目的 探讨根据CT检查数据建立肝周下腔静脉数字模型的可行性.方法 选取2013年1-5月沧州市中心医院120例受试者(无肝脏基础疾病者)的临床资料.分析受试者CT检查图像,设定肝周下腔静脉4个层次(P1:下腔静脉入右心房水平、P2:肝静脉根部汇入下腔静脉上缘水平、P4:下腔静脉肝脏下缘水平、P5:肾静脉根部汇入下腔静脉上缘水平)测量周长及各层次间的垂直距离.在假设肝周下腔静脉完全充盈前提下,利用周长计算出肝周下腔静脉各层次的理论直径(P1D、P2D、P3D、P4D),结合不同层次间垂直距离(P1P2L、P2P4L、P1P4L、P4P5L)推导关系式,制作肝周下腔静脉数字模型.对测量数据使用方差分析配对样本t检验及独立样本t检验,使用相关及回归方法分析数据间关系.结果 3例受试者同时缺失P1与P2层次数据,8例受试者缺失P4层次数据.各层次理论直径:P1D为(28.1±4.0)mm,P2D为(28.7±3.5)mm,P4D为(23.5 ±2.7)mm,P5D中位值为24.3 mm,P1-P2-P4层次间下腔静脉为一个中间略微突出的柱形立体结构.P1D-P2D,P2D-P4D,P1D-P4D之间直径差距比较,差异有统计学意义(F=77.5,P＜0.05).进一步分析发现P2D-P4D和P1D-P4D直径差距比较,差异有统计学意义(t=14.893,11.210,P＜0.05).各层次垂直距离:P1P2L中位值为7.5mm,P1P4L为(85.2±11.0)mm,P2P4L为(78.2±9.8)mm,P4P5L中位值为10.0 mm.P1D-P2D、P2D-P4D、P2D-P5D、P4D-P5D之间数据变化呈正相关(r=0.862,0.308,0.186,0.788,P＜0.05),P1D-P4D和P2D-P5D则无相关性(r=0.180,0.118,P＞0.05).P2D与体质量有关,P5D与年龄有关(r =0.200,0.130,P＜0.05).男性受试者和女性受试者的下腔静脉P1D、P2D、P4D和P5D分别为(28.5±3.7)mm和(27.8±4.2)mm、(29.0±3.4)mm和(28.5±3.6)mm、(23.9±2.8) mm和(23.1±2.5)mm、(24.3±2.6)mm和24.0 mm(非正态分析为中位数据),在不同性别之间理论直径比较,差异无统计学意义(t=0.911,0.809,1.588,1.902,P＞0.05).P1D和P2D与P1P2L呈负相关(r=-0.245,-0.160,P＜0.05),P1D而与P4P5L呈正相关(r=0.149,P＜0.05);P2D与P2P4L呈正相关(r=0.195,P＜0.05).P1P2L与受试者年龄、身高、体质量无关(r=-0.092,-0.047,-0.033,P＞0.05),P2P4L、P1P4L均与受试者年龄呈现负相关(r=-0.343,-0.371,P＜0.05),与体质量呈现正相关(r=0.271,0.208,P＜0.05),P4P5L与身高和体质量呈正相关(r =0.154,0.255,P＜0.05).不同性别间P1P2L、P1P4L、P2P4L、P4P5L比较,差异均无统计学意义(t=-1.046,-1.274,-0.908,1.375,P＞0.05).P2P4L长度接近肝后下腔静脉长度,推导出关系式:P2P4L(mm) =71.23-0.293×年龄(岁)+0.32×体质量(kg).结论 根据CT检查数据建立肝周下腔静脉数字模型简便可行,能为相关的临床研究提供实验依据.
