右半肝内门静脉的断层影像解剖学研究  

SECTIONAL AND IMAGING ANATOMY OF THE RIGHT HEMILIVER INTRAHEPATIC PORTAL VEIN

作　　者：赵振美[1] 刘树伟[1] 林祥涛[1] 刘学静[2] 李振平[1] 汤煜春[1] 马刚[1] 娄丽[2] 

机构地区：[1]山东大学医学院解剖学教研室 [2]山东省医学影像学研究所,济南250021

出　　处：《解剖学报》2008年第5期760-764,共5页Acta Anatomica Sinica

基　　金：山东省卫生系统“1020”人才工程资助项目(200414)

摘　　要：目的探讨右半肝内门静脉的走行、分布规律及门静脉肝裂和肝静脉的关系,进而为肝段的划分提供断层解剖学依据。方法使用30例上腹部连续断层标本(10例横断面、20例冠状面)以及20例多层螺旋CT图像和三维图像,探讨右半肝内门静脉的分支类型和常见变异以及肝内门静脉和肝静脉之间的关系。结果50例标本和图像中,右半肝内门静脉均可分为前上和后下两组分支。76%(38/50)的门静脉右前支的分支向后分布至肝右静脉后方的部分区域。40%(20/50)的门静脉右后支的起始部向尾侧发出的第一分支分布至肝右静脉前的部分区域。门静脉右前支的分布区域,越过肝中静脉偏向左侧,在15例无门静脉右支主干的标本和图像中尤其明显。肝右前叶无明显横裂存在。门静脉的亚段分型有显著的个体差异,且无优势分支类型。结论右半肝可分为右前上叶和右后下叶,两叶之间为一弯曲的"裂隙"。肝右前上叶有一恒定的纵裂存在。肝右静脉不是右叶间裂的准确定位标志,尤其在其上份和下份。肝中静脉不是正中裂的准确识别标志,尤其在门静脉右支主干缺如的人群中。Objective The purpose of this study was to evaluate the course, distribution characteristic of the right hemiliver intrahepatic portal vein. We also investigated the relationships between hepatic veins and portal hepatic fissures, including sectional anatomic data for the division of hepatic segments. Methods Using 30 successive sections of the upper abdomen of the adult cadavers （10 transverse, 20 coronal） and multi-slice computed tomography enhanced images and three- dimensional images of 20 patients, we investigated the branch pattern and common variation of right hemiliver intrahepatic portal veins and the relationship between the hepatic veins and intrahepatic portal veins. Results The intrahepatic portal vein of the right hemiliver can be divided into the anterior-superior and posterior-inferior group branches in all 50 specimens and images. In 38 （76%） of the 50 specimen and CT images, the branches of the right anterior portal vein supplied the area that was posterior to the right hepatic vein. In 20 （40%） of 50 specimen and CT images the first branch arising from the initial part of the right posterior portal vein towards the caudal supply the part area where anterior to the right hepatic vein. The blood-supply to the area of the right anterior portal vein expands to the left of the middle hepatic vein, especially in 15 patients whose right portal vein trunks was absent. There was no obvious transverse fissure in the right anterior lobe of liver. Further subdivision of the portal segments showed marked individual variability, with no prevailing branching pattern. Conclusion The right hemiliver could be divided into right anterior-superior and right posterior-inferior lobes, and there was a curved fissure between them. There was a constant longitudinal fissure in the right anterior-superior lobe of liver. In addition, the right hepatic vein was not an accurate indicator of the position of the right interlobar fissure especially in the superior part and inferior part. The middle hepatic vein was

关 键 词：肝内门静脉 肝段 断层解剖学 人 

分 类 号：R322.492[医药卫生—人体解剖和组织胚胎学]