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多排计算机断层血管造影术研究保加利亚成人人群的肾动脉血管解剖及其变异。

Multidetector computed tomography angiography study of the renal arterial vasculature anatomy and its variations in a Bulgarian adult population.

机构信息

Department of Radiology, Prof. Dr. Alexander Chirkov University Hospital, Pencho Slaveykov Blvd, 1431 52A, Sofia, Bulgaria.

Department of Radiology, Medical University Sofia, Sofia, Bulgaria.

出版信息

Surg Radiol Anat. 2023 Mar;45(3):289-296. doi: 10.1007/s00276-023-03092-0. Epub 2023 Feb 2.

Abstract

PURPOSE

Renal arterial anatomy has a great clinical importance during surgical and endovascular procedures. However, comprehensive data on renal arterial variations in the Bulgarian population has not yet been provided. The aim of this study was to conduct a detailed research about the normal anatomy and variations of the renal arteries in the Bulgarian population.

METHODS

Five hundred sixty-one patients underwent contrast-enhanced multidetector computed tomography scans for the period 2016-2021. The images were retrospectively reviewed. Number, branching pattern, origin level and course of the renal arteries were noted. Data were categorized on the basis of laterality, gender and symmetry.

RESULTS

Only 46.3% of the patients exhibited normal renal arterial anatomy. Variations were observed in 301 patients (53.7%). The most common variant was the presence of accessory renal arteries (ARA), discovered in 41.2% of the subjects. There was no significant difference based on gender and laterality (p > 0.05). Hilar ARA (72.6%) were significantly more common than polar ARA (p < 0.001). The most common origin location of the main renal arteries and ARA was the aorta, followed by the common iliac arteries. Early division was observed in 21.7% of the patients, significantly more common on the right. Precaval course was found in 0.5% of the right main renal arteries and in 30% of ARA and the difference was significant (p < 0.001).

CONCLUSION

These results show novel insight into the prevalence of renal arterial variations in the Bulgarian population. Anatomic renal vasculature variants are common therefore awareness is crucial for the success of surgical and interventional procedures.

摘要

目的

肾动脉解剖学在外科和血管内手术中具有重要的临床意义。然而,保加利亚人群中关于肾动脉变异的综合数据尚未提供。本研究旨在详细研究保加利亚人群中肾动脉的正常解剖结构和变异。

方法

2016 年至 2021 年期间,561 名患者接受了增强型多排螺旋 CT 扫描。对图像进行回顾性审查。记录肾动脉的数量、分支模式、起源水平和走行。根据侧别、性别和对称性对数据进行分类。

结果

只有 46.3%的患者表现出正常的肾动脉解剖结构。301 名患者(53.7%)出现了变异。最常见的变异是存在副肾动脉(ARA),在 41.2%的受试者中发现。性别和侧别之间没有显著差异(p>0.05)。叶间 ARA(72.6%)明显多于极 ARA(p<0.001)。主肾动脉和 ARA 的最常见起源部位是主动脉,其次是髂总动脉。早期分支在 21.7%的患者中观察到,右侧更为常见。右侧主肾动脉的 precaval 走行占 0.5%,而 ARA 为 30%,差异显著(p<0.001)。

结论

这些结果提供了保加利亚人群中肾动脉变异发生率的新见解。解剖肾血管变异很常见,因此对手术和介入操作的成功至关重要。

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