层螺旋CT肝脏血管成像评价横断位Couninaud肝脏分段法.doc

16层螺旋CT肝脏血管成像评价横断位Couninaud肝脏分段法 李 杨，杜 勇，杨汉丰，黄小华 （川北医学院附属医院放射科，四川 南充 637000） 摘要：目的 利用16层螺旋CT肝门静脉和肝静脉成像技术评价横断位Couninaud肝脏分段法是否能准确运用到肝段解剖的划分。方法 选择100例行上腹部CT检查的正常人进行门静脉和肝静脉成像，采用VR、MIP三维成像的方式，观察门静脉和肝静脉分支情况及利用门静脉属支追踪法分析门静脉和肝静脉的关系。结果 门静脉段级分支位于相应的肝段中，而肝静脉及其分支位于相应肝段间，肝静脉相邻各段门静脉分支可跨过肝静脉平面，肝段的分界不是简单的直线或者平面。结论 传统的横断解剖Couinaud肝脏分段法存在一定缺陷，三维门静脉和肝静脉成像可以用于肝段解剖的划分，采用门静脉属支追踪法对肝段描述可能更有临床价值。 关键词：门静脉；肝静脉；血管造影术；体层摄影术，X线计算机；肝段解剖 Evaluate of Couinaud,s segmengtation of the liver in transaxial imaging with 16-slice spiral CT angiography LI Yang, DU Yong, YANG Han-feng, HANG Xiao-hua (Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Sichuan Abstract: Objective The purpose of this study was to assess whether the Couinaud,s segmengtation of the liver in transaxial imaging was accurate indicator of hepatic segment with 16-slice spiral CT hepatic portography and venography. Methods A total of 100 healthy subjects underwent 16-slice spiral CT hepatic portography and venography. Three-dimensional maximum intensity projection(MIP) and volume rendering(VR) of the portal and hepatic venous structures were created. The portal and hepatic vein branches were observed and relationship between the portal and hepatic veins system were evaluated with tracking the branches of portal vein. Results Segmental branches of portal vein supplied correspondingly hepatic segment, and hepatic vein and its branches located between adjacent hepatic segment. Branches of portal vein could crosses the adjacent hepatic vein. The boundaries of hepatic segments were not simple straight lines or flat planes. Conclusion Couinaud,s segmengtation of the liver in transaxial imaging has limitation. Three-dimension(3D) angiography of portal and hepatic venous systems can be applied to divide hepatic segment accurately. Hepatic segment is analyzed by tracking the branches of portal vein that was more clinical value. Key words: portal vein; hepatic vein; angiography; tomography, X-ray computed; hepatic