计算机体层扫描血管成像结合静脉成像三维重建腋动脉和腋静脉及其分布关系的临床应用  

Clinical application of computed tomography angiography and venography three⁃dimensional reconstruction of axillary artery and axillary vein and their distribution

作　　者：魏钰 毛耀可 龚佳艺 张乐 吴鹏翱 陈伟[2] 张慧[3] WEI Yu;MAO Yao-ke;GONG Jia-yi;ZHANG Le;WU Peng-ao;CHEN Wei;ZHANG Hui(Grade 2020 Medical Imaging Major,School of Medical Imaging,Changsha Medical College,Changsha 410219,China;Department of Radiology,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Human Anatomy,Changsha Medical College,Changsha 410219,China)

机构地区：[1]长沙医学院医学影像学院,长沙410219 [2]中南大学湘雅医院放射科,长沙410008 [3]长沙医学院人体解剖学教研室,长沙410219

出　　处：《解剖学报》2025年第2期214-222,共9页Acta Anatomica Sinica

基　　金：2022年国家级大学生创新创业项目(教高司函[2022]10号202210823022);湖南省线下一流本科课程《断层解剖学》(湘教通[2021]322号362)。

摘　　要：目的通过结合计算机体层扫描血管成像(CTA)与静脉成像(CTV)技术,探讨腋动脉与腋静脉间相互关系,为临床经腋窝处手术血管损伤建立有效血液循环路径提供影像资料。方法共收集30例同时行左上肢、腋窝CTA及CTV患者的影像数据,通过GE AW4.6工作站对图像三维重建处理后,观察腋动脉的走行、分支分型及变异情况,腋静脉的走行、属支回流情况和腋动脉、腋静脉的相互关系,测量全段、分段长度及各段起始点处内径并进行统计学分析。结果腋动脉分型以主干发出的支数分为7型。腋静脉根据血管支数变异将数量变异分5型;未知静脉属支共汇入32支,第1段占37.5%,第2段占46.9%,第3段占15.6%。根据动脉分支是否缺如将腋动脉与腋静脉关系分为2型。结论腋动脉分支分型与腋静脉属支回流情况众多,变异类型复杂,腋动脉分支变化影响腋静脉属支分布,结合CTA及CTV图像清晰直观地反映腋窝血管间的走行关系,为临床腋窝治疗建立新供血及回流途径提供影像资料参考。Objective To explore the relationship between axillary artery and axillary vein by combining computed tomography angiography computed tomography angiography(CTA)and computed tomography venography(CTV),and to provide imaging data for establishing an effective blood circulation pathway for vascular injury in clinical transaxillary surgery.Methods The image data of 30 patients who underwent left upper limb and axillary CTA and CTV at the same time were collected.After three⁃dimensional reconstruction of the images by GE AW4.6 workstation,the course,branch type and variation of axillary artery,the course of axillary vein,the reflux of subordinate branches and the relationship between axillary artery and axillary vein were observed.The length of the whole segment,the length of segment and the inner diameter of the starting point of each segment were measured and statistically analyzed.Results According to the number of branches from the main trunk,the axillary artery was divided into 7 types.According to the variation of the number of blood vessels,the axillary vein was divided into 5 types;The unknown vein branches converge into 32 branches,of which the first segment accounted for 37.5%,the second segment accounted for 46.9%,and the third segment accounted for 15.6%.According to the absence of arterial branches,the relationship between axillary artery and axillary vein was divided into 2 types.Conclusion There are many types of branches of axillary arteries and branches of axillary veins,and the variation types are complex.The changes of branches of axillary arteries affect the distribution of branches of axillary veins.Combined with CTA and CTV images,the relationship between axillary vessels can be reflected clearly and intuitively,which can provide imaging reference for the establishment of new ways of blood supply and reflux in clinical axillary treatment.

关 键 词：腋动脉 腋静脉 计算机体层扫描血管成像术 计算机体层扫描静脉成像术 人 

分 类 号：R445[医药卫生—影像医学与核医学]