Purpose To explore whether there are some rules in the relationship between inferior phrenic artery (IPA) originated from the abdominal aorta and the celiac trunk. Materials and Methods The origin of IPA in 200 patients (174 with abdomen scan and 26 with chest-abdomen scan) who underwent two-phase enhanced CT scan at Philips 256-slice helical CT were respectively observed. The relationship of the orifice position between IPA originated from the abdominal aorta and the celiac trunk was analysed. Results RIPA was shown in 200 cases with total 201 branches. LIPA was shown in 198 cases with total 203 branches. 2 cases of LIPA were not shown. Bilateral IPA originated from a common stem was seen in 48 of 200 cases (24％). RIPA originated from the celiac trunk in 70/201 cases(34.8％) , from the aorta in 82/201 cases(40.8％), from the right renal artery in 37/201cases (18.4％), from the right accessory renal artery in 4/201cases (2.0％) and from the lefi gastric artery in 8/201 cases (4％). LIPA originated from the celiac trunk in 113/203 cases (55.7％), from the aorta in 77/203 cases (37.g％), from the left gastric artery in 11/203 cases(5.4％) and from the spleen artery in 2/203 cases (1.0％). There are some rules in the relationship between the origin of IPA originated from the abdominal aorta (135cases) and the celiac trunk: ① 98.3％ of RIPA located in the 9-12 o'clock position relative to the wall of the aorta. LIPA and IPA which originated from a common stem located in the 12-3 o'clock position relative to the wall of aorta ; ② 80.0％ of IPA had orifice located 10mm upper or lower of the orifice of the celiac trunk and the remaining located 10mm lower than the orifice of the celiac trunk.③ 63.8％ of RIPA had the orifice located under the orifice of the celiac trunk. 43.4％ of LIPA and 54.2％ of IPA which originated from a common stem located upper than the orifice of the celiac trunk. ④ 86.8％ of IPA had the orifice located under the orifice of the celiac trunk. The nearer the orifice of IPA to the 9 or 3 o'clock position of the abdominal aorta wall, the farther the orifice of IPA to the orifice of the celiac trunk. If the orifice of IPA was near to the wall of the 12 o'clock position of the abdonunal aorta, 52.5％ of IPA had orifice located above the orifice of the celiac trunk. Conclusion There are some rules in the relationship between the IPA originated from abdominal aorta and the celiac trunk. Taking advantage of these rules could help interventional physicians to simplify the catheterization process and find the IPA quickly and exactly.%目的 探讨起源于腹主动脉的膈下动脉(inferior phrenic artery,IPA )与腹腔干的位置关系是否存在规律.资料与方法连续观察200 例行Philips 256 层螺旋CT 双期增强扫描(腹部174 例,胸腹联合26 例)患者IPA 起源、起源于腹主动脉的IPA 开口与腹腔干开口的位置关系.结果 200 例患者右膈下动脉(right inferior phrenic artery,RIPA )均显示,共201 支;198 例患者左膈下动脉(left inferior phrenic artery,LIPA )显示,2 例LIPA 未显示,共203 支.IPA 左右共干起源占24.0%(48/200).RIPA 起自腹腔干占34.8%(70/201),腹主动脉占40.8%(82/201),右肾动脉占18.4%(37/201),右副肾动脉占2.0%(4/201),胃左动脉占4.0%(8/201);LIPA 起自腹腔干占55.7%(113/203),腹主动脉占37.9%(77/203),胃左动脉占5.4% (11/203),脾动脉占1.0%(2/203).起源于腹主动脉的IPA(135 例)开口与腹腔干关系存在规律:①98.3%(57/58 )的RIPA 位于腹主动脉壁9 ～12 点位置,LIPA 及共干IPA 均位于腹主动脉壁12 ～3 点位置;②80.0%(108/135 )的IPA 开口位于腹腔干开口上下10mm 以内,其余20.0%(27/135 )均位于腹腔干开口下10mm 以外.③63.8%(37/58)的RIPA 开口在腹腔干开口下方,43.4%(23/53)的LIPA 及54.2%(13/24)的共干起源的IPA 开口在腹腔干开口上方.④IPA 开口位置越接近腹主动脉壁9 点或3 点位置时,其与腹腔干开口的距离越大,86.8%(46/53 )开口位于腹腔干开口下方;开口位置接近腹主动脉壁12 点位置时,52.5%(42/80 )的IPA 开口位于腹腔干上方.结论 起源于腹主动脉的IPA 与腹腔干的位置关系存在规律,结合这一规律,可简化血管介入科医师插管流程,更快捷、准确地找到IPA.
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