目的 探討根據CT檢查數據建立肝週下腔靜脈數字模型的可行性.方法 選取2013年1-5月滄州市中心醫院120例受試者(無肝髒基礎疾病者)的臨床資料.分析受試者CT檢查圖像,設定肝週下腔靜脈4箇層次(P1:下腔靜脈入右心房水平、P2:肝靜脈根部彙入下腔靜脈上緣水平、P4:下腔靜脈肝髒下緣水平、P5:腎靜脈根部彙入下腔靜脈上緣水平)測量週長及各層次間的垂直距離.在假設肝週下腔靜脈完全充盈前提下,利用週長計算齣肝週下腔靜脈各層次的理論直徑(P1D、P2D、P3D、P4D),結閤不同層次間垂直距離(P1P2L、P2P4L、P1P4L、P4P5L)推導關繫式,製作肝週下腔靜脈數字模型.對測量數據使用方差分析配對樣本t檢驗及獨立樣本t檢驗,使用相關及迴歸方法分析數據間關繫.結果 3例受試者同時缺失P1與P2層次數據,8例受試者缺失P4層次數據.各層次理論直徑:P1D為(28.1±4.0)mm,P2D為(28.7±3.5)mm,P4D為(23.5 ±2.7)mm,P5D中位值為24.3 mm,P1-P2-P4層次間下腔靜脈為一箇中間略微突齣的柱形立體結構.P1D-P2D,P2D-P4D,P1D-P4D之間直徑差距比較,差異有統計學意義(F=77.5,P＜0.05).進一步分析髮現P2D-P4D和P1D-P4D直徑差距比較,差異有統計學意義(t=14.893,11.210,P＜0.05).各層次垂直距離:P1P2L中位值為7.5mm,P1P4L為(85.2±11.0)mm,P2P4L為(78.2±9.8)mm,P4P5L中位值為10.0 mm.P1D-P2D、P2D-P4D、P2D-P5D、P4D-P5D之間數據變化呈正相關(r=0.862,0.308,0.186,0.788,P＜0.05),P1D-P4D和P2D-P5D則無相關性(r=0.180,0.118,P＞0.05).P2D與體質量有關,P5D與年齡有關(r =0.200,0.130,P＜0.05).男性受試者和女性受試者的下腔靜脈P1D、P2D、P4D和P5D分彆為(28.5±3.7)mm和(27.8±4.2)mm、(29.0±3.4)mm和(28.5±3.6)mm、(23.9±2.8) mm和(23.1±2.5)mm、(24.3±2.6)mm和24.0 mm(非正態分析為中位數據),在不同性彆之間理論直徑比較,差異無統計學意義(t=0.911,0.809,1.588,1.902,P＞0.05).P1D和P2D與P1P2L呈負相關(r=-0.245,-0.160,P＜0.05),P1D而與P4P5L呈正相關(r=0.149,P＜0.05);P2D與P2P4L呈正相關(r=0.195,P＜0.05).P1P2L與受試者年齡、身高、體質量無關(r=-0.092,-0.047,-0.033,P＞0.05),P2P4L、P1P4L均與受試者年齡呈現負相關(r=-0.343,-0.371,P＜0.05),與體質量呈現正相關(r=0.271,0.208,P＜0.05),P4P5L與身高和體質量呈正相關(r =0.154,0.255,P＜0.05).不同性彆間P1P2L、P1P4L、P2P4L、P4P5L比較,差異均無統計學意義(t=-1.046,-1.274,-0.908,1.375,P＞0.05).P2P4L長度接近肝後下腔靜脈長度,推導齣關繫式:P2P4L(mm) =71.23-0.293×年齡(歲)+0.32×體質量(kg).結論 根據CT檢查數據建立肝週下腔靜脈數字模型簡便可行,能為相關的臨床研究提供實驗依據.
목적 탐토근거CT검사수거건립간주하강정맥수자모형적가행성.방법 선취2013년1-5월창주시중심의원120례수시자(무간장기출질병자)적림상자료.분석수시자CT검사도상,설정간주하강정맥4개층차(P1:하강정맥입우심방수평、P2:간정맥근부회입하강정맥상연수평、P4:하강정맥간장하연수평、P5:신정맥근부회입하강정맥상연수평)측량주장급각층차간적수직거리.재가설간주하강정맥완전충영전제하,이용주장계산출간주하강정맥각층차적이론직경(P1D、P2D、P3D、P4D),결합불동층차간수직거리(P1P2L、P2P4L、P1P4L、P4P5L)추도관계식,제작간주하강정맥수자모형.대측량수거사용방차분석배대양본t검험급독립양본t검험,사용상관급회귀방법분석수거간관계.결과 3례수시자동시결실P1여P2층차수거,8례수시자결실P4층차수거.각층차이론직경:P1D위(28.1±4.0)mm,P2D위(28.7±3.5)mm,P4D위(23.5 ±2.7)mm,P5D중위치위24.3 mm,P1-P2-P4층차간하강정맥위일개중간략미돌출적주형입체결구.P1D-P2D,P2D-P4D,P1D-P4D지간직경차거비교,차이유통계학의의(F=77.5,P＜0.05).진일보분석발현P2D-P4D화P1D-P4D직경차거비교,차이유통계학의의(t=14.893,11.210,P＜0.05).각층차수직거리:P1P2L중위치위7.5mm,P1P4L위(85.2±11.0)mm,P2P4L위(78.2±9.8)mm,P4P5L중위치위10.0 mm.P1D-P2D、P2D-P4D、P2D-P5D、P4D-P5D지간수거변화정정상관(r=0.862,0.308,0.186,0.788,P＜0.05),P1D-P4D화P2D-P5D칙무상관성(r=0.180,0.118,P＞0.05).P2D여체질량유관,P5D여년령유관(r =0.200,0.130,P＜0.05).남성수시자화녀성수시자적하강정맥P1D、P2D、P4D화P5D분별위(28.5±3.7)mm화(27.8±4.2)mm、(29.0±3.4)mm화(28.5±3.6)mm、(23.9±2.8) mm화(23.1±2.5)mm、(24.3±2.6)mm화24.0 mm(비정태분석위중위수거),재불동성별지간이론직경비교,차이무통계학의의(t=0.911,0.809,1.588,1.902,P＞0.05).P1D화P2D여P1P2L정부상관(r=-0.245,-0.160,P＜0.05),P1D이여P4P5L정정상관(r=0.149,P＜0.05);P2D여P2P4L정정상관(r=0.195,P＜0.05).P1P2L여수시자년령、신고、체질량무관(r=-0.092,-0.047,-0.033,P＞0.05),P2P4L、P1P4L균여수시자년령정현부상관(r=-0.343,-0.371,P＜0.05),여체질량정현정상관(r=0.271,0.208,P＜0.05),P4P5L여신고화체질량정정상관(r =0.154,0.255,P＜0.05).불동성별간P1P2L、P1P4L、P2P4L、P4P5L비교,차이균무통계학의의(t=-1.046,-1.274,-0.908,1.375,P＞0.05).P2P4L장도접근간후하강정맥장도,추도출관계식:P2P4L(mm) =71.23-0.293×년령(세)+0.32×체질량(kg).결론 근거CT검사수거건립간주하강정맥수자모형간편가행,능위상관적림상연구제공실험의거.
