计算机体层扫描血管成像结合静脉成像三维重建腋动脉和腋静脉及其分布关系的临床应用

魏钰 毛耀可 龚佳艺 张乐 吴鹏翱 陈伟 张慧

解剖学报 ›› 2025, Vol. 56 ›› Issue (2) : 214-222.

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解剖学报 ›› 2025, Vol. 56 ›› Issue (2) : 214-222. DOI: 10.16098/j.issn.0529-1356.2025.02.012

计算机体层扫描血管成像结合静脉成像三维重建腋动脉和腋静脉及其分布关系的临床应用

  • 魏钰1 毛耀可1 龚佳艺1 张乐1 吴鹏翱1 陈伟2 张慧3* 

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Clinical application of computed tomography angiography and venography three-dimensional reconstruction of axillary artery and axillary vein and their distribution

  • WEI  Yu1  MAO  Yao-ke1  GONG  Jia-yi1  ZHANG  Le1  WU  Peng-ao1  CHEN  Wei2  ZHANG  Hui3*
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摘要

目的 通过结合计算机体层扫描血管成像 (CTA)与静脉成像(CTV) 技术,探讨腋动脉与腋静脉间相互关系,为临床经腋窝处手术血管损伤建立有效血液循环路径提供影像资料。 方法 共收集30例同时行左上肢、腋窝CTA及CTV患者的影像数据,通过GE AW4.6工作站对图像三维重建处理后,观察腋动脉的走行、分支分型及变异情况,腋静脉的走行、属支回流情况和腋动脉、腋静脉的相互关系,测量全段、分段长度及各段起始点处内径并进行统计学分析。 结果 腋动脉分型以主干发出的支数分为7型。腋静脉根据血管支数变异将数量变异分5型;未知静脉属支共汇入32支,第1段占37.5%,第2段占46.9%,第3段占15.6%。根据动脉分支是否缺如将腋动脉与腋静脉关系分为2型。 结论 腋动脉分支分型与腋静脉属支回流情况众多,变异类型复杂,腋动脉分支变化影响腋静脉属支分布,结合CTA及CTV图像清晰直观地反映腋窝血管间的走行关系,为临床腋窝治疗建立新供血及回流途径提供影像资料参考。

Abstract

Objective To explore the relationship between axillary artery and axillary vein by combining computed tomography angiography computed tomography angiography(CTA) and computed tomography venography(CTV), and to provide imaging data for establishing an effective blood circulation pathway for vascular injury in clinical transaxillary surgery.
Methods The image data of 30 patients who underwent left upper limb and axillary CTA and CTV at the same time were collected. After three-dimensional reconstruction of the images by GE AW4.6 workstation, the course, branch type and variation of axillary artery, the course of axillary vein, the reflux of subordinate branches and the relationship between axillary artery and axillary vein were observed. The length of the whole segment, the length of segment and the inner diameter of the starting point of each segment were measured and statistically analyzed.   Results  According to the number of branches from the main trunk, the axillary artery was divided into 7 types. According to the variation of the number of blood vessels, the axillary vein was divided into 5 types; The unknown vein branches converge into 32 branches, of which the first segment accounted for 37.5%, the second segment accounted for 46.9%, and the third segment accounted for 15.6%. According to the absence of arterial branches, the relationship between axillary artery and axillary vein was divided into 2 types.   Conclusion  There are many types of branches of axillary arteries and branches of axillary veins, and the variation types are complex. The changes of branches of axillary arteries affect the distribution of branches of axillary veins. Combined with CTA and CTV images, the relationship between axillary vessels can be reflected clearly and intuitively, which can provide imaging reference for the establishment of new ways of blood supply and reflux in clinical axillary treatment.

关键词

 腋动脉 / 腋静脉 / 计算机体层扫描血管成像术 / 计算机体层扫描静脉成像术 /

Key words

 Axillary artery / Axillary vein / Computed tomography angiography / Computed tomography venography / Human


引用本文

导出引用
魏钰 毛耀可 龚佳艺 张乐 吴鹏翱 陈伟 张慧. 计算机体层扫描血管成像结合静脉成像三维重建腋动脉和腋静脉及其分布关系的临床应用[J]. 解剖学报. 2025, 56(2): 214-222 https://doi.org/10.16098/j.issn.0529-1356.2025.02.012
WEI Yu MAO Yao-ke GONG Jia-yi ZHANG Le WU Peng-ao CHEN Wei ZHANG Hui. Clinical application of computed tomography angiography and venography three-dimensional reconstruction of axillary artery and axillary vein and their distribution[J]. Acta Anatomica Sinica. 2025, 56(2): 214-222 https://doi.org/10.16098/j.issn.0529-1356.2025.02.012
中图分类号: R445.3   

