摘要目的 探讨64层螺旋CT下腔静脉畸形的影像表现.方法 回顾性分析6986例受检者的腹部64层螺旋CT增强扫描资料,共发现25例下腔静脉先天畸形.分析下腔静脉畸形的影像表现.结果 25例下腔静脉畸形中包括左下腔静脉6例,CT表现为肾下段腹主动脉左侧上行的下腔静脉.双下腔静脉10例,CT表现为肾下段腹主动脉两侧上行的下腔静脉.左肾静脉畸形5例,CT增强扫描横断面显示腹主动脉后和环主动脉走行的左肾静脉.肝下段下腔静脉中断伴奇静脉延续2例,胸腹部CT增强扫描显示肝段至肾上段下腔静脉缺如,肾段下腔静脉由奇静脉延续回流人上腔静脉,而肝静脉直接回流右心房.腔静脉血管造影见对比剂经增粗的奇静脉和半奇静脉通过上腔静脉回流右心房.肝下段下腔静脉中断伴门静脉延续1例,增强CT显示下腔静脉直接与门静脉在肝门部连接,肝门部门静脉呈瘤样扩张.左下腔静脉伴半奇静脉延续1例,增强CT可见左下腔静脉与半奇静脉连接,上行汇入奇静脉.结论 64层螺旋CT可清晰显示下腔静脉及其属支的畸形,可成为下腔静脉畸形的重要诊断方法.

abstractsObjective To evaluate the imaging findings of congenital anomalies of inferior vena eava (IVC) with 64-slice spiral CT. Methods Between January 2008 and May 2009, 6986 patients who had routine abdominal 64-row multi-detector computed tornography were retrospectively analyzed for congenital anomalies of IVC. Results Among 6986 cases, 25 cases with congenital anomalies of IVC were identified. Six case were left IVC, showing IVC left to the aorta inferior to the renal hilum. Ten cases were double IVC, showing two IVC besides the aorta inferior to the renal hilum. Five cases were abnormal renal vein, showing retroaortic and circumaortic left renal vein. Two cases were IVC interruption with collateral circultion by azygous or hemiazygous vein, contrast-enhanced CT scan showing deficiency of the IVC between hepatic and renal hilums, the enlarged azygos vein communicating with IVC at renal level and the hepatice vein draining into the right atrium. Venography showed that IVC draining into the superior vena cava through azygous or hemiazygous veins. One case was interruption of the IVC with portal vein continuation, contrastenhanced CT scan showing the communication between the IVC and portal vein. One case was hemiazygos continuation of a left IVC, contrast-enhanced CT scan demonstrating dilatation hemiazygos continuation of a left IVC and jointed the azygos vein. Conclusion The 64-slice spiral CT can be a diagnostic standard for congenital anomalies of inferior vena cava.