CT评估3种类型永久植入下腔静脉滤器穿透血管壁差异  

Evaluation of differences in perforation of inferior vena cava among three types permanent filter by CT

作　　者：郭子义[1,2] 李晓光[2] 金征宇[2] 

机构地区：[1]中南大学湘雅医学院附属海口医院放射科,海南海口570208 [2]中国医学科学院北京协和医学院北京协和医院放射科,北京100730

出　　处：《中国介入影像与治疗学》2015年第2期79-83,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的 CT对比观察TrapEase滤器、Vena-Tech LP滤器及伞状滤器(Greenfield和Simmons)永久置入后穿出下腔静脉(IVC)血管壁的差异。方法回顾性分析2008年1月—2014年3月87例接受永久性下腔静脉滤器(IVF)置入术患者共87枚滤器的CT图像,其中TrapEase滤器39枚(TE组)、Vena-Tech LP滤器24枚(VT组)、伞状滤器24枚(G&S组)。评估不同类型IVF穿透IVC血管壁的级别,并观察毗邻组织器官损伤情况。结果 TE组(22/52,42.31%)和VT组(21/49,42.86%)中滤器穿出IVC血管壁1级所占的比例显著高于G&S组(7/39,17.95%,P<0.001)。滤器仅穿入1个邻近器官所占比例在TE和VT组中分别为90.91%(10/11)和100%(9/9),而G&S组中滤器多同时穿入2个及以上器官者占63.33%(19/30)。3只以上滤器脚(柱)同时穿入邻近器官的情况多见于G&S组(16/18,88.89%)。结论G&S型IVF较TE和VT型具有更高的穿透IVC血管壁风险,且存在同时穿入多个毗邻组织器官的可能。Objective To assess the difference of vena caval perforation of three types inferior vena cava（IVC）filters,including TrapEase,Vena-Tech LP,and umbrella filters（Greenfield and Simmons filters）using CT images.Methods Imaging data of 87 patients with permanent IVC filters implantation（87filters）from Jan 2008 to Mar 2014 were retrospectively analyzed.There were 39 TrapEase filters（TrapEase group）,24 Vena-Tech LP filters（Vena-Tech LP group）and 24 umbrella filters（Greenfield and Simmons filters,GS group）.The grade of vena caval perforation between different types filters were evaluated.And the damage of adjacent tissues or organs were observed.Results There was significant difference of perforation grade 1rate between TE group（22/52,42.31%）,VT group（21/49,42.86%）and GS group（7/39,17.95%,P〈0.001）.Filters penetrated only one neighboring tissue or organ accounted for 90.91%（10/11）and100%（9/9）in TE and VT groups,respectively.More than one organs or tissues penetrating accounted for 63.33%（19/30）in GS group.More than 3 feet（column）of the filter simultaneously penetrated adjacent tissues or organs were common in GS group（16/18,88.89%）.Conclusion GS group had higher propensity to penetrate wall of IVC than that of TE or VT group.And it has the possiblity of perforated several other adjacent organst at same time.

关 键 词：腔静脉 下 体层摄影术 X线计算机 滤器 

分 类 号：R543.6[医药卫生—心血管疾病] R816.2[医药卫生—内科学]