肝内管道CT三维重建在囊性肝包虫病中的应用研究及意义  

Application and Significance of CT Three Dimensional Reconstruction of Hepatic Duct in Hepatic Hydatidosis

作　　者：杨宏强[1] 彭心宇[1] 张示杰[1] 牛建华[1] 宋发亮[2] 李勇[2] 王成伟[2] 孙红[1] 

机构地区：[1]新疆石河子大学医学院第一附属医院普外一科,新疆石河子832008 [2]新疆石河子大学医学院第一附属医院CT室,新疆石河子832008

出　　处：《实用放射学杂志》2006年第5期543-545,556,共4页Journal of Practical Radiology

基　　金：国家自然科学基金资助项目(No.30260108);新疆生产建设兵团医疗专项课题(No.NKB01SDXNK30YX)

摘　　要：目的探讨肝内肝动脉、肝静脉和胆道等管道系统的螺旋CT三维重建在囊性肝包虫病的应用研究及意义。方法8例囊性肝包虫病患者术前进行肝内管道包括肝动脉、肝静脉、门静脉及胆管螺旋CT造影扫描,多轴向投照容积重建法三维重建,观察分析三维重建图像中肝动脉、肝静脉、门静脉及胆管的主要分支显影、形态、分布、受压和移位情况,分别将肝包虫囊肿的空间位置关系,与“外膜内完整摘除术”中实际情况进行对照。结果肝脏螺旋CT三维重建图像清晰地显示病变与肝内管道的三维空间关系,包括管道的受压移位并与包虫囊肿呈半抱球状。部分肝门静脉、肝管左右支夹角增大,部分胆管壁嵌于包虫外囊壁内。8例“外膜内完整摘除术”均成功,术中证实三维图像与实际情况相符。结论利用CT三维重建技术,对囊性肝包虫进行术前的准确定位、对指导囊性肝包虫“外膜内完整摘除术”的操作具有重大指导意义。Objective To discuss the application and significance of three dimensional reconstruction of hepatic artery, hepatic veinw portal vein and bile duct in hepatic hydatidosis. Methods CT multi - projection volume reconstruction of hepatic artery, hepatic vein, portal vein and bile duct was performed after spiral CT scan before the sub - advititalpericystectomy operation in 8 cases of hepatic hydatidosis. The shape , distribution and the dislocation of the main branches of hepatic ducts and their spatial relationship with cyst on the three dimensionalimages were analysed. The three dimensional CT angiography and was compared with the actual conditions in operation. Results The spatial relationship between the hepatic duct system and hydatidosis was clearly showed by 3D CT images w including the pressing and semi - spherically or sphericaUy embraced the cysts of hepatic duct system ,the angle between main branches of portal vein and bile ducts was increased, and the part of bile ducts was embedded in the external layer of cysts. The operation was successful in all cases. The findings of 3D CT were corresponded with that of operation. Conclusion CT three dimensional reconstruction can give exact guidance to the sub advititalpericystectomy.

关 键 词：囊性肝包虫病 肝内管道 体层摄影术 X线计算机 三维重建 

分 类 号：R532.32[医药卫生—内科学] R575[医药卫生—临床医学]