| 粟丽,余建群,彭礼清,张文钊,刘莹.多排螺旋CT静脉血管成像评估植入Cuff导管后的中心静脉[J].中国医学影像技术,2018,34(7):1014~1018 |
| 多排螺旋CT静脉血管成像评估植入Cuff导管后的中心静脉 |
| Multi-detector CT venography in assessment of central veins after implantation of tunneled-cuffed dialysis catheters |
| 投稿时间：2017-10-25 修订日期：2018-04-18 |
| DOI：10.13929/j.1003-3289.201710030 |
| 中文关键词: 导管 血栓形成 中心静脉 静脉造影术 体层摄影术,X线计算机 |
| 英文关键词:Catheters Thrombosis Central veins Phlebography Tomography,X-ray computed |
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| 中文摘要: |
| 目的 探讨多排螺旋CT静脉血管成像（MDCTV）对评估双腔带Cuff中心静脉导管植入术后，导管相关功能障碍的应用价值。方法 回顾性收集110例双腔带Cuff中心静脉导管植入术后慢性肾衰竭患者，均接受胸部MDCTV检查。观察静脉导管术后相关的CT特征，包括导管置入位置、导管尖端位置、血栓形成情况及相应位置、中心静脉狭窄或闭塞情况、侧支循环形成。结果 MDCTV示Cuff导管主要从右侧颈内静脉置入（102/110，92.73%），其次是左侧颈内静脉（5/110，4.55%）、右侧锁骨下静脉（2/110，1.82%）以及右侧头臂静脉（1/110，0.91%）。导管尖端主要位于右心房（57/110，51.82%）和上腔静脉（47/110，42.73%），少数在下腔静脉内（6/110，5.45%）。中心静脉留置导管术后血栓发生率为58.18%（64/110）。不同导管尖端位置血栓发生率差异无统计学意义（P>0.05）。血栓组（64例）留置导管时间明显长于非血栓组（46例），差异有统计学意义（P<0.05）。血栓主要发生于上腔静脉（41/64，64.06%）、右侧头臂静脉（23/64，35.94%）及右侧颈内静脉（14/64，21.86%），少许见于左侧头臂静脉（3/64，4.69%）、左侧颈内静脉（3/64，4.69%）和右侧锁骨下静脉（2/64，3.13%）。中心静脉发生狭窄或闭塞者共68例（68/110，61.82%），其中有22例累及多条静脉，其主要发生于右侧头臂静脉（45/68，66.18%）及右侧颈内静脉（28/68，41.18%）。结论 MDCTV技术可以较全面地评估中心静脉留置的带Cuff双腔导管。 |
| 英文摘要: |
| Objective To explore the application value of the multi-detector CT venography (MDCTV) in detection for abnormalities of central veins after implantation of tunneled-cuffed dialysis catheters (TDC).Methods Totally 110 patients with chronic renal failure who underwent central veins TDC implantation were retrospectively collected. All the patients received 3-dimensional thoracic CT imaging. Postoperative CT features were observed, including the insertion and location of catheters, amount of thrombi and the location in central veins, as well as central veins stenosis or occlusion.Results MDCTV showed that most TDC were inserted from the right internal jugular vein (RIJV; 102/110, 92.73%), followed by the left internal jugular vein (LIJV; 5/110, 4.55%), the right subclavian vein (RSV; 2/110, 1.82%) and the right innominate vein (RIV; 1/110, 0.91%). The catheter tip mainly located in the right atrium (57/110, 51.82%) and superior vena cava(SVA; 47/110, 42.73%), and a few in the inferior vena cava(IVA; 5.45%, 6/110). The incidence rate of thrombosis after TDC was 58.18% (64/110). There was no statistical difference in the incidence of thrombus among different catheter tip positions (P>0.05). The average duration of implanted TDC in the thrombosis group was significantly longer than that in the non-thrombosis group (P<0.05). In thrombosis group, venous thrombosis was mainly detected in the superior vena cava (SVA; 41/64, 64.06%), RIV (23/64, 35.94%) and RIJV (14/64, 21.86%), and less in the RSV (2/64, 3.13%), the left innominate vein (LIV; 3/64, 4.69%) as well as LIJV (3/64, 4.69%). There were 68 patients (68/110, 61.82%) with stenosis or occlusive disease in central veins, of which 22 patients were found with multi-venous conflation, mainly occurred in RIV (45/68, 66.18%) and RIJV (28/68, 41.18%).Conclusion MDCTV is an effective method in comprehensive evaluation on TDC implanted in central veins. |
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