多层螺旋CT三维成像下肾盂、肾盏及肾窦的解剖研究
发布时间：2018-07-28 18:51
【摘要】：目的探索肾盂、肾盏、肾窦的解剖结构及其相互间的关系并从中找出一定的规律,为临床诊断和治疗肾脏疾病进一步提供解剖学依据,为泌外器械造用、开发提供参考数据。方法收集无肾脏及肾周疾病、肾功能正常且需行腹部CT增强扫描的患者作为初步研究对象。签署知情同意书后,静脉注射造影剂,设定扫描范围和扫描参数,延迟90秒开始行东芝16排螺旋CT扫描,图像拆薄后传输至后处理工作站;运用VR(Volume rendering)、MIP(Maximum intensity projection)及MPR(Multi-planner reformation)技术三维重建;在VR图像上三维旋转观察肾盂肾盏充盈情况,并进行充盈评分,双侧肾脏充盈程度均大于等于8分者纳入测量研究对象。在VR图像上对肾盂形态、肾盏形态进行形态学观察,在MIP图像上对肾盂、肾盏进行相关测量,在MPR图像上对肾窦及肾门进行测量。所有数据运用SPSS19.0统计软件进行统计分析,以α=0.05为检验水准,α0.05有统计学差异,α0.01有显著统计学差异。结果1.肾盂分型中肾内型、中央型、肾外型所占比例分别为69.0%,26.2%和4.8%,左肾和右肾分布无统计学差异(p=0.812)。2.肾盂发育形态中,壶腹型、胚胎型、分支型和蜘蛛足型所占比例分别为92.9%,2.8%,3.2%和1.1%,左肾和右肾分布无统计学差异(p=0.129)。3.肾盂分盏处直径左肾为13.56±4.05mm,右肾为13.65±4.07mm,左肾和右肾无统计学差异(p=0.780),男性和女性无统计学差异(p=0.070)。4.upj(ureteropelvicjunction,肾盂输尿管连接处)直径左肾为4.35±1.22mm,右肾为4.22±1.23mm,左肾和右肾无统计学差异(p=0.318),男性和女性无统计学差异(p=0.425)。5.肾大盏类型中,三大盏占59.9%,两大盏占38.1%,特殊型占2%,左肾和右肾无统计学差异(p=0.407)。6.肾大盏盏颈长径,左肾上盏为18.98±5.32mm,右肾上盏为18.49±4.94mm;左肾中盏为9.21±4.72mm,右肾中盏为9.06±3.80mm;左肾下盏为14.10±3.40mm,右肾下盏为13.94±3.30mm;左肾和右肾无统计学差异(p0.05),男性和女性无统计学差异(p0.05)。7.肾大盏盏颈宽径,左肾上盏为4.30±1.96mm,右肾上盏为4.83±2.28mm;左肾中盏为4.38±2.81mm,右肾中盏为4.39±2.66mm;左肾下盏为6.11±2.77mm,右肾下盏为6.54±2.76mm;左肾和右肾有统计学差异(p0.05),男性和女性有统计学差异(p0.05)。8.肾小盏数量,左肾为9.78±1.96个,右肾为9.63±2.14个,左肾和右肾无统计学差异(p=0.081),男性和女性无统计学差异(p=0.079)。9.肾小盏颈部分型中,有颈型、半颈型、无颈型所占比例分别为75%,2.9%和22.1%,左肾和右肾有统计学差异(p0.01)。10.肾小盏盏面形态,平凹型、平凸型所占比例分别为85.2%和14.8%;肾小盏盏颈位置,居中型、偏移型所占比例分别为67.5%和32.5%;左肾和右肾无统计学差异(p0.05)。11.肾小盏盏面直径,左肾为6.37±1.40mm,右肾为6.53±1.40mm;肾小盏盏颈直径,左肾为4.67±1.37mm,右肾为4.82±1.40mm;左肾和右肾有统计学差异(p0.05),男性和女性有统计学差异(p0.01)。12.肾小盏盏颈高径,左肾为5.39±1.36mm,右肾为5.37±1.53mm;肾小盏盏面与盏颈夹角,左肾为91.75±5.71°,右肾为91.31±6.66°,左肾和右肾无统计学差异(p0.05),男性和女性无统计学差异(p0.05)。13.肾窦长径,左肾为58.40±9.23mm,右肾为55.05±9.06mm;肾窦宽径,左肾为17.81±4.69mm,右肾为17.27±4.84mm;肾窦厚径,左肾为15.44±6.56mm,右肾为12.35±4.15mm;左肾和右肾有统计学差异(p0.05),男性和女性有统计学差异(p0.05)。14.肾窦深度,左肾为34.90±4.59mm,右肾为35.29±5.35mm;肾门高度,左肾为26.46±7.27mm,右肾为22.86±6.32mm;左肾和右肾有统计学差异(p0.05),男性和女性有统计学差异(p0.05)。15.肾大盏上盏、中盏、下盏长径与肾小盏长径具有相关性,相关度和p值分别为(r=0.351,p0.01),(r=0.312,p0.01),(r=0.195,p0.01)。16.肾大盏上盏、中盏、下盏长径与肾窦长径具有相关性,相关度和p值分别为(r=0.278,p0.01),(r=0.133,p0.01),(r=0.272,p0.01)。17.肾大盏上盏、中盏、下盏宽径与肾小盏宽径具有相关性,相关度和p值分别为(r=0.449,p0.01),(r=0.481,p0.01),(r=0.459,p0.01)。18.肾小盏数量与肾小盏面径、颈宽、颈高具有相关性,相关度和P值分别为(r=-0.183,p0.01),(r=-0.175,p0.01),(r=-0.156,p0.01),和肾小盏盏面与盏颈夹角无相关性(r=-0.017,p=0.727)。结论1.肾盂分型和肾盂发育形态分型变异较大,不同型别所占比例,左肾和右肾无差异,不同性别之间无差异。2.肾盂分盏处直径和UPJ直径变异较大,左肾和右肾无差异,不同性别之间无差异。3.肾大盏盏颈长径左肾和右肾无差异,不同性别之间无差异。肾大盏盏颈宽径右肾比左肾宽,女性比男性宽。4.肾小盏数量无性别及左右肾差异。肾小盏盏面直径、盏颈直径右肾比左肾宽,女性比男性宽。肾小盏高径及肾小盏盏面与盏颈夹角左肾和右肾无差异,不同性别之间无差异。5.肾窦大小男性比女性大,左肾比右肾大。肾门高度男性比女性高,左肾比右肾高。肾窦深度男性比女性深,而左肾和右肾无明显差异。6.肾大盏长径、宽径与肾小盏长径、宽径成正相关。肾小盏数量与肾小盏面径、颈宽、颈高成负相关。
[Abstract]:Objective to explore the anatomical structure of the renal pelvis, the renal calyx and the renal sinus and the relationship between them and to find some rules to provide the anatomical basis for the clinical diagnosis and treatment of renal diseases, and to provide reference data for the development of the external instruments. Methods to collect no renal and perirenal diseases, normal renal function and need abdominal CT enhanced scan. After signing informed consent book, after signing informed consent book, intravenous contrast agent, set scanning range and scanning parameters, delay 90 seconds to start the Toshiba 16 row spiral CT scan, image dismantling after transmission to post processing workstation; VR (Volume rendering), MIP (Maximum intensity projection) and MPR (Multi-planner reformation) Three