基于CTA和DSA评价膈下动脉解剖学变异和临床相关性:一项系统评价和Meta分析  

Evaluating the prevalence and clinical implications of the inferior phrenic arteries on CTA and DSA:a systematic review and meta-analysis

作　　者：严高文 严高武 李宏伟 李勇 赵林伟[2] 范小萍[2] 邓建涛 严静 王毅 YAN Gao-wen;YAN Gao-wu;LI Hong-wei(Department of Radiology,the First People's Hospital of Suining City,Sichuan 629000,China)

机构地区：[1]遂宁市第一人民医院放射科,四川629000 [2]遂宁市中心医院放射影像科,四川629000 [3]绵阳市第三人民医院·四川省精神卫生中心放射科,四川621000 [4]陆军军医大学陆军特色医学中心(大坪医院)核医学科,重庆400042

出　　处：《放射学实践》2024年第9期1199-1206,共8页Radiologic Practice

基　　金：四川省卫生健康委员会科研课题(19PJ284);遂宁市青年科技人才托举工程科研课题(06);遂宁市中心医院科研课题(2021y09、2022ypj01);四川省医疗卫生与健康促进会科研项目(KY2023QN0065)。

摘　　要：目的:评价基于CT血管成像(CTA)和数字减影血管造影(DSA)的膈下动脉(IPA)解剖学变异的发生率与临床相关性。方法:系统检索PubMed、Web of Science、Scopus、Embase、Google Scholar、CBM、CNKI、WanFang、VIP和Baidu Scholar等数据库,纳入与左、右膈下动脉(LIPA和RIPA)相关的文献,并采用Stata 17.0软件进行Meta分析。结果:共纳入19篇文献,包括6754例患者。IPA共干和单独起源的汇总发生率分别为29.4%(95%CI:24.8%~34.2%)和70.6%(95%CI:65.8%~75.2%);IPA共干以起源于腹主动脉和腹腔干最为常见,汇总发生率分别为48.2%(95%CI:42.4%~54.1%)和49.0%(95%CI:43.3%~54.7%);RIPA单独起源以腹主动脉和腹腔干最为常见,汇总发生率分别为40.9%(95%CI:36.7%~45.3%)和34.8%(95%CI:30.7%~38.9%);LIPA单独起源以腹腔干和腹主动脉最为常见,汇总发生率分别为58.5%(95%CI:53.2%~63.7%)和32.6%(95%CI:27.3%~38.1%)。结论:IPA的起源变异十分丰富,熟悉IPA的起源变异对介入放射学、胃肠病学、外科学和创伤学医师具有十分重要的临床意义。Objective:To evaluate the incidence and clinical relevance of anatomical variations of the inferior phrenic arteries(IPA)based on computed tomography angiography(CTA)and digital subtraction angiography(DSA).Methods:A comprehensive search was conducted across multiple databases(PubMed,Web of Science,Scopus,Embase,Google Scholar,CBM,CNKI,WanFang,VIP,and Baidu Scholar)to include literature related to both left and right IPA.Meta-analysis was performed using the Stata 17.0 software.Results:A total of 19 studies encompassing 6754 patients were included.The pooled incidence of common trunk and independent origin of the IPA were 29.4%(95%CI:24.8%~34.2%)and 70.6%(95%CI:65.8%~75.2%),respectively.The most common origins of the IPA common trunk were the abdominal aorta and celiac trunk,with pooled incidences of 48.2%(95%CI:42.4%~54.1%)and 49.0%(95%CI:43.3%~54.7%),respectively.For separate origins of RIPA,the abdominal aorta and celiac trunk were also the most common,with a pooled prevalence of 40.9%(95%CI:36.7%~45.3%)and 34.8%(95%CI:30.7%~38.9%),respectively.Similarly,for separate origins of LIPA,the celiac trunk and abdominal aorta were the most prevalent,with a pooled prevalence of 58.5%(95%CI:53.2%~63.7%)and 32.6%(95%CI:27.3%~38.1%),respectively.Conclusion:The anatomical variations of IPA origins are highly diverse.Awareness with these variations is of great clinical significance for interventional radiologists,gastroenterologists,surgeons,and trauma specialists.

关 键 词：膈下动脉 CT血管成像 数字减影血管造影 起源 解剖变异 系统评价 META分析 

分 类 号：R322.1[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]