腘动脉解剖对下肢动脉CT血管造影选择监测层面的影响  

Effect of popliteal artery anatomy on selecting monitor level in lower extremity peripheral arterial computed tomography angiography

作　　者：王国良[1] 倪炯[1] 张炜[1] 陈惟[1] 王培军[1] 

机构地区：[1]同济大学附属同济医院医学影像科,上海200065

出　　处：《第二军医大学学报》2014年第2期221-224,共4页Academic Journal of Second Military Medical University

摘　　要：目的观察下肢动脉CT血管造影(CTA)扫描不同膝关节层面腘动脉的解剖走行,探讨下肢CTA的最佳腘动脉监测层面。方法回顾性分析2012年5月至2013年4月间47例(共94侧)糖尿病患者腘动脉图像,将其分为髌骨上缘组、髌骨正中组及髌骨下缘组。分析腘动脉与腘静脉的关系及腘动脉斑块的发生情况。结果髌骨上缘组中有76侧腘动脉位于腘静脉前内侧,11侧位于腘静脉正前方,1侧位于外前方,1侧位于正外方,5侧有血管干扰显示不清。髌骨正中组中有68侧腘动脉位于腘静脉前内侧,10侧位于腘静脉正前方,3侧位于外前方,1侧位于外后方,12侧有血管干扰显示不清。髌骨下缘组中有41侧腘动脉位于腘静脉前内侧,17侧位于腘静脉正前方,4侧位于外前方,1侧位于正外方,2侧位于外后方,29侧有血管干扰显示不清。经χ2检验,髌骨上缘和正中层面的腘动脉稳定性较髌骨下缘层面高(P<0.05),血管干扰少(P<0.05)。髌骨上缘层面腘动脉斑块发现率[44.68%(42/94)]高于髌骨正中层面[25.53%(24/94),P<0.05]。结论髌骨正中层面可作为下肢动脉CTA腘动脉监测的最佳监测层面。当髌骨正中层面腘动脉辨认困难时,可选择髌骨上缘层面作为替代监测层面。Objective To observe the popliteal artery anatomy courses at different levels of knee using computed tomography angiography （CTA） scan, so as to explore the best CTA monitoring level in lower limb popliteal artery. Methods A retrospective analysis of popliteal artery images was conducted in 47 （94 sides） diabetic patients from May 2012 to April 2013. The image data were divided into three groups, namely, the upper edge （group A）, the middle portion （group B） and the lower edge （group C） of the patella. The relation between popliteal artery and popliteal vein was analyzed and the occurrence of popliteal artery plaques was evaluated. Results In group A, 76 sides of popliteal artery were observed in the anteromedian of the popliteal vein, 11 sides in the front, 1 side in the anterolateral, 1 side in the lateral of the popliteal vein, and 5 sides were unclear due to disturbance by other vessels. In group B, 68 sides of popliteal artery were recorded in the anteromedian of the popliteal vein, 10 sides in the front, 3 sides in the anterolateral, 1 side in the posterior of the popliteal vein, and 12 sides were unclear due to disturbance by other vessels. In group C, 41 sides of popliteal artery were found in the anteromedian of the popliteal vein, 17 sides in the front, 4 sides in the anterolateral, 1 side in the lateral, 2 sides in the posterior of the popliteal vein, and 29 sides were unclear due to disturbance by other vessels. Results of χ^2 test indicated that the stability of the popliteal artery in group A and B was significantly higher （P〈0.05） and the vascular disturbance was significantly less （P〈0.05） than those in group C. The incidence of plaque in group A （44.68%, 42/94） was significantly higher than that in group B （25.53%, 24/94, P〈0. 05）. Conclusion The median patella level is the best CTA monitoring level for lower limb popiiteal artery. When the popliteal artery at the median patella level is hard to identify, the upper edge level of the patella can be chosen

关 键 词：螺旋计算机体层摄影术 血管造影术 腘动脉 解剖学 

分 类 号：R813.1[医药卫生—放射医学]