Vertebra lumbalis seviyesinde Vena Cava Inferior'un çok kesitli bilgisayarlı tomografi ile morfometrik analizi
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Tarih
2015
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Yayıncı
Necmettin Erbakan Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Vena cava inferior (VCI) abdomen, pelvis, perine ve alt ekstremitelerdeki venöz kanı kalbin atrium dextrum'una drene eder. Günümüzde giderek popülerlik kazanan lumbal spinal cerrahi türlerinden, anterior cerrahi yaklaşımın en büyük dezavantajı VCI ve aorta abdominalis (AA)'in yaralanma riskidir. Bu çalışmada, anterior yaklaşım sırasında zarar görme riski bulunan VCI'nın komşuluk, lokalizayon, çap, açı gibi morfometrik verilerinin ve bu değerlerin cinsiyet, boy, kilo ve yaş demografik özellikler açısından karşılaştırılması amaçlanmıştır. Çalışma, Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Radyoloji Anabilim Dalı'nda çeşitli tıbbi gerekçeler ile çekilen, yaşları 50 ile 84 arasında değişen 200 (100 erkek ve 100 kadın) olgunun abdomen çok kesitli bilgisayarlı tomografi (ÇKBT) görüntüleri üzerinde gerçekleştirildi. Görüntüler iş istasyonuna (Leonardo Workstation, Siemens Medical Solutions Erlangen Germany) aktarıldı ve koronal-aksiyal-sagittal kesitlerde morfometrik veriler ve morfolojik varyasyon tipleri elde edildi. Değerlendirmeler sonucunda, VCI'nın regio iliocavalis'i erkeklerde ortalama %60, kadınlarda %68, tüm bireylerde %64 L4 seviyesinde tespit edildi. VCI'nın %73 sağda, regio iliocavalis'in %97 bifurcatio aorta (BA)'nın altında seyrettiği gözlendi. VCI'nın iliocaval açısı tüm bireylerde 60o (erkeklerde 56.53o ve kadınlarda 64.01o), iliocaval açı yüksekliği 2.99 cm olarak gözlendi. VCI'nın L1 ve L2 vertebralara uzaklığı, lordoz açısı (ILA) erkeklerde (2.65cm, 1.81cm ve 45,64o), kadınlarda (2.11cm, 1.42cm ve 52,14o) cinsiyetler arasında yüksek düzeyde anlamlılık; regio iliocavalis, L3 ve L4 vertebralara uzaklığı erkeklerde (0.65cm, 1.05cm ve 0.69cm), kadınlarda (0.49cm, 0.91cm ve 0.55cm) cinsiyetler arasında anlamlılık tespit edildi. V. iliaca communis dextra'nın regio iliocavalis'in 1 cm altındaki genişliği (IDG) (erkeklerde 1,41cm ve kadınlarda 1,31cm), v. iliaca communis sinistra'nın regio iliocavalis'in 1 cm altındaki genişliği (ISG) (erkeklerde 1,73cm kadınlarda 1,58cm) olarak gözlendi. Elde edilen bu sonuçların yeni planlanacak cerrahi girişimler sırasında cerrahlara katkı sağlayacağı ve bir farkındalık yaratacağı düşüncesindeyiz.
