基于胸部增强CT显示肩胛下动脉系统的变异  

Anatomical Variation of the Subscapular Artery System:Analysis Based on Enhanced Chest CT

作　　者：孙芙蓉[1] 张艺[2] 陈丽娟[1] SUN Furong;ZHANG Yi;CHEN Lijuan(Department of Radiology,Rujin Hospital North,Shanghai Jiao Tong University School of Medicine,Shanghai 201801,China;Shanghai Jiading Hospital of Traditional Chinese Medicine)

机构地区：[1]上海交通大学医学院附属瑞金医院北部院区放射科,上海市201801 [2]上海市嘉定区中医医院

出　　处：《中国医学计算机成像杂志》2024年第6期709-715,共7页Chinese Computed Medical Imaging

摘　　要：目的:分析肩胛下动脉(SSA)系统的解剖特点,归纳其分布规律。方法:回顾性分析80例胸部增强CT图像,记录SSA的起源及长度,SSA及其分支——旋肩胛动脉(CSA)、胸背动脉(TDA)的管径及伴随静脉的归属,并进行归类。结果:160支腋动脉(AA)中,88.13%(141/160)存在SSA分支,其中75.89%(107/141)起源于AA3,24.11%(34/141)起源于AA2;11.87%(19/160)SSA缺如。男性SSA起源于AA2者多于女性(25/80 vs 9/80),女性SSA缺如者多于男性(16/80 vs 3/80),性别间差异显著(P<0.01)。SSA管径为(4.72±0.76)mm,长度为(29.56±11.9)mm,CSA管径为(3.45±0.69)mm,TDA管径为(2.92±0.56)mm。SSA长度与管径性别间差异较明显(P<0.05)。SSA来源不同,分支不同(P<0.001)。AA2来源的分出胸外侧动脉(LTA)的概率高于AA3,AA3来源的发出旋肱后动脉(PCHA)的概率则高于AA2。SSA来源不同,伴随静脉汇入腋静脉点较恒定,92.52%(99/107)AA3来源、94.12%(32/34)AA2来源,52.63%(10/19)SSA缺如的分支伴随静脉汇合后,均汇入腋静脉偏外侧。结论:SSA系统变异较多,性别差异明显。胸部增强CT能清晰显示SSA系统的解剖细节,能为临床术前提供准确的血管评估。Purpose:To analyze the anatomical characteristics of the subscapular arterial system and summarize its distribution patterns.Methods:A retrospective study was conducted on the collection of chest enhanced CT raw images from 80 ordinary individuals.The origin and length of subscapular artery(SSA),the diameters of SSA and its branches—the circumflex scapular artery(CSA)and thoracodorsal artery(TDA),and the attribution of accompanying veins were recorded and classified.Results:Among 160 axillary arteries(AA),88.13%(141/160)were found the presence of SSA,of which 75.89%(107/141)originated from AA3 and 24.11%(34/141)from AA2,and 11.87%(19/160)were found the absence of SSA.The probability of SSA originating from AA2 in males was higher than that in females(25/80 vs 9/80),while the probability of SSA deficiency in females was higher than that in males(16/80 vs 3/80),with statistically significant differences(P<0.01).The average diameter of SSA was(4.72±0.76)mm,with a length of(29.56±11.9)mm.The average diameter of CSA was(3.45±0.69)mm,and the diameter of TDA was(2.92±0.56)mm.There were significant differences in length and diameter of SAA between males and females(P<0.05).SSAs with different sources had different branches(P<0.001).The probability of issuing LTA from AA2 was higher than that from AA3.The probability of issuing PCHA from AA3 was higher than that from AA2.92.52%(99/107)of AA3 sources,94.12%(32/34)of AA2 sources,and 52.63%(10/19)of concomitant venous(absence of SSA)converged;all converge into the lateral side of the axillary vein.Conclusion:There were many variations in the subscapular arterial system with significant gender differences.Chest enhanced CT can clearly display the anatomical details of the subscapular arterial system,and provide accurate vascular assessment for clinical preoperative planning.

关 键 词：胸部 计算机体层成像 肩胛下动脉 旋肩胛动脉 胸背动脉 

分 类 号：R814[医药卫生—影像医学与核医学]