Sponza M, Pozzi Mucelli R, Pozzi Mucelli F
Istituto di Radiologia, Università, Trieste.
Radiol Med. 1993 Sep;86(3):260-7.
A hundred patients with different conditions underwent CT and the results were retrospectively reviewed to evaluate the visibility of the celiac trunk, of its branches and of the superior mesenteric artery. Thirty-six patients underwent angiography too, which allowed the anatomical variants suspected on CT to be demonstrated, according to Kuhns' criteria. The other 64 patients were consecutively selected and only aneurysmal changes were not included. All examinations were performed using a General Electric 9800 Advantage scanner, with 2 second scanning time and 10 mm-thick contiguous scans. In 20 patients 5 mm contiguous scans were performed. All examinations followed i.v. injections of contrast agents which were given with an automatic injector. The cases with suspected anatomical variants on CT but with no angiographic confirmation were not considered. A hundred CT exams were retrospectively reviewed: the celiac trunk and the common hepatic artery were demonstrated in all of them. Visibility of the other branches was 40% for the hepatic artery, 53% for the right branch of the hepatic artery and 39% for its left branch, 70% for the gastroduodenal artery, 82% for the left gastric artery, 97% for the splenic artery and 100% for the superior mesenteric artery. As for the 36 patients who underwent both CT and angiography, right hepatic artery from the superior mesenteric artery was seen in 19% of cases with both modalities; common hepatic artery arising from the superior mesenteric artery was detected in 2% of cases. In both instances, these anatomical variants appeared as a vessel running posterior to the portal vein. The careful investigation of axial CT scans showed the level of origin of the artery from the superior mesenteric artery. These results are in agreement with the angiographic data reported in the literature. Our study demonstrated that the celiac trunk and its variants are always depicted by the new CT scanner. The knowledge of these variants may be useful in the patients to submit to liver surgery. The celiac trunk and its variants are demonstrated with conventional 10 mm slices. The use of 5 mm slices improves the visibility of thin anatomical branches but is not essential to recognize the major vessels and anatomical variants.
对100例患有不同病症的患者进行了CT检查,并对结果进行回顾性分析,以评估腹腔干、其分支以及肠系膜上动脉的显影情况。36例患者还接受了血管造影检查,根据库恩斯标准,这使得在CT上怀疑的解剖变异得以证实。另外64例患者是连续入选的,仅排除了动脉瘤样改变的病例。所有检查均使用通用电气9800 Advantage扫描仪进行,扫描时间为2秒,层厚10mm连续扫描。20例患者进行了层厚5mm的连续扫描。所有检查均在静脉注射造影剂后进行,造影剂由自动注射器注入。CT上怀疑有解剖变异但无血管造影证实的病例未纳入考虑。对100例CT检查进行回顾性分析:所有病例均显示出腹腔干和肝总动脉。肝动脉其他分支的显影率为40%,肝右支为53%,肝左支为39%,胃十二指肠动脉为70%,胃左动脉为82%,脾动脉为97%,肠系膜上动脉为100%。对于36例同时接受CT和血管造影检查的患者,两种检查方式均在19%的病例中发现肠系膜上动脉发出右肝动脉;在2%的病例中检测到肝总动脉起源于肠系膜上动脉。在这两种情况下,这些解剖变异均表现为一条走行于门静脉后方的血管。对轴向CT扫描的仔细观察显示了动脉从肠系膜上动脉发出的水平。这些结果与文献报道的血管造影数据一致。我们的研究表明,新型CT扫描仪总能显示出腹腔干及其变异。了解这些变异可能对接受肝脏手术的患者有用。腹腔干及其变异在常规10mm层厚扫描中即可显示。使用5mm层厚扫描可提高细小解剖分支的显影率,但对于识别主要血管和解剖变异并非必需。