化A组5例(7.14%),B组17例(56.67%)(P=0.000)。结论 SIVC倾斜度、平均长度、非圆形态及R值与C/RL-r呈正相关,前二者可能与右肝叶萎缩牵拉效应较大、肝硬化萎缩及局部脂肪积聚有关;后二者可能与尾状叶肥大、脂肪积聚压迫有关。Objective To evaluate the relationship between the morphology of subdiaphragmatic inferior vena cava （SIVC） and the ratio of modified caudate-right lobe （C/RL） with use of the right portal vein to set the lateral boundary（ C/ RL r）. Methods 100 patients were randomly drawn from a dynamic enhanced abdominal MSCT image datebase, C/RL r was measured. 100 patients were divided into two groups of A （ C/RL r〈 1 ） and B（ C/RL r 〉 1 ）. The mean length, the ratio of left right diameter （R） of SIVC leave from IVC fossa to that of SIVC out of the diaphragmatic muscle hiatus and the inclination of SIVC toward the sagittal plane of human body were measured on coronal images. The intergroup difference of measurement was detected with the t test. The section morphology of SIVC was observed, The intergroup difference of the section morphology of SIVC and the diagnostic rate of liver cirrhosis by clinic and imageology were determined using chi square test. Results Of 100 cases,70 cases in group A,30 cases in group B;The mean length and the inclination of the SIVC were（0.45 ＋0.46）cm,（0.95 ±0.52）cm （P =0.000） and7.14° ±5.14°,10.34° ±5.95°P =0. 007）in turn re- speetively. The sectional morphology of SIVC was classified into round in whieh group A （4 cases） and group B （ 12 cases ） and unround in which group A （ 24 cases ）and group B （18 cases） （P = 0.017 ） in turn respectively. The mean of R was 1.23 ± 0.83 and 2.21 ±1.33 （ P = 0.024 ） in two groups respectively. 5 cases in group A （ 7.14% ） and 17 eases in group B （ 56.67% ） （ P = 0.000 ） were diagonsed of liver eirrhosis. Conclusion There is a positive correlation between the inelina- tion, mean length, morphology of SIVC, R value with C/RL r, the inclination, mean length of SIVC may be relate to the large pull effeetive of the right lobe in the process of liver cirrhosis, diaphragmatic surface of liver shrunk back cranioeaudal direction and compressed by fat collection cephalad direction, and

关 键 词：硬化 肝 下腔静脉 体层摄影术 X线计算机 测量 

分 类 号：R816.2[医药卫生—放射医学]