dimensional reconstruction of the renal pelvis and renal calyx was observed on the VR image. The filling score of the renal pelvis and kidney was observed and the filling degree of the kidney was more than equal to 8. The morphology of the renal pelvis and the calyx was observed on the VR image, the renal pelvis and the calyx were measured on the MIP image, and on the MPR image. The renal sinus and the renal portal were measured. All the data were statistically analyzed by SPSS19.0 software. Alpha 0.05 was tested, alpha 0.05 had statistical differences. There were significant differences in alpha 0.01. Results the proportion of renal type, central type and renal type in 1. renal pelvis was 69%, 26.2% and 4.8%, and the distribution of left kidney and right kidney was not statistically poor. In p=0.812.2. renal pelvis, the proportion of ampulla, embryonal, branch and spider foot were 92.9%, 2.8%, 3.2% and 1.1% respectively. There was no statistical difference between the left kidney and right kidney (p=0.129), the left kidney of the.3. pyelonephrosis was 13.56 + 4.05mm, the right kidney was 13.65 + 4.07mm, and there was no statistical difference between the left kidney and the right kidney (p=0.780), male and female. There was no statistical difference (p=0.070).4.upj (ureteropelvicjunction, ureteropelvic junction) in diameter of left kidney was 4.35 + 1.22mm, right kidney was 4.22 + 1.23mm, there was no statistical difference between left kidney and right kidney (p=0.318). There was no statistical difference between male and female (p=0.425).5. kidney type, three large calyx 59.9%, two large 38.1%, special type 2%, left kidney. There was no statistical difference between the right kidney (p=0.407).6. renal calyx long diameter, left renal calyx 18.98 + 5.32mm, right renal calyx 18.49 + 4.94mm, left renal calyx 9.21 + 4.72mm, right renal calyx 9.06 + 3.80mm, left renal calyx 14.10 + 3.40mm, right kidney lower 13.94 + 3.30mm, left kidney and right kidney no statistical difference (P0.05), male and female no statistics The difference (P0.05).7. renal calyx wide diameter, left renal calyx 4.30 + 1.96mm, right renal calyx 4.83 + 2.28mm, left renal calyx 4.38 + 2.81mm, right renal calyx 4.39 + 2.66mm; left kidney 6.11 + 2.77mm, the right kidney is 6.54 + 2.76mm; left kidney and right kidney have statistical difference (P0.05), male and female have statistical difference (P0.05).8. kidney small kidneys The number of calyx, left kidney was 9.78 + 1.96, right kidney was 9.63 + 2.14, left kidney and right kidney had no statistical difference (p=0.081), there was no statistical difference between male and female (p=0.079).9. kidney small cervix part, there were neck, half neck type, 75%, 2.9% and 22.1%, left kidney and right kidney had statistical difference (P0.01).10. kidney calyccap shape The proportion of state, flat concave and flat convex were 85.2% and 14.8%, respectively, the proportion of the small calygal cervix position, the middle type and the offset type were 67.5% and 32.5%, the left kidney and right kidney had no statistical difference (P0.05).11. kidney small calyx diameter, left kidney 6.37 1.40mm, right kidney 6.53 + 1.40mm; small calyx neck diameter, left kidney 4.67 + 1.37mm, right kidney 4. There was a statistical difference between the left kidney and the right kidney (P0.05). There was a statistical difference between the left kidney and the right kidney (P0.01) (P0.01) the high diameter of