目的 借助可视化3D影像认识肝脐裂静脉(Umbilical fissure vein,UFV)的解剖。 方法 回顾性分析2017年6月-2018年12月期间60例有肝胆相关疾病患者的影像资料,在可视化3D影像下分析肝脐裂静脉的发生率、脐裂静脉的走形及汇入方式、脐裂静脉与Ⅳb段肝静脉的关系。 结果 55例病人发现了UFV静脉,发生率91.6%。UFV发自肝左静脉的有49例,发生率89.1%(49/55);发自肝中静脉的4例,发生率7.3%(4/55);发自肝中肝左共干的2例,发生率3.6%(3/55),17例发现肝Ⅳb段汇入UFV,发生率为30.9%(17/55)。 结论 可视化3D影像对于术前辨明UFV及其走行有很大的帮助,有助于避免手术中的副损伤。
Abstract
Objective To investigate the ramification of the umbilical fissure vein based on the visual three-dimension imaging. Methods A total of 60 patients diagnosed with hepatobiliary diseases who had been received CT angiography scanning from Jun.2017 to Dec.2018 were observed and analyzed retrospectively. The incident rate, the form and afflux way of the umbilical fissure vein and the relationship between the umbilical fissure vein and the IVb hepatic vein were analyzed based on the visual 3D imaging. Results UFV was observed in 55 patients (incidence rate: 91.6%), while there were 49 cases arising from left hepatic vein (LHV) in the 55 cases of UFV (incidence rate: 89.1%), 4 cases arising from the middle hepatic vein(MHV) (incidence rate: 7.3%), 2 cases from the common trunk of the LHV and MHV(3.6%). There was 17 cases occurring segment IVb hepatic vein afflux into UFV. Conclusions There is great help for the visual 3D imaging to distinguish UFV and make surgery planning preoperative, which can avoid operative side injuries.
关键词
可视化3D影像 /
脐裂静脉 /
肝
Key words
Three-dimension imaging /
Umbilical fissure vein(UFV) /
Liver
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参考文献
[1] Nakamura S, Tsuzuki T. Surgical anatomy of the hepatic veins and the inferior vena cava[J]. Surg Gynecol Obstet, 1981, 152(1):43-50.
[2] Kawasaki S, Makuuchi M, Miyagawa S, et al. Extended lateral segmentectomy using intraoperative ultrasound to obtain a partial liver graft[J]. Am J Surg, 1996, 171(2):286-288.
[3] Tani K, Shindoh J, Akamatsu N, et al. Venous drainage map of the liver for complex hepatobiliary surgery and liver transplantation[J]. HPB (Oxford), 2016, 18(12):1031-1038.
[4] 董家鸿, 叶晟. 开启精准肝胆外科的新时代[J].中华普外科手术学杂志(电子版), 2016, 10(3):181-184.
[5] Leeuwen MSV, Fernandez MA, Es HWV, et al. Variations in venous and segmental anatomy of the liver: two- and three-dimensional MR imaging in healthy volunteers[J]. Am J Roentgenol, 1994, 162(6):1337-1345.
[6] 范应方, 项楠, 蔡伟, 等. 三维可视化技术在精准肝切除术前规划中的应用[J]. 中华肝外科手术学电子杂志, 2014, 3(5):8-11.
[7] Strasberg SM. Terminology of liver anatomy and liver resections: coming to grips with hepatic Babel[J]. J Am Coll Surg, 1997, 184(4):413-434.
[8] Mise Y, Satou S, Shindoh J, et al. Three-dimensional volumetry in 107 normal liver reveals clinically relevant intersegment variation in size[J]. HPB (Oxford),2014,16(5):439-447.
[9] Kobayashi K, Hasegawa K, Kokudo T, et al. Extended segmentectomy II to left hepatic vein: importance of preserving umbilical fissure vein to avoid congestion of segment III[J]. J Am Coll Surg,2017, 225(3): e5-e11.
[10] Silvestrini N, Coppola A, Ardito F, et al. Anatomical liver resection of segment 4a en bloc with the caudate lobe[J]. J Surg Oncol, 2016, 113(6):665-667.