目的:确定肾静脉变异的患病率。目的探讨肾静脉的分布情况。
方法:我们回顾性回顾了两个月期间进行的腹部螺旋计算机断层扫描(CT)扫描。相同的协议用于所有CT扫描:相同的多探测器行CT扫描仪(Siemens(®)),1至2毫米的截面厚度,静脉注射iomeprol。研究组包括121例患者,年龄21.7至93.4岁(平均年龄60.9±15.4岁)。性别比例为2/1,男性80人,女性41人。
结果:73%的研究组(88例患者)没有肾静脉变异。实际上,几乎40%(48名患者)每侧有一条动脉和一条静脉,与典型的课程,33%(40例)的患者有肾动脉的病程和/或数量变异。右肾静脉的变体包括20.6%(25例)的多条静脉。我们没有发现多个左肾静脉,但我们描述了其病程的变化,占9.1%(11例):主动脉后左肾静脉5例(4.1%)和环主动脉左肾静脉6例(5%)。这11例患者中有3例伴有右双肾静脉。右肾静脉变异的概率明显高于左肾静脉变异的概率(OR=2.6,P=0.01)。我们发现女性有静脉变异的风险明显更高(OR=2.4,P=0.04)。我们没有发现下腔静脉变异的病例。
结论:在我们的研究中,环主动脉或后主动脉左肾静脉的患病率高于文献中先前报道的(9.1%).了解肾脉管系统的解剖变异是至关重要的,这项研究强调了肾血管的病程和数量的变化。这些变化并不少见,放射科医生和外科医生都应该知道。他们的知识在实践中具有重要的临床意义,有助于肾脏和腹膜后手术的安全性。
OBJECTIVE: To determine the prevalence of renal vein variants. To investigate the distribution of renal veins.
METHODS: We retrospectively reviewed spiral computed tomography (CT) scans of the abdomen performed during a two-month period. The same protocol was used for all CT scans: same multidetector-row CT scanner (Siemens(®)), 1 to 2-mm section thickness, injection of intravenous iomeprol. The
study group included 121 patients, aged 21.7 to 93.4 years (mean age 60.9 ± 15.4 years). The sex ratio was 2/1, with 80 men and 41 women.
RESULTS: Seventy-three percent of the
study group (88 patients) had no variants of the renal veins. Indeed almost 40% (48 patients) had one artery and one vein on each side, with typical course, and 33% (40 patients) had course and/or number variants of the renal arteries. Variants of the right renal vein consisted in multiple veins in 20.6% (25 cases). We detected no case of multiple left renal veins, but we described variations of its course in 9.1% (11 cases): 5 cases of retroaortic left renal vein (4.1%) and 6 cases of circumaortic left renal vein (5%). Three of these 11 patients had an associated double right renal vein. The probability to have a right renal vein variant was significantly higher than a left one (OR = 2.6, P = 0.01). And we found a significantly higher risk of having a venous variant in women (OR = 2.4, P = 0.04). We detected no case of inferior vena cava variant.
CONCLUSIONS: In our
study, prevalence of a circum- or retroaortic left renal vein appeared higher than previously reported in the literature (9.1%). Knowledge of anatomical variants of renal vasculature is crucial and this
study puts the emphasis on variations of course and number of renal vessels. Those variations are not so uncommon and should be known by radiologists and also by surgeons. Their knowledge has major clinical implications in practice and it contributes to the safety of renal and retroperitoneal surgery.