64层螺旋CT在门腔分流模拟穿刺角度测量中的应用及其意义  

Application of 64-Slice spiral CT on the measurement of the simulated puncture angle during intrahepatic portosystemic shunt

作　　者：王剑华[1] 周庭永[2] 杨新文[1] 吕发金[2] 张本斯[1] 张琳[2] 刘本菊[2] 

机构地区：[1]大理学院解剖学教研室,云南大理671000 [2]重庆医科大学,重庆400016

出　　处：《中国临床解剖学杂志》2010年第1期54-57,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的通过对非肝病患者及肝硬化患者模拟穿刺途径与门静脉右支及肝中、肝右静脉夹角的测量,以期为肝内门腔分流提供形态学资料。方法选取上腹部64-MSCT扫描非肝病被检查组共40例;肝硬化组符合纳入标准14例。用智能追踪技术启动扫描。并将所得数据在GEADW4.2工作站进行处理。结果无论正常组或肝硬化Child-PughA、B分级组,肝中、肝右静脉1、2、3cm和门静脉右支1、2cm间的模拟穿刺途径与肝静脉间夹角平均值呈减小趋势,而模拟穿刺途径与门静脉右支间夹角则依次增大。按照α=0.05标准认为正常组与肝硬化Child-PughA、B分级组模拟穿刺途径与肝中、肝右静脉和门静脉间夹角没有显著差异。结论TIPSS模拟穿刺途径与肝中、肝右静脉和门静脉右支间夹角变化方向相反。在肝中静脉2cm与门静脉2cm间穿刺较为适合。Objective To provide anatomic data for intrahepatic portosystemic shunt,by simulating puncture channel and measuring the angle between right branch of portal vein and intermediate hepatic veins or right hepatic veins.Methods 40 cases without liver diseases and 14 cases of cirrhosis underwent the upper abdomen 64-MSCT scan,which was initiated after the test of the celiac levels of abdominal aorta by the smart tracking technology（Smart Prep）.The imaging data was processed on the GE ADW4.2 workstations.Results Despite of normal or cirrhosis Child-Pugh A,B grade group,the puncture channels of right hepatic vein or middle hepatic vein about 1cm,2cm,3cm and right branch of portal vein about 1cm and 2cm,and the average angle between the hepatic veins,showed a decreased tendency,however,the puncture channel between the right branch of portal vein showed a increased tendency.There was no significant difference for puncture channels and angles among normal group and liver cirrhosis Child-Pugh A,B grade group.Conclusions The angle between the intermediate hepatic veins and right hepatic veins or right branch of portal vein is the opposite direction,compared to the simulated puncture channel.It is suitable to puncture between intermediate hepatic veins 2cm and right branch of portal vein 2cm.

关 键 词：64层螺旋CT 三维重建 肝内门腔分流 测量 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]