基于CTA对肾动脉狭窄与肾动脉主干形态学特征的相关性分析

Correlation analysis between renal artery stenosis and renal artery trunk morphological features based on CT angiography

    摘要
  • 摘要:
    目的 研究肾动脉狭窄与肾动脉主干的形态学特征，特别是与肾动脉变异曲度的相关性。
    方法 收集62例肾动脉狭窄的患者男性37例、女性25例，年龄36~78（52.64±16.32）岁进行肾动脉CT血管造影（CTA），分别测量狭窄侧与非狭窄侧的肾动脉主干的平均管腔直径、管腔横截面积、长度、主干CT值、肾动脉主干强化CT值与腹主动脉强化CT值的比值（RA/AA）、肾皮质的平均强化CT值、最大曲度、肾动脉主干起点至最大曲度顶点的距离以及狭窄侧肾动脉主干起点至狭窄近端的距离。组间比较采用配对样本t检验。
    结果 肾动脉狭窄62支，对侧肾动脉正常62支，伴有斑块形成的肾动脉狭窄侧，其肾动脉走行的最大曲度（0.15±0.02）明显大于非狭窄侧（0.08±0.02），差异有统计学意义（t=19.487，P<0.05），而狭窄侧与非狭窄侧的肾动脉主干的平均管腔直径、管腔横截面积、长度、肾动脉主干CT值、RA/AA、肾皮质的平均强化CT值分别为（5.39±0.53） mm、（20.52±7.22） mm2、（34.51±13.12） mm、 （349.54±51.23） HU、（94.25±3.46）%、（278.41±35.47） HU和（5.27±.062） mm、（18.97±5.05） mm2、 （35.27±14.74） mm、（353.31±54.37） HU、（93.46±3.62）%、（284.21±37.92） HU，二者比较差异均无统计学意义（t=1.158、1.385、0.303、0.397、1.242、0.879，均P>0.05）。狭窄侧与非狭窄侧肾动脉主干起点至最大曲度顶点的距离分别为（9.62±1.34） cm和（9.79±1.47） cm，差异无统计学意义（t=0.673，P>0.05）。狭窄侧肾动脉主干起点至狭窄近端的距离为（9.42±1.61） cm，与肾动脉起点至最大曲度顶点的距离（9.62±1.34） cm比较，差异无统计学意义（t=0.752，P>0.05）。
    结论 CTA能够直接显示肾动脉水平的形态，其变异曲度与肾动脉狭窄有一定的相关性。

     

    Abstract:
    Objective To determine the correlation between renal artery stenosis and renal artery trunk morphological features, especially the renal artery variation of curvature.
    Methods A total of 62 patients37 men and 25 women, aged 36−78(52.64±16.32) years with diagnosed unilateral renal artery stenosis were subjected to CT angiography. The data between stenotic renal arteries and nonstenotic renal arteries were measured. These data included the inner diameter of the renal artery trunk, cross-sectional area, length, main CT value, the ratio of CT value of renal artery to abdominal aorta(RA/AA), average enhanced CT value of the renal cortex, maximum curvature, distance from the starting point to the maximum curvature vertex of the renal artery trunk, and the distance from the starting point to the narrow proximal side of the renal artery stenosis. Contrast analysis of the correlation was also performed. T test was used for all comparisons between groups in statistics.
    Results All data were divided into two groups(62 cases of stenotic renal arteries and 62 cases of nonstenotic renal arteries). The renal maximum curvature of the plaque side(0.15±0.02) was significantly greater than those in the normal side(0.08±0.02), and the differences were significant(t=19.487, P<0.05). The other parameters including the inner diameter of the renal artery trunk, cross-sectional area, length, renal artery CT value, RA/AA, and average enhanced CT value of the renal cortex were(5.39±0.53) mm, (20.52±7.22) mm2, (34.51±13.12) mm, (349.54±51.23) HU, (94.25±3.46)%, (278.41±35.47) HU and(5.27±0.62) mm, (18.97±5.05) mm2, (35.27±14.74) mm,(353.31±54.37) HU, (93.46±3.62)%, (284.21±37.92) HU, respectively. All differences had no statistical significance(t=1.158, 1.385, 0.303, 0.397, 1.242, and 0.879, respectively; all P>0.05). The distance from the starting point to the maximum curvature vertex of the renal artery trunk in the narrow and normal sides were(9.62±1.34) cm and(9.79±1.47) cm, respectively, and the difference was not statistically significant(t=0.673, P>0.05). The distance from the starting point to the narrow proximal side of the renal artery stenosis was(9.42±1.61) cm, and no significant difference(t=0.752, P>0.05) was observed between the distance(19.62±1.34) cm from the starting point to the maximum curvature vertex and to the narrow proximal side.
    Conclusion CT angiography can directly show the shape of renal artery trunk, which variation curvature has a certain correlation with the renal artery stenosis.

     

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