the small calyx in.12. kidney, the left kidney was 5.37 + 1.36mm, the right kidney was 5.37 + 1.53mm, the small calyx and the cervix angle, the left kidney was 91.75 + 5.71 degrees, the right kidney was 91.31 + 6.66 degrees, and there was no statistical difference between the left kidney and the right kidney (P0.05). There was no difference between the male and the female. Statistical difference (P0.05).13. renal sinus length, left kidney was 58.40 + 9.23mm, right kidney was 55.05 + 9.06mm, renal sinus wide diameter, left kidney 17.81 + 4.69mm, right kidney 17.27 + 4.84mm, renal sinus thickness, left kidney 15.44 + 6.56mm, right kidney 12.35 + 4.15mm, left kidney and right kidney were statistically different (P0.05), male and female had statistical difference (P0.05).14. renal sinus depth The left kidney was 34.90 + 4.59mm, the right kidney was 35.29 + 5.35mm, the renal portal height, the left kidney was 26.46 + 7.27mm, the right kidney was 22.86 + 6.32mm, the left kidney and the right kidney had statistical difference (P0.05). There were statistically significant differences between the male and the female (P0.05) the upper calycate of the.15. kidney, the middle and lower calycate length were correlated with the length of the kidney, and the correlation and P value were respectively (r=0.351, P0). .01), (r=0.312, P0.01), (r=0.195, P0.01).16. renal calys, the middle calyx and the length of the lower calyx have correlation with the length of the renal sinus. The correlation and P values are (r=0.278, P0.01), (r=0.133, P0.01), and the width of the kidney is correlated with the width of the kidney. 1, P0.01), the number of (r=0.459, P0.01).18. small renal calyx was correlated with the diameter of the small calyx, neck width and neck height, and the correlation and P values were (r=-0.183, P0.01), (r=-0.175, P0.01), (r=-0.156, P0.01), and no correlation between the small calycex and the angle of the cervix. Conclusion the 1. renal pelvis and pyelodevelopment patterns were different. There was no difference between the left kidney and the right kidney. There was no difference between the.2. pyelonephrosis and the diameter of the UPJ. There was no difference between the left kidney and the right kidney. There was no difference between the.3. and the right kidneys in the different sex. There was no difference between the left kidney and the right kidney in the different sexes. The number of male wide.4. kidneys had no sex and left and right kidney differences. The diameter of the small calyx of the kidney, the diameter of the right kidney of the cervix diameter was larger than that of Zuo Shenkuan, and the female was wider than that of the male. There was no difference between the small calyx of the kidney and the small calyx of the kidney and the left kidney and right kidney of the cervix. There was no difference between the male and the right kidney in the size of the.5. renal sinus and the greater of the left kidney. Compared with the female, the left kidney was higher than the right kidney. The depth of the renal sinus was deeper in male than in the female. There was no significant difference between the left kidney and the right kidney in the long diameter of the.6. kidney. The width of the kidney was positively correlated with the length of the kidneys and the width of the kidneys. The number of small renal calys was negatively related to the size of the small calyx, the neck width and the neck height.
