国人肝段在冠状断层上的划分  

Classification of Chinese Hepatic Segments on Coronal Planes

作　　者：赵振美[1] 刘树伟[2] 林祥涛[2] 巩念明[1] 李跃[1] 安淑红[1] 刘帅[1] 于连峰[1] 

机构地区：[1]泰山医学院解剖学教研室,271000 [2]山东大学医学院解剖学教研室

出　　处：《解剖与临床》2010年第1期3-6,共4页Anatomy and Clinics

基　　金：山东省自然科学基金资助项目（ZR2009CM037）;山东省卫生系统“1020”人才工程资助项目（200414）

摘　　要：目的：为肝内微小病变精确定位诊断和外科治疗提供冠状断层解剖学依据。方法：采用30例上腹部连续冠状断层标本、20例肝内门静脉和肝静脉解剖正常的薄层MSCT断层图像及其三维重建图像，在冠状断层上对其门静脉肝段进行精确划分。结果：经胆囊、门静脉左支及肝左静脉的冠状断面上，肝中静脉主干是划分右前上叶和左前下叶的识别标志，门静脉左支角部是左前下叶的段间裂识别标志，亦是右前上叶和左前下叶的亚段间裂识别标志。经肝门静脉主干的冠状断面上，门静脉右前支主干是右前上叶的段间裂识别标志，该层面以前为右前上叶的腹侧段，该层面以后则为右前上叶的背侧段。经网膜孔的冠状断面上、下腔静脉的右缘是划分尾状叶和右半肝的识别标志，门静脉右后支主干是划分右前上叶背侧段和右后下叶下段的标志，经下腔静脉和肝右静脉的冠状面上，肝右静脉主干是划分右前上叶的背侧段和右后下叶上段的标志；门静脉右后支主干是右后下叶的段间裂识别标志。结论：国人门静脉肝段在冠状断面上的精确划分，不仅有利于肝内微小病变的精确定位，且有利于探索新的和更加安全的外科术式。Objective：To provide anatomic evidence of coronal section for the precise allocation of hepatic minimal lesions and surgical treatment. Methods ： The serial coronal sections of 30 cadaveric epigastric zones, serial MSCT slice images and three-dimensional MSCT images of 20 patients whose intrahepatic portal veins and hepatic veins were normal, were used to explore the sectional precise manifestations of Chinese hepatic segments of portal veins on coronal planes. Results：On the coronal sections through gallbladder, left hepatic portal vein and left hepatic vein, the venae hepaticae intermediae is an identification mark, which divides right anterosuperior lobe and left anteroinferior lobe. The left branch angulus of portal vein is the mark of intersegmental fissure of left anteroinferior lobe and subintersegmental fissure of right and left anterosuperior lobes. On the coronal sections through main portal vein, the trunk of right anterior branch of portal vein indicates the intersegmental fissure of right anterosuperior lobe. The ventral segment of right anterosuperior lobe is in front of this section, whereas its dorsal segment is at the back. On the coronal section through epiploic foramen, the fight border of inferior vena cava is the demarcation of caudate lobe and right half liver. The trunk of right posterior branch of portal vein is the landmark of the dorsal segment of right anterosuperior lobe and the inferior segment of right posteroinferior lobe. On the coronal section through inferior vena cava and right hepatic vein, the trunk of right hepatic vein is the landmark separating the dorsal segment of right anterosuperior lobe from the superior segment of right posteroinferior lobe ; the trunk of right posterior branch of portal vein is the identification mark of intersegmental fissure of right posteroinferior lobe. Conclusions： The Chinese precise manifestations of hepatic segments of portal vein on coronal planes, not only contribute to the precise allocation of minimal lesions in liver, but also pr

关 键 词：肝段 断层解剖学 冠状断层 

分 类 号：R816.5[医药卫生—放射医学] R575[医药卫生—临床医学]