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下腔静脉中断或先天性狭窄:患病率、影像学表现及临床发现。

Interruption or congenital stenosis of the inferior vena cava: prevalence, imaging, and clinical findings.

作者信息

Koc Zafer, Oguzkurt Levent

机构信息

Başkent University, School of Medicine, Department of Radiology, Adana, Turkey.

出版信息

Eur J Radiol. 2007 May;62(2):257-66. doi: 10.1016/j.ejrad.2006.11.028. Epub 2006 Dec 11.

Abstract

OBJECTIVE

To present the prevalence, clinical, and imaging findings of interruption or congenital stenotic lesions of the inferior vena cava (IVC), associated malformations, and their clinical relevance.

MATERIALS AND METHODS

Between March 2004 and March 2006, 7972 patients who had undergone consecutive routine abdominal multidetector row computed tomography were analyzed for interruption or stenotic lesion of the IVC.

RESULTS

Prevalence of interruption (n=8) or congenital stenosis (n=4) of the IVC occurred in 12 (0.15%) of 7972 patients. Four patients with interruption and four patients with congenital stenosis of the IVC were symptomatic with DVT (n=4), leg swelling (n=4), leg pain (n=2), lower extremity varices (n=2), hepatic vein thrombosis (n=1), and hematochezia (n=1). All four of the asymptomatic patients were from the interruption group, and these patients had interrupted IVC with well-developed azygos/hemiazygos continuation. Eight symptomatic patients did not have a well-developed azygos/hemiazygos continuation, and drainage of lower extremity was mainly from collateral veins. Additional findings in eight symptomatic patients were abdominal venous collaterals (n=8), venous aneurysm (n=2), lower extremity varices (n=2), varicocele (n=2), and pelvic varices (n=1).

CONCLUSION

Interruption or stenosis of the IVC are rare on routine abdominal CT examinations and may cause different clinical findings depending on the variant drainage patterns or collaterals. Interrupted IVC is commonly asymptomatic if associated with well-developed azygos/hemiazygos continuation, whereas commonly symptomatic if well-developed azygos/hemiazygos continuation is not present.

摘要

目的

介绍下腔静脉(IVC)中断或先天性狭窄病变的患病率、临床及影像学表现、相关畸形及其临床意义。

材料与方法

2004年3月至2006年3月期间,对7972例行连续常规腹部多排螺旋CT检查的患者进行IVC中断或狭窄病变分析。

结果

7972例患者中,IVC中断(n = 8)或先天性狭窄(n = 4)的患病率为12例(0.15%)。4例IVC中断患者和4例IVC先天性狭窄患者出现症状,表现为深静脉血栓形成(n = 4)、腿部肿胀(n = 4)、腿部疼痛(n = 2)、下肢静脉曲张(n = 2)、肝静脉血栓形成(n = 1)和便血(n = 1)。所有4例无症状患者均来自中断组,这些患者的IVC中断且奇静脉/半奇静脉延续发育良好。8例有症状的患者奇静脉/半奇静脉延续发育不佳,下肢主要通过侧支静脉引流。8例有症状患者的其他表现包括腹部静脉侧支(n = 8)、静脉瘤(n = 2)、下肢静脉曲张(n = 2)、精索静脉曲张(n = 2)和盆腔静脉曲张(n = 1)。

结论

IVC中断或狭窄在常规腹部CT检查中较为罕见,根据不同的引流模式或侧支情况可能导致不同的临床表现。IVC中断若伴有发育良好的奇静脉/半奇静脉延续通常无症状,而若奇静脉/半奇静脉延续发育不佳则通常有症状。

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