McKenney Kyle, Boneva Dessilava, Deeter Matthew, Barquist Erik, Ang Darwin, Kaye Marc
1 Kendall Regional Medical Center, Miami, FL, USA.
Int Surg. 2014 Nov-Dec;99(6):734-8. doi: 10.9738/INTSURG-D-13-00192.1.
The objective of this study was to determine if admission abdominal/pelvic CT on trauma patients can be used as a novel method to evaluate the inferior vena cava (IVC) anatomy and facilitate potential IVC filter placement. Consecutive trauma admission CT's were reviewed. The potential landing zone for filters was determined by the IVC mid portion between the renal and iliac veins. The IVC landmarks were described anatomically using the thoracic and lumbar vertebral bodies as reference points. The IVC diameter and anatomic anomalies which would affect filter placement were also evaluated from the CT. The records of 610 Trauma patients were reviewed. There were 518 (84.9%) that had an admission CT, forming the basis of the study. The CT for 500 of 518 (96.5%) was of sufficient quality to accurately evaluate the IVC. The third lumbar location of the IVC was a safe landing zone in 476 of 500 (95.2%). Anatomic anomalies were present in 47 of 500 (9.4%). We had the following three conclusions. The admission CT in over 96% of trauma patients can be used to determine the IVC filter landing zone. The third lumbar region of the IVC was a safe landing zone in over 95%. Anatomical anomalies affecting IVC filter placement were revealed in 9.4%.
本研究的目的是确定创伤患者入院时的腹部/盆腔CT是否可作为一种新方法来评估下腔静脉(IVC)解剖结构并便于潜在的下腔静脉滤器置入。回顾了连续的创伤入院CT。滤器的潜在着陆区由肾静脉和髂静脉之间的下腔静脉中部确定。以下腔椎体和腰椎椎体作为参考点,对下腔静脉的标志进行解剖学描述。还从CT评估了下腔静脉直径和会影响滤器置入的解剖异常情况。回顾了610例创伤患者的记录。其中518例(84.9%)有入院时的CT,构成了本研究的基础。518例中的500例(96.5%)的CT质量足以准确评估下腔静脉。下腔静脉在第三腰椎水平的位置在500例中的476例(95.2%)是一个安全着陆区。500例中有47例(9.4%)存在解剖异常。我们有以下三个结论。超过96%的创伤患者入院时的CT可用于确定下腔静脉滤器着陆区。下腔静脉的第三腰椎区域在超过95%的情况下是一个安全着陆区。9.4%的患者显示存在影响下腔静脉滤器置入的解剖异常。