Objective To investigate the feasibility of establishing a digital model of juxtahepatic vena cava.Methods The clinical data of 120 participants (without liver diseases) who were admitted to the Cangzhou Central Hospital from January 2013 to May 2013 were collected.The results of computed tomography were analyzed.The diameters of juxtahepatic vena cava on different levels (P1 plane:inferior vena cava at the entrance to the right atrium,P2 plane:the upper margin of the roots of hepatic veins,P4 plane:lower boundary of liver,P5 plane:confluence of renal veins and inferior vena cava),and the circumference of the inferior vena cava and the lengths between these levels were recorded.A digital model of juxtahepatic vena cava was established by these data on the premise that the juxtahepatic vena cava was engorged.All data were analyzed using the analysis of variance,paired sample t test and independent samples t test,and correlation and regression were used in analysis of relations between there data.Results Data of the P1 plane and P2 plane were both missed in 3 cases,and the data of the P4 plane was missed in 8 cases.The theoretical diameter of hepatic vena cava at the P1,P2 and P4 planes were (28.1 ± 4.0) mm,(28.7 ± 3.5) mm and (23.5 ± 2.7) mm,respectively.The median diameter of hepatic vena cava at the P5 plane was 24.3 mm.The juxtahepatic vena cava was a 3 dimensional structure of cylinder with a slightly protruding middle part.There were significant differences in P1D-P2D,P2D-P4D,P1D-P4D (F =77.5,P ＜ 0.05).There were significant differences between P2D-P4D and P1D-P4D (t =14.893,11.210,P ＜ 0.05).The median length of hepatic vena cava between P1 and P2 planes was 7.5 mm.The lengths of hepatic vena cava between P1 and P4 planes,P2 and P4 planes were (85.2 ± 11.0)mm and (78.2 ±9.8)mm,respectively.The median length of hepatic vena cava between the P4 and P5 planes was 10.0 mm.P1D-P2D,P2D-P4D,P2D-P5D and P4D-P5D were positively correlated (r =0.862,0.308,0.186,0.788,P ＜ 0.05),while P1D-P4D and P2D-P5D did not correlated (r =0.180,0.118,P ＞0.05).P2D was correlated with the body weight,and P5 D was correlated with the age (r =0.200,0.130,P ＜ 0.05).The P1 D,P2D,P4D and P5 D of the inferior vena cava were (28.5 ± 3.7) mm,(29.0 ± 3.4) mm,(23.9 ± 2.8) mm and (24.3 ± 2.6) mm in males,and (27.8 ±4.2) mm,(28.5 ± 3.6) mm,(23.1 ± 2.5) mm and 24.0 mm in females.There were no significant difference in P1D,P2D,P4D and P5D between males and females (t =0.911,0.809,1.588,1.902,P ＞ 0.05).The length between P1 and P2 planes was negatively correlated with P1D and P2D (r =-0.245,-0.160,P ＜ 0.05),while the length between P4 and P5 planes was positively correlated with P1D (r =0.149,P ＜ 0.05).The length between P2 and P4 planes was positively correlated with P2D (r =0.195,P ＜ 0.05).The length between P1 and P2 planes did not correlated with the age,height and body weight (r =-0.092,-0.047,-0.033,P ＞ 0.05).The lengths between P2 and P4 planes,P1 and P4 planes were negatively correlated with the age (r =-0.343,-0.371,P ＜ 0.05),but positively correlated with the body weight (r =0.271,0.208,P ＜ 0.05).The length between P4 and P5 planes was positively correlated with the height and body weight (r =0.154,0.255,P ＜ 0.05).There were no significant difference in the lengths between P1 and P2 planes,P1 and P4 planes,P2 and P4 planes,P4 and P5 planes between males and females (t =-1.046,-1.274,-0.908,1.375,P ＞ O.05).The length between P2 and P4 planes was similar to the length of retrohepatic vena cava.The length between P2 and P4 planes(mm) =71.23-0.293 × age (years) +0.32 × body weight (kilogram).Conclusion The establishment of digital model of juxtahepatic vena cava based on the computed tomography imaging data is feasible,which provides basis for clinical investigation.
