亚毫米CT观察肝外胆管的供血小动脉  

Sub millimeter CT observations of the blood supplying arterioles of extrahepatic bile duct

作　　者：王显龙[1,2] 方驰华[3] 全显跃[2] 杨剑[3] 贾洪顺[2] 梁波[2] 肖莉 江永焰[2] 

机构地区：[1]南方医科大学,广东省广州市510515 [2]南方医科大学珠江医院,影像中心,广东省广州市510282 [3]南方医科大学珠江医院,肝胆一科,广东省广州市510282 [4]广东省育才幼儿园二院,广东省广州市510080

出　　处：《中国组织工程研究》2012年第18期3305-3309,共5页Chinese Journal of Tissue Engineering Research

基　　金：2011国家自然基金面上项目(81170458)~~

摘　　要：背景:亚毫米CT扫描速度极快,有效减少了运动伪影,分辨力极高,可以观察到内径在1mm以下的小动脉。目的:采用亚毫米CT观察肝外胆管的供血小动脉。方法:纳入因各种原因需行上腹部亚毫米CT血管造影患者54例,利用连续薄层源图像观察,辅以多平面重组、最大密度投影、容积再现,观察小动脉起源、支数、分布优势,同时测量胆总管直径。结果与结论:54例图像中胆总管均为1支,走行无特殊,其中51例能观察到胰十二指肠上动脉,伴行于胆总管下段;其中7例胰十二指肠上动脉与胰十二指肠下动脉吻合成动脉弓,亦伴行下段胆总管;上段供血小动脉中11例为胆囊动脉近段,14例发自右肝动脉,2例发自肝固有动脉,1例发自肝总动脉,1例发自左肝动脉。下段胆管供血小动脉占优势者39例,上段供血小动脉占优势者10例,其余5例较为均衡。54例胆总管内径4-24(11.0±5.8)mm。表明胆总管上段供血脆弱,因此该区术中不宜盲目分离、结扎小血管;对于胆石症与肝胰良恶性占位的中老年患者,术前行上腹部CT血管造影检查是有必要的。BACKGROUND：Sub millimeter CT scan has the advantages of extremely high speed,reducing the motion artifacts and high resolution;it can be used to observe the arterioles with the diameter less than 1 mm.OBJECTIVE：To observe the blood supplying arterioles of extrahepatic bile duct by sub millimeter CT.METHODS：Fifty-four cases that need to perform the sub-millimeter CT angiography on the abdomen due to various reasons were selected,a continuous thin source image observation was used combined with multi-planar reconstruction,maximum intensity projection and volume rendering to observed the arteriolar origin,count and distribution dominance,as well as the bore of the common bile duct.RESULTS AND CONCLUSION：There were 54 images and one common bile duct in each image and there was no special running.The superior pancreaticoduodenal artery could be observed in 51 cases,accompanied by the inferior segment of common bile duct;in 7 cases,the superior and the inferior pancreaticoduodenal artery anastomosed to be artery arch,also accompanying inferior segment of common bile duct;in the superior blood supplying arterioles,11 cases were cystic artery proximal segment,14 patients from the right hepatic artery,2 patients from the hepatic artery,1 patient from the common hepatic artery and 1 patient from left hepatic artery.Thirty-nine cases of lower segment of bile duct blood supplying arterioles were in advantage,10 cases of upper segment of bile duct blood supplying arterioles were in advantage and the remaining 5 cases were in balance.The inside diameter of the common bile duct of the 54 cases were 4-14（11.0±5.8） mm.The inferior common bile duct supplying arteries are fragile,so the blind separation and the ligation of small blood vessels are not favorable during the operation.For cholelithiasis and liver and pancreatic malignant and benign space-occupying lesions in elderly patients,preoperative abdominal CT angiography examination is necessary.

关 键 词：胆总管 动脉 血供 计算机断层成像(CT) 血管造影 

分 类 号：R318[医药卫生—生物医学工程]