文章摘要

子宫动脉造影解剖分析及其临床意义

作者: 1贺茜, 2王喻, 3邓靓雅, 3姜凯元, 3黄桁, 3莫帅佳, 4田东
1 川北医学院 医学影像学院,四川 南充 637000
2 川北医学院 转化医学研究中心,四川 南充 637000
3 川北医学院 基础医学院,四川 南充 637000
4 川北医学院 附属医院胸外科,四川 南充 637000
通讯: 田东 Email: 22tiandong@163.com
DOI: 10.3978/j.issn.2095-6959.2018.08.016
基金: 四川省教育厅科研基金(14ZB0203)。

摘要

目的:研究子宫动脉造影的解剖学特点,为临床子宫动脉栓塞术提供理论基础。方法:回顾性分析2013年1月至2016年7月经导管子宫动脉栓塞、灌注化疗的115例患者子宫动脉造影资料,观察子宫动脉的起源、走行及分支等影像学解剖特点。结果:收集115例患者的数字减影血管造影(digital subtraction angiography,DSA)资料,其中产后出血25例,异位妊娠73例,其他诊断类型17例。子宫动脉在髂内动脉有前干、后干、主干3处起始部位;子宫动脉起始段可呈锐角、直角、钝角3种方式发出;子宫动脉的主要分支包括卵巢支、子宫圆韧带支、子宫颈支、输卵管支、阴道支;子宫动脉起始处左侧横径为(2.77±0.96) mm,右侧横径为(2.74±0.92) mm;子宫动脉起始处至同侧髂总动脉分叉处距离左侧为(73.06±25.14) mm,右侧为(77.67±34.62) mm;产后出血病例中,子宫动脉起始处横径为(2.37±0.64) mm;异位妊娠病例中,子宫动脉起始处横径为(2.89±1.00) mm。异位妊娠,产后出血两种病例间双侧子宫动脉起始处直径差异有统计学意义(P<0.05);左右两侧子宫动脉起始处至同侧髂总动脉分叉处距离差异无统计学意义(P>0.05);左右两侧子宫动脉起始处横径差异无统计学意义(P>0.05)。结论:熟悉子宫动脉造影的解剖学特点,对提高手术成功率,正确选择栓塞方法及减少并发症有重要临床意义。
关键词: 子宫动脉;造影;解剖学

Anatomical analysis of uterine arteriography and its significance

Authors: 1HE Xi, 2WANG Yu, 3DENG Jingya, 3JIANG Kaiyuan, 3HUANG Heng, 3MO Shuaijia, 4TIAN Dong
1 Department of Medical Imaging, Affiliated Hospital of North Sichuan Medical College, Nanchong Sichuan 637000, China
2 Translational Medicine Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong Sichuan 637000, China
3 Department of Basic Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong Sichuan 637000, China
4 Department of Cardiothoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong Sichuan 637000, China

CorrespondingAuthor: TIAN Dong Email: 22tiandong@163.com

DOI: 10.3978/j.issn.2095-6959.2018.08.016

Foundation: This work was supported by the Scientific Research Foundation of the Education Department of Sichuan Province, China (14ZB0203).

Abstract

Objective: To investigate the anatomical features of uterine arteriography and provide theoretical basic for the clinical uterine artery embolization. Methods: The uterine artery angiography of 115 patients with uterine artery embolization and perfusion chemotherapy from January 2013 to July 2016 were retrospectively analyzed, the anatomical features of uterine artery origins, running and branches were observed. Results: The digital subtraction angiography (DSA) data of 115 patients were collected, including 25 cases of postpartum hemorrhage, 73 cases of ectopic pregnancy and 17 other diagnostic types. The uterine arteries originated from the anterior, the posterior, the branch trunk of iliac artery. The starting section can be a sharp, right and obtuse angle. The main branches including ovarian branch, round ligament of the uterus, fallopian tube branch, cervical and vagina branch. The average diameter of uterine arteries on the left side is (2.77±0.96) mm, the right side is (2.74±0.92) mm. The average distance between the ipsilateral iliac artery bifurcation and the left uterine artery is (73.06±25.14) mm, another side is (77.67±34.62) mm. In the cases of postpartum hemorrhage, the uterine artery diameter is (2.37±0.64) mm; as for the cases of ectopic pregnancy, the diameter is (2.89±1.00) mm. The differences about the diameter of the bilateral uterine arteries in the two cases were statistically significant (P<0.05); there is no significant difference between the distance from bilateral uterine arteries to the ipsilateral iliac artery bifurcation(P>0.05); both sides of uterine artery had no significant difference in diameter (P>0.05). Conclusion: It is of important clinical significance to be familiar with the anatomical characteristics of uterine arteriography, to improve the success rate, to select the method of embolization and to reduce the complications.
Keywords: uterine arteries; radiography; anatomy

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