基于CT数据的三维可视化技术在肾血管解剖变异分析中的应用  

Application of three-dimensional visualization technique based on CT data in the analysis of renal vascularanatomical variation

作　　者：赵伟[1] 李玉侨[1] 黄官礼[1] 陈晨 丁浩 闫慧磊 程岩 马云波[1] Zhao Wei;Li Yuqiao;Huang Guanli;Chen Chen;Ding Hao;Yan Huilei;Cheng Yan;Ma Yunbo(Department of Urology,Liaocheng People's Hospital,Liaocheng 252000,China)

机构地区：[1]聊城市人民医院泌尿外科,聊城252000

出　　处：《中华泌尿外科杂志》2023年第10期742-747,共6页Chinese Journal of Urology

摘　　要：目的探讨基于CT数据的三维可视化技术在肾血管解剖变异分析中的应用价值。方法回顾性分析2020年10月至2021年6月聊城市人民医院收治的210例患者的临床资料,患者因肾肿瘤、肾上腺肿瘤或肾囊肿等行肾增强CT检查。男114例,女96例。年龄(56.5±13.2)岁。将CT检查数据通过3DSlicer软件重建包含肾血管的三维可视化模型。根据三维可视化模型,以腹腔镜根治性肾切除术和腹腔镜肾部分切除术时是否需要处理的角度,分析肾血管解剖情况。肾动脉变异分为多支肾动脉、肾动脉早发分支,以及同时具有以上两种变异的混合型。肾静脉变异分为多支肾静脉、肾静脉晚期汇合,以及同时具有以上两种变异的混合型。结果本研究210例,男性和女性的肾动脉变异分别为95例(41.7%)和79例(41.2%)(P=0.914),肾静脉变异分别为58例(25.4%)和62例(32.3%)(P=0.121),差异均无统计学意义。本研究420个肾脏中,肾动脉变异(174/420,41.4%)较肾静脉变异(121/420,28.8%)更常见(P<0.01)。不同肾动脉变异类型的肾脏数量:多支肾动脉分别为右肾32个(7.6%),左肾38个(9.0%)(P=0.432);肾动脉早发分支分别为右肾89个(42.4%),左肾37个(17.6%)(P<0.01);24个(5.7%)肾脏存在混合型肾动脉变异,分别为右肾19个(9.1%),左肾5个(2.4%)(P<0.01)。不同肾静脉变异类型的肾脏数量:多支肾静脉分别为右肾53个(12.6%),左肾3个(0.7%)(P<0.01);肾静脉晚期汇合分别为右肾41个(9.8%),左肾33个(7.9%)(P=0.306);混合型肾静脉变异8个(1.9%),均为右肾。以腹腔镜手术的角度分析,左肾有71例(33.8%)需要处理≥2支肾动脉,右肾为103例(49.1%)(P<0.01);左肾有44例(21.0%)需要处理≥2支肾静脉,右肾为78例(37.1%)(P<0.01)。结论基于肾CT检查数据的三维可视化技术有助于术前精准评估肾血管解剖情况。右肾血管变异更常见。Objective To explore the application value of three-dimensional visualization technique based on CT data in the analysis of renal vascular anatomical variation.Methods The clinical data of 210 patients with renal tumors,adrenal tumors and renal cysts who underwent renal enhanced CT from October 2020 to June 2021 were retrospectively analyzed.Among the patients,there were 114 males and 96 females with an average age of(56.5±13.2)years.The CT data were reconstructed by 3D slicer software.According to the three-dimensional visualization model,the renal vascular anatomy was analyzed from the perspective of whether it needs to be treated during laparoscopic radical nephrectomy and laparoscopic partial nephrectomy.The variation of renal artery can be divided into multiple renal arteries,premature branches of renal artery and the mixed type with the above two variations.Renal vein variation can be divided into multiple renal veins,late confluence of renal veins and mixed type with the above two variations.Results Among the 210 patients in this study,there were no statistically significant differences in anatomical variations of renal arteries and veins between males and females(P=0.914 and P=0.121).Among 420 kidneys,renal artery variation(174/420,41.4%)was more common than renal vein variation(121/420,28.8%)(P<0.01).32(7.6%)right kidneys and 38(9.0%)left kidneys have multiple renal arteries(P=0.432).Eighty-nine cases(42.4%)had premature branches in the right renal artery,while 37 cases(17.6%)in the left kidney(P<0.01).24 kidneys(5.7%)showed mixed renal artery variation.53(12.6%)right kidneys and 3(0.7%)left kidneys had multiple renal veins(P<0.01).Late confluence of renal veins was found in 41 right kidneys(9.8%)and 33 left kidneys(7.9%),respectively(P=0.306).8(1.9%)mixed renal vein variants were all right kidneys..From the perspective of laparoscopic renal surgery,there were 71 cases(33.8%)of the left kidney to deal with≥2 renal arteries,as well as 103 cases(49.1%)of the right kidney(P<0.01).There were 44 cases(21.0

关 键 词：肾动脉 肾静脉 三维可视化技术 血管变异 腹腔镜肾脏手术 

分 类 号：R736.6[医药卫生—肿瘤] R737.11[医药卫生—临床医学]