参考文献

 [1] Van  Oostendorp SE, Tan EC, Geeraedts LM Jr. Prehospital control of life-threatening truncal and junctional haemorrhage is the ultimate challenge in optimizing trauma care; a review of treatment options and their applicability in the civilian trauma setting[J]. Scand J Trauma Resusc Emerg Med, 2016, 24(1): 110.
 [2] Cui  HX, Li RX. Regional Anatomy[M]. Beijing: People’s Health Publishing House, 2018: 212-216. (in Chinese) 
崔慧先,李瑞锡. 局部解剖学[M].北京: 人民卫生出版社 ,2018: 212-216.
 [3] Yu  ShM, Zhu X, Shao JSh. Axillary vein in Chinese [J]. Journal of Anatomy, 1985,8 (4): 322-326. (in Chinese)
俞寿民,朱晞,邵静山. 中国人的腋静脉[J]. 解剖学杂志,1985,8(4):322-326.
 [4] Jiang  ZW, Huang F, Zheng XH, et al. A case of floating shoulder injury with early ischemic muscle contracture [J]. Hainan Medical Science, 2012, 23(17): 135-136.(in Chinese) 
姜自伟,黄枫,郑晓辉,等. 浮肩损伤并早期缺血性肌挛缩一例[J]. 海南医学,2012,23(17):135-136.
 [5] Qi  L, Jiao LQ, Li ShM, et al. Study on the method of mechanical recanalization of subclavian artery occlusion [J]. Journal of Interventional Radiology, 2010, 19 (2): 138-141. (in Chinese) 
齐立,焦力群,李慎茂,等. 锁骨下动脉闭塞机械再通的方法研究[J]. 介入放射学杂志,2010,19(2):138-141.
 [6] Li  JX, Jiang LJ, Huang J. A case of variation of right axillary artery branch [J]. Anatomical Research, 2021, 43(6): 663-664. (in Chinese) 
李佳锡,蒋璐鞠,黄娟. 右侧腋动脉分支变异一例[J]. 解剖学研究,2021,43(6):663-664.
 [7] Wang  X. Applied anatomy of axillary vein puncture [J]. Sichuan Journal of Anatomy, 2000, 8(4): 201-202.(in Chinese) 
王啸. 腋静脉穿刺的应用解剖学[J]. 四川解剖学杂志,2000,8(4):201-202.
 [8] Guo  Y, Zhang HY, Liu H, et al. Study on in vitro localization and branch origin classification of axillary artery by CTA [J]. Acta Academiae Medicinae Militaris Tertiae, 2021, 43(16): 1507-1512.(in Chinese) 
郭勇,张画羽,刘衡,等. 通过CTA行腋动脉体外定位及其分支起源分型的研究[J]. 第三军医大学学报,2021,43(16):1507-1512.
 [9] Wang  ZhY, Xu WJ. Sectional Imaging Anatomy of Human Body [M]. Beijing: People’s Health Publishing House, 2016: 123-130. (in Chinese) 
王振宇,徐文坚. 人体断层影像解剖学[M]. 北京:人民卫生出版社,2016:123-130.
 [10] Medical  Imaging Nursing Committee of the Imaging Technology Branch of the Chinese Medical Society. Expert consensus on the application of intravenous infusion tools for image enhancement examination [J]. China Medical Equipment, 2021, 36(3): 1-5. (in Chinese) 
中华医学会影像技术分会医学影像护理专委会. 影像增强检查静脉输注工具规范应用专家共识[J]. 中国医疗设备,2021,36(3):1-5.
 [11] Lin  ZhSh, Wang JW, Deng J, et al. Study on reducing head and neck CTA hard beam artifacts by reducing developer dose [J]. China Medical equipment, 2019, 34(10): 68-71. (in Chinese) 
林智胜,王建伟,邓婕,等. 关于降低显影剂剂量消减头颈CTA硬束伪影的研究[J]. 中国医疗设备,2019,34(10):68-71.
 [12] Cheng  GL, Zhang ZM. Observation of axillary artery [J]. Acta Anatomica Sinica, 1965, 8(2): 101-110. (in Chinese) 
程耕历,张宗铭. 腋动脉的观察[J]. 解剖学报,1965,8(2):101-110.
 [13] Ding  JM, Lei Y, Huang YCh. Anatomical observation of axillary artery branches [J]. Journal of North Sichuan Medical College, 2005, 20(1): 3-4.(in Chinese) 
丁家明,雷英,黄永春. 腋动脉分支的解剖学观察[J]. 川北医学院学报,2005,20(1):3-4.
