目的 利用64排螺旋CT对上腔静脉(SVC)的解剖进行观察分析,为临床应用及相关研究提供基础.方法 回顾分析本院306例患者的胸部薄层增强CT影像资料,测量气管隆突水平SVC的左右径及前后径,分析性别和年龄因素在SVC管径测值差异性;另外分别记录SVC起始部及房腔交界对应椎体的位置.结果 306例患者气管隆突水平SVC左右径、前后径分别为(18.8±2.9)mm、(21.4±2.9)mm.左右径存在显著性别差异,但相同性别不同年龄组间比较差异无统计学意义;前后径无显著性别及年龄差异.68.6％的患者SVC起始部位于T3水平、81.7％的患者房腔交界位于T6～T7水平.结论 胸部薄层增强CT可以清晰显示SVC的解剖结构及毗邻关系,可为临床应用提供可靠的解剖依据.

Objective To investigate the anatomical parameters involved in positioning the tip of peripherally inserted central catheter( PICC) . Methods Imaging data of 334 patients underwent contrast-enhanced thin-slice chest CT scan in the Affiliated Cancer Hospital of Xiangya School of Medicine of Central South University from June 2013 to January 2015 were retrospectively analyzed. Absolute value of anatomical parameters including distance between the upper margin of the right clavicular notch( RSCJ) and atriocaval junction ( ACJ) , distance between RSCJ and pericardial reflection( PR) , distance between carina and ACJ, distance between carina and PR, distance between right tracheobronchial angle ( RTBA) and ACJ, distance between RTBA and PR ,and the length of superior vena cava were calculated respectively. Each absolute value of anatomical parameter was divided by the height of the sixth thoracic vertebra body unit ( T6 unit) , denoted as relative value of anatomical parameters correspondingly. Results The ACJs were identified at the level of T6 or T7 in 82%(274/334) of patients. The PRs were found at the level of T5 or T6 in 79. 3%(265/334) of patients. The absoulute distance and relative distance (mean ± SD) of carina-to-ACJ, carina-to-PR, RSCJ-to-ACJ, RSCJ-to-PR, RTBA-to-ACJ and RTBA-to-PR were (38. 4 ± 8. 8),(21. 9 ± 9. 2), (50. 7 ± 9. 1),(34. 2 ± 9. 4),(110. 2 ± 15. 9),(93. 7 ± 16. 3 )mm, and (1. 85 ± 0. 43), (1. 05 ± 0. 44), (2. 44 ± 0. 45),(1. 64 ± 0. 45), (5. 30 ± 0. 75),(4. 50 ± 0. 75), respectively. The correlation analysis showed the absolute values of anatomic parameters were highly related with the patients ’ heights ( P <0. 01), while the relative values were significantly weakened with the patients’ heights and the partial relative values of anatomic parameters were not related with the patients’ heights(P>0. 05). Conclusions due to the varied position of PR.