Inferior Vena Cava (IVC) drains the blood from abdomen, pelvis, perineum and lower extremity into the right atrium of the heart. The biggest disadvantage of the anterior surgical approach of lumbal spinal surgery which is increasingly popular today, is the risk of injury of IVC and abdominal aorta (AA). In this study it is aimed that measuring the value of morphometric datas such as diameter, neighbourhood, location, angle and height of the IVC, which is one of the vessels under the risk of injury during the anterior surgical approach, and comparing these with demographic values such as gender, height, body weight and age. The study was performed on the abdomen Multidetector Computed Tomography (MDCT) images for various medical resasons of 200 cases (100 male and 100 female) that ranged in age from 50 to 84 years at the Necmettin Erbakan Universtiy, Meram Faculty of Medicine, Department of Radiology. The images were transferred to work station (Leonardo Workstation, Siemens Medical Solutions Erlangen Germany) and morphometric datas and morphological variaton types were obtained from the evaluation of the coronal and sagittal images. As a result of the assesments, the confluence level of IVC was detected 60 % in males, 68 % in females and average % 64 in all individuals at 4th lumbal vertebra (L4)level. It was measured that IVC was at right of aorta in 73 % and located below the aortic bifurcation (AB) in 97 % of the cases. It is observed that the iliocaval angle of the IVC was 60 o in all individuals (56,53o in males and 64,01o in females), and the average height of angle of the ilioacaval region of IVC was as 2.99 cm. The distance of IVC to 1st lumbal vertebra (L1) and 2nd lumbal vertebra (L2) vertebra and the lordosis angle(ILA) was measured as (2,65cm ve 1,81cm and 45,64 o) in males and (2,11cm and 1,42cm and 52,14 o) in females a high level of significance between the sexes; the distance of IVC to iliocaval region, 3rd lumbal vertebra (L3) and L4 was measured as (0,65cm, 1,05cm and 0,69cm) in males and (0,49cm, 0,91cm and 0,55cm) in females significance between the sexes was detected. The width of the right common iliac vein,1cm below the iliocaval region, was measured as 1.41 cm in males and 1.31 cm in females; the width of the left common iliac vein,1cm below the iliocaval region, was measured as 1.73 cm in males and 1.58 cm in females. We believe that the obtained results will contribute to the surgeons during the planning of new surgery and raise awareness.
Inferior Vena Cava (IVC) drains the blood from abdomen, pelvis, perineum and lower extremity into the right atrium of the heart. The biggest disadvantage of the anterior surgical approach of lumbal spinal surgery which is increasingly popular today, is the risk of injury of IVC and abdominal aorta (AA). In this study it is aimed that measuring the value of morphometric datas such as diameter, neighbourhood, location, angle and height of the IVC, which is one of the vessels under the risk of injury during the anterior surgical approach, and comparing these with demographic values such as gender, height, body weight and age. The study was performed on the abdomen Multidetector Computed Tomography (MDCT) images for various medical resasons of 200 cases (100 male and 100 female) that ranged in age from 50 to 84 years at the Necmettin Erbakan Universtiy, Meram Faculty of Medicine, Department of Radiology. The images were transferred to work station (Leonardo Workstation, Siemens Medical Solutions Erlangen Germany) and morphometric datas and morphological variaton types were obtained from the evaluation of the coronal and sagittal images. As a result of the assesments, the confluence level of IVC was detected 60 % in males, 68 % in females and average % 64 in all individuals at 4th lumbal vertebra (L4)level. It was measured that IVC was at right of aorta in 73 % and located below the aortic bifurcation (AB) in 97 % of the cases. It is observed that the iliocaval angle of the IVC was 60 o in all individuals (56,53o in males and 64,01o in females), and the average height of angle of the ilioacaval region of IVC was as 2.99 cm. The distance of IVC to 1st lumbal vertebra (L1) and 2nd lumbal vertebra (L2) vertebra and the lordosis angle(ILA) was measured as (2,65cm ve 1,81cm and 45,64 o) in males and (2,11cm and 1,42cm and 52,14 o) in females a high level of significance between the sexes; the distance of IVC to iliocaval region, 3rd lumbal vertebra (L3) and L4 was measured as (0,65cm, 1,05cm and 0,69cm) in males and (0,49cm, 0,91cm and 0,55cm) in females significance between the sexes was detected. The width of the right common iliac vein,1cm below the iliocaval region, was measured as 1.41 cm in males and 1.31 cm in females; the width of the left common iliac vein,1cm below the iliocaval region, was measured as 1.73 cm in males and 1.58 cm in females. We believe that the obtained results will contribute to the surgeons during the planning of new surgery and raise awareness.
Açıklama
Doktora Tezi
Anahtar Kelimeler
Aorta Abdominalis, Vena Cava Inferior, Bifurcatio Aorta, Lordoz Açısı, Regio Iliocavalis, Abdominal Aorta, Aortic Bifurcation, Iliocaval Angle, Inferior Vena Cava, Lordosis Angle
Kaynak
WoS Q Değeri
Scopus Q Değeri
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Sayı
Künye
Keskinöz, E. N. (2015). Vertebra lumbalis seviyesinde Vena Cava Inferior'un çok kesitli bilgisayarlı tomografi ile morfometrik analizi. (Yayımlanmamış doktora tezi). Necmettin Erbakan Üniversitesi, Sağlık Bilimleri Enstitüsü Anatomi Anabilim Dalı, Konya.
