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[通过多种影像技术对下腔静脉先天性异常进行临床和辅助临床诊断(附4例报告)]

[Clinical and paraclinical identification by various imaging technics of congenital anomalies of the inferior vena cava (apropos of 4 cases)].

作者信息

Rettori R, Larroque P, Benzimra J C

机构信息

Hôpital Corentin Celton, CHU Necker-Enfants Malades (Paris V), Service de Chirurgie, Issy-les-Moulineaux.

出版信息

J Mal Vasc. 1989;14(3):191-201.

PMID:2674313
Abstract

Four cases of anomalies of the inferior vena cava (IVC) were studied by two noninvasive imaging techniques: real-time ultrasonography and computed tomography. These techniques were used alone in 1 case of left IVC to determine the diagnosis. The other 3 cases were studied initially by phlebography: left IVC with iliac phlebitis; double IVC, also with iliac phlebitis, and a special case in which it was not clear whether the diagnosis was agenesis of the IVC or postnatal caval thrombosis. The two patients with recent iliac vein thrombosis were treated by heparin, but the other two received no particular therapy. Concerning these 4 cases, the authors speak of the known complexity of embryogenesis of the IVC which accounts for the great diversity in its anomalies. Left and double IVC are among the most frequent anomalies along with periaortic venous rings and the ureter behind the IVC. These anomalies are most often asymptomatic, but an understanding of them is essential for correct interpretation of the results of different imaging techniques and for effective performance of surgical and medical acts concerning the IVC directly or indirectly. For diagnosis of IVC anomalies, iliac venacavography, when not performed initially, can in certain cases be replaced by routine noninvasive imaging techniques, to which may now be added magnetic resonance imaging.

摘要

采用实时超声检查和计算机断层扫描这两种非侵入性成像技术,对4例下腔静脉(IVC)异常病例进行了研究。在1例左位下腔静脉病例中单独使用了这些技术来明确诊断。另外3例最初采用静脉造影检查:1例为左位下腔静脉合并髂静脉炎;1例为双下腔静脉,同样合并髂静脉炎;还有1例特殊病例,无法明确诊断是下腔静脉发育不全还是产后腔静脉血栓形成。2例近期发生髂静脉血栓形成的患者接受了肝素治疗,但另外2例未接受特殊治疗。关于这4例病例,作者提到下腔静脉胚胎发育过程已知的复杂性,这解释了其异常情况的多样性。左位下腔静脉和双下腔静脉是最常见的异常情况,主动脉旁静脉环和下腔静脉后方的输尿管也属于此类。这些异常情况大多无症状,但了解它们对于正确解读不同成像技术的结果以及直接或间接针对下腔静脉进行有效手术和医疗操作至关重要。对于下腔静脉异常的诊断,若最初未进行髂静脉腔静脉造影,在某些情况下可由常规非侵入性成像技术替代,现在还可增加磁共振成像。

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