 [14] Cai  YL, Wu Q, Zou YY, et al. Variation of axillary artery and brachial artery and their branches [J]. Miscellaneous Chronicles of Anatomy, 2021, 44(4): 370-373.(in Chinese) 
蔡永莉,吴琴,邹暄潆,等. 腋动脉和肱动脉及其分支变异[J]. 解剖学杂志,2021,44(4);370-373.
 [15] Zheng  YF, Jiang Y, Hua JH, et al. Aortic valve replacement by transaxillary approach without contrast medium in 1 case [J]. Journal of Interventional Radiology, 2021, 30(11): 1189-1192.(in Chinese) 
郑耀富,姜宇,华经海,等. 经腋动脉入路全程无对比剂经导管主动脉瓣置换术1例[J]. 介入放射学杂志,2021,30(11):1189-1192.
 [16] Zhang  XQ, Ge ShT. Endovascular repair of traumatic axillary artery injury [J]. Miscellaneous Records of Chinese Clinical Medical Imaging, 2017, 28(9): 657-659, 664.(in Chinese) 
张希全,葛世堂. 创伤性腋动脉损伤的腔内修复治疗[J]. 中国临床医学影像杂志,2017,28(9):657-659,664.
 [17] Biz  C, Maso G, Citterio S, et al. Acute deep venous thrombosis and late onset axillary artery injury after a displaced, proximal humerus fracture-dislocation in an octogenarian patient[J]. Aging Clin Exp Res, 2020, 32(6): 341-342.
 [18] Zhou  JB, Tian YF, Qiu YP, et al. Research progress of axillary vein puncture technique [J]. International Journal of Cardiovascular Diseases, 2022, 49(2): 72-74.(in Chinese) 
周靖博,田艳丰,仇裕鹏,等. 腋静脉穿刺技术研究进展[J]. 国际心血管病杂志,2022,49(2):72-74.
 [19] Fan  HY, Chen XCh, Wang YH, et al. Study on the safety of transfusion port catheter after ectopic transfusion in patients with breast cancer [J]. Journal of Regional Anatomy and Operative Surgery, 2020, 29(7): 586-589. (in Chinese) 
范海燕,陈显春,王寅欢,等. 乳腺癌患者输液港导管异位后安全性探讨[J].局解手术学杂志,2020,29(7):586-589.
 [20] Chen  TY, Yuan M, Yang BSh, et al. Clinical study on puncture mode of proximal segment of left axillary vein implanted into infusion port [J]. Journal of Interventional Radiology, 2021, 30(12): 1286-1291. (in Chinese) 
陈天佑,袁敏,杨柏帅,等. 经左侧腋静脉近侧段植入输液港穿刺方式临床研究[J]. 介入放射学杂志,2021,30(12):1286-1291.
 [21] Zheng  X, Wang YZh, Zhan Sh, et al. Research progress of cephalic venous arch stenosis [J]. Mixed Records of Kidney Disease and Dialysis Kidney Transplantation, 2023, 32(1): 84-89. (in Chinese) 
郑欣,王玉柱,詹申,等. 头静脉弓狭窄的研究进展[J]. 肾脏病与透析肾移植杂志,2023,32(1):84-89.
 [22] Yu  M, Wu YG, Chen LY, et al. Comparison of endoscopic axillary thoracic approach and breast approach in the treatment of unilateral thyroid micropapillary carcinoma [J]. Hebei Medicine, 2023, 45 (15): 2294-2297.(in Chinese) 
于铭,吴运舸,陈柳茵,等. 腔镜下经小切口腋胸入路与乳腺入路治疗单侧甲状腺微小乳头状癌的应用比较[J]. 河北医药,2023,45(15):2294-2297.
 [23] Jiang  GQ, Jiao FD, Yu TM, et al. Observation on the efficacy of transaxillary internal fixation in the treatment of Ideberg Ⅰ and Ⅱ scapular fractures[J]. Chinese Journal of Bone and Joint Injuries, 2023,38(1): 71-73. (in Chinese) 
姜刚强,焦福德,虞天明,等. 经腋窝入路内固定治疗IdebergⅠ、Ⅱ型肩胛骨骨折疗效观察[J]. 中国骨与关节损伤杂志,2023,38(1):71-73.
 [24] Yin  F, Shen H, Zhang J, et al. The value and imaging features of contrast-enhanced CT in the diagnosis of breast cancer and axillary lymph node metastasis [J]. Chinese Journal of CT and MRI, 2023, 21(7): 93-94,102. (in Chinese) 
尹峰,沈辉,张娟,等. 增强CT在乳腺癌诊断、腋窝淋巴结转移诊断中的价值及影像特征观察[J]. 中国CT和MRI杂志,2023,21(7):93-94,102.


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