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R692;R322.61
本文编号：2151272
[Abstract]:Objective to explore the anatomical structure of the renal pelvis, the renal calyx and the renal sinus and the relationship between them and to find some rules to provide the anatomical basis for the clinical diagnosis and treatment of renal diseases, and to provide reference data for the development of the external instruments. Methods to collect no renal and perirenal diseases, normal renal function and need abdominal CT enhanced scan. After signing informed consent book, after signing informed consent book, intravenous contrast agent, set scanning range and scanning parameters, delay 90 seconds to start the Toshiba 16 row spiral CT scan, image dismantling after transmission to post processing workstation; VR (Volume rendering), MIP (Maximum intensity projection) and MPR (Multi-planner reformation) Three dimensional reconstruction of the renal pelvis and renal calyx was observed on the VR image. The filling score of the renal pelvis and kidney was observed and the filling degree of the kidney was more than equal to 8. The morphology of the renal pelvis and the calyx was observed on the VR image, the renal pelvis and the calyx were measured on the MIP image, and on the MPR image. The renal sinus and the renal portal were measured. All the data were statistically analyzed by SPSS19.0 software. Alpha 0.05 was tested, alpha 0.05 had statistical differences. There were significant differences in alpha 0.01. Results the proportion of renal type, central type and renal type in 1. renal pelvis was 69%, 26.2% and 4.8%, and the distribution of left kidney and right kidney was not statistically poor. In p=0.812.2. renal pelvis, the proportion of ampulla, embryonal, branch and spider foot were 92.9%, 2.8%, 3.2% and 1.1% respectively. There was no statistical difference between the left kidney and right kidney (p=0.129), the left kidney of the.3. pyelonephrosis was 13.56 + 4.05mm, the right kidney was 13.65 + 4.07mm, and there was no statistical difference between the left kidney and the right kidney (p=0.780), male and female. There was no statistical difference (p=0.070).4.upj (ureteropelvicjunction, ureteropelvic junction) in diameter of left kidney was 4.35 + 1.22mm, right kidney was 4.22 + 1.23mm, there was no statistical difference between left kidney and right kidney (p=0.318). There was no statistical difference between male and female (p=0.425).5. kidney type, three large calyx 59.9%, two large 38.1%, special type 2%, left kidney. There was no statistical difference between the right kidney (p=0.407).6. renal calyx long diameter, left renal calyx 18.98 + 5.32mm, right renal calyx 18.49 + 4.94mm, left renal calyx 9.21 + 4.72mm, right renal calyx 9.06 + 3.80mm, left renal calyx 14.10 + 3.40mm, right kidney lower 13.94 + 3.30mm, left kidney and right kidney no statistical difference (P0.05), male and female no statistics The difference (P0.05).7. renal calyx wide diameter, left renal calyx 4.30 + 1.96mm, right renal calyx 4.83 + 2.28mm, left renal calyx 4.38 + 2.81mm, right renal calyx 4.39 + 2.66mm; left kidney 6.11 + 2.77mm, the right kidney is 6.54 + 2.76mm; left kidney and right kidney have statistical difference (P0.05), male and female have statistical difference (P0.05).8. kidney small kidneys The number of calyx, left kidney was 9.78 + 1.96, right kidney was 9.63 + 2.14, left kidney and right kidney had no statistical difference (p=0.081), there was no statistical difference between male and female (p=0.079).9. kidney small cervix part, there were neck, half neck type, 75%, 2.9% and 22.1%, left kidney and right kidney had statistical difference (P0.01).10. kidney calyccap shape The proportion of state, flat concave and flat convex were 85.2% and 14.8%, respectively, the proportion of the small calygal cervix position, the middle type and the offset type were 67.5% and 32.5%, the left kidney and right kidney had no