成人肝门静脉多层螺旋CT血管成像正常解剖研究  

Study of Normal Anatomy of Hepatic Portal Vein in Adult with Multislice Spiral CT Angiography

作　　者：齐战元[1,2] 李顺姬[1] 袁涛[1] 全冠民[1] 雷建明[1] 王颖杰[1] 

机构地区：[1]河北医科大学第二医院影像科,河北石家庄050000 [2]河北省井陉县中医院放射科

出　　处：《实用放射学杂志》2011年第2期218-222,共5页Journal of Practical Radiology

基　　金：河北省科技厅科技支撑计划资助项目（编号：0720611032D）;河北医科大学第二医院科研资助项目.

摘　　要：目的探讨16层螺旋CT肝门静脉成像对成人门静脉主干及主要分支、属支解剖形态的显示能力，确定不同性别血管最大管径的正常值。方法选取无影响门静脉系统疾病者227例行门静脉多层螺旋CT血管成像（MSCTA）。后处理技术包括最大强度投影（MIP）、曲面重组（CPR）及容积再现（VR）。观察MSCTA对门静脉主干及其分支、属支的显示能力。参照Couinaud方法分析门静脉解剖类型。测量门静脉系统主要血管的最大径，比较不同性别、年龄组之间有无差别。结果MSCTA对门静脉主干及其第1～4级分支、脾静脉、肠系膜上静脉显示率100％，可显示5级分支者208例（91．6％）、6级132例（58．1％）、7级19例（8．4％）。门静脉分支正常型约84．1％，Ⅰ型变异8．8％，Ⅱ型变异6．6％，Ⅳ型变异0．4％。肠系膜静脉解剖类型中Ⅰ型52．0％，Ⅱ型32．2％，Ⅲ型15．8％，各解剖类型比例接近文献报道。男性及女性门静脉主干95％参考值范围为10．4～17．0mm及9．9～15．0mm。门静脉系统主要血管不同性别血管最大径有显著统计学差异，不同年龄组之间门静脉左支及肠系膜上静脉最大管径无显著统计学差异，其余血管不同年龄组有差别。结论MSCTA能够很好地显示肝门静脉系统解剖。门静脉分支以常见型最多。男、女性门静脉系统血管径线均有明显差异。提示MSCTA上男、女性门静脉主干最大径不超过17mm及15mm。Objective To study the normal anatomy of portal vein and its main branches with 16--slice CT portal vein angiogra- phy,and to establish the normal range of maximum diameter of the portal vein and its branches. Methods 227 patients with no dis- eases influencing portal vein underwent conventional epigastric contrast--enhanced CT scan. The post--processing techniques included maximum intensity projection （MIP）, curved planar reformation（ CPR） and volume rendering（VR）. The capability of MSCTA for displaying the anatomy of portal vein system was evaluated The anatomic pattern of portal vein system was analyzed according to the method of Couinaud. The maximum diameters of portal vein and its main branches were measured and compared between the sex and age. Results The stem of portal vain and its first to forth branches,splenic vein,superior mesentric veim（SMV） were all revealed on MSCTA. The rates of display for the fifth to seventh branches of portal vein were 91.6%, 58.1 % and 8.4 %, separately. The normal division, type Ⅰ, Ⅱ and Ⅳ variation of portal vein were 84.1 %, 8.8 % and 6.6 %, respectively. The anatomic types of mesenteric vein included type Ⅰ （52.0%） , type Ⅱ （ 32.2%} and type Ⅲ（ 15.8% ） . These results were similar to that of the reports of other authors in literatures. 95% reference ranges of main portal vein were 10.4-17.0 mm and 9.9-15.0 mm in men and women respectively There was significant statistical difference in the maximum diameter of main branches of portal system between two genders. Except for the left division of portal vein and SMV , various difference was found among different ages for other branches of portal vein system . Conclusion MSCTA can display the portal vein and its main branches with good legibility. Normal division is the most

关 键 词：肝脏 门静脉 血管造影 体层摄影术 X线计算机 

分 类 号：R575[医药卫生—消化系统] R814.43[医药卫生—内科学]