Zurcher Kenneth S, Staack Sasha O, Spencer E Brooke, Liska Addison, Alzubaidi Sadeer J, Patel Indravadan J, Naidu Sailendra G, Oklu Rahmi, Dymek Ryanne A, Knuttinen Martha-Gracia
From the Division of Vascular and Interventional Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ (K.S.Z., S.O.S., S.J.A., I.J.P., S.G.N., R.O., M.G.K.); Minimally Invasive Procedure Specialists, Highlands Ranch, Colo (E.B.S., A.L.); and University of Illinois College of Medicine at Chicago, Chicago, IL (R.A.D.).
Radiographics. 2022 Sep-Oct;42(5):1532-1545. doi: 10.1148/rg.220012. Epub 2022 Jul 22.
The pelvic venous system is complex, with the potential for numerous pathways of collateralization. Owing to stenosis or occlusion, both thrombotic and nonthrombotic entities in the pelvis may necessitate alternate routes of venous return. Although the pelvic venous anatomy and collateral pathways may demonstrate structural variability, a number of predictable paths often can be demonstrated on the basis of the given disease and the level of obstruction. Several general categories of collateral pathways have been described. These pathway categories include the deep pathway, which is composed of the lumbar and sacral veins and vertebral venous plexuses; the superficial pathway, which is composed of the circumflex and epigastric vessels; various iliofemoral collateral pathways; the intermediate pathway, which is composed of the gonadal veins and the ovarian and uterine plexuses; and portosystemic pathways. The pelvic venous anatomy has been described in detail in cadaveric and anatomic studies, with the aforementioned collateral pathways depicted on CT and MR images in several imaging studies. A comprehensive review of the native pelvic venous anatomy and collateralized pelvic venous anatomy based on angiographic features has yet to be provided. Knowledge of the diseases involving a number of specific pelvic veins is of clinical importance to interventional and diagnostic radiologists and surgeons. The ability to accurately identify common collateral patterns by using multiple imaging modalities, with accurate anatomic descriptions, may assist in delineating underlying obstructive hemodynamics and diagnosing specific occlusive disease entities. RSNA, 2022.
盆腔静脉系统复杂，存在众多侧支循环途径。由于狭窄或闭塞，盆腔内的血栓性和非血栓性病变都可能需要静脉回流的替代途径。尽管盆腔静脉解剖结构和侧支循环途径可能存在结构变异，但根据特定疾病和梗阻水平，通常可以显示出一些可预测的路径。已经描述了几种侧支循环途径的一般类别。这些途径类别包括深部途径，由腰静脉、骶静脉和椎静脉丛组成；浅部途径，由旋髂血管和腹壁血管组成；各种髂股侧支循环途径；中间途径，由性腺静脉以及卵巢和子宫丛组成；以及门体循环途径。盆腔静脉解剖结构已在尸体解剖和解剖学研究中详细描述，上述侧支循环途径在多项影像学研究的CT和MR图像上也有显示。基于血管造影特征对正常盆腔静脉解剖结构和侧支循环盆腔静脉解剖结构进行全面综述尚未见报道。了解涉及一些特定盆腔静脉的疾病对介入放射科医生、诊断放射科医生和外科医生具有临床重要性。通过使用多种成像方式准确识别常见侧支循环模式，并进行准确的解剖描述，可能有助于描绘潜在的阻塞性血流动力学并诊断特定的闭塞性疾病实体。RSNA，2022年。