statistical difference (P0.05).11. kidney small calyx diameter, left kidney 6.37 1.40mm, right kidney 6.53 + 1.40mm; small calyx neck diameter, left kidney 4.67 + 1.37mm, right kidney 4. There was a statistical difference between the left kidney and the right kidney (P0.05). There was a statistical difference between the left kidney and the right kidney (P0.01) (P0.01) the high diameter of the small calyx in.12. kidney, the left kidney was 5.37 + 1.36mm, the right kidney was 5.37 + 1.53mm, the small calyx and the cervix angle, the left kidney was 91.75 + 5.71 degrees, the right kidney was 91.31 + 6.66 degrees, and there was no statistical difference between the left kidney and the right kidney (P0.05). There was no difference between the male and the female. Statistical difference (P0.05).13. renal sinus length, left kidney was 58.40 + 9.23mm, right kidney was 55.05 + 9.06mm, renal sinus wide diameter, left kidney 17.81 + 4.69mm, right kidney 17.27 + 4.84mm, renal sinus thickness, left kidney 15.44 + 6.56mm, right kidney 12.35 + 4.15mm, left kidney and right kidney were statistically different (P0.05), male and female had statistical difference (P0.05).14. renal sinus depth The left kidney was 34.90 + 4.59mm, the right kidney was 35.29 + 5.35mm, the renal portal height, the left kidney was 26.46 + 7.27mm, the right kidney was 22.86 + 6.32mm, the left kidney and the right kidney had statistical difference (P0.05). There were statistically significant differences between the male and the female (P0.05) the upper calycate of the.15. kidney, the middle and lower calycate length were correlated with the length of the kidney, and the correlation and P value were respectively (r=0.351, P0). .01), (r=0.312, P0.01), (r=0.195, P0.01).16. renal calys, the middle calyx and the length of the lower calyx have correlation with the length of the renal sinus. The correlation and P values are (r=0.278, P0.01), (r=0.133, P0.01), and the width of the kidney is correlated with the width of the kidney. 1, P0.01), the number of (r=0.459, P0.01).18. small renal calyx was correlated with the diameter of the small calyx, neck width and neck height, and the correlation and P values were (r=-0.183, P0.01), (r=-0.175, P0.01), (r=-0.156, P0.01), and no correlation between the small calycex and the angle of the cervix. Conclusion the 1. renal pelvis and pyelodevelopment patterns were different. There was no difference between the left kidney and the right kidney. There was no difference between the.2. pyelonephrosis and the diameter of the UPJ. There was no difference between the left kidney and the right kidney. There was no difference between the.3. and the right kidneys in the different sex. There was no difference between the left kidney and the right kidney in the different sexes. The number of male wide.4. kidneys had no sex and left and right kidney differences. The diameter of the small calyx of the kidney, the diameter of the right kidney of the cervix diameter was larger than that of Zuo Shenkuan, and the female was wider than that of the male. There was no difference between the small calyx of the kidney and the small calyx of the kidney and the left kidney and right kidney of the cervix. There was no difference between the male and the right kidney in the size of the.5. renal sinus and the greater of the left kidney. Compared with the female, the left kidney was higher than the right kidney. The depth of the renal sinus was deeper in male than in the female. There was no significant difference between the left kidney and the right kidney in the long diameter of the.6. kidney. The width of the kidney was positively correlated with the length of the kidneys and the width of the kidneys. The number of small renal calys was negatively related to the size of the small calyx, the neck width and the neck height.
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R692;R322.61
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