目的 通过三维重建国人胆道系统，研究国人胆道走行及其解剖变异特点。 方法 利用海信计算机辅助手术系统对100例梗阻性胆道疾病患者的腹部CT数据进行三维重建，得到胆道三维模型，观察肝内胆道系统的走形，根据黄氏分型法（右后叶胆管、右前叶胆管与左肝管的汇入方式）以及是否存在副肝管对胆道进行分型。 结果 成功重建100例国人的胆道三维模型，观察到胆道有7种类型，54%（54例）拥有典型的胆道解剖结构（Ⅰ型）；46%（46例）有解剖变异，其中10%（10例）为Ⅱ型，14%（14例）为Ⅲ型，10%（10例）为Ⅳ型，2%（2例）为Ⅴ型，2%（2例）为Ⅵ型，此外有8%（8例）存在副肝管，其中6例同时伴有其他变异。 结论 通过三维重建模型，能清晰识别国人胆道系统走形及变异特点，发现新的胆道变异类型，有助于指导临床诊疗。
Abstract
Objective This study is aimed to explore the walking of biliary system and the characteristics of anatomic variation, by reconstructing the three-dimensional model of biliary system in Chinese people. Methods According to the abdominal CT data of 100 patients who suffer from obstructive disease of biliary tract, three-dimensional models were reconstructed by using the Hisense computer-aided surgery (CAS) system，and were used to analyze the movement of intrahepatic biliary system. The biliary tract was classified according to Huang’s classification, that is the confluent mode of right posterior bile duct, right anterior bile duct and left hepatic duct, and the presence or absence of accessory hepatic duct. Results The three-dimensional models of bile ducts were successfully reconstructed in 100 Chinese patients. Seven types of biliary ducts can be observed. 54 cases (54%) had typical biliary tract anatomy (type I). 46 cases (46%) had anatomical variations, of which 10 cases (10%) were type II variants, 14 cases (14%) were type III variants, 10 cases (10%) were type IV variants, 2 cases (2%) were type V variants, and 2 cases (2%) were type VI variants. In addition, 8 cases (8%) had accessory hepatic ducts, of which 6 cases were accompanied by other variants. Conclusions The path and variation characteristics of biliary system can be identified clearly, by reconstructed Chinese biliary system in three dimensions. To discover news types of biliary tract variation can guide clinical diagnosis and treatment.
关键词
三维重建 /
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胆道系统 /
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胆道变异
Key words
Three-dimensional reconstruction /
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Biliary tract system /
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Bile duct variation
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参考文献
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