3D技术指导下个体化肝静脉分型及其在肝脏肿瘤切除中的应用  

3D imaging-guided individualized hepatic vein typing: Application to liver tumor resection

作　　者：陈铁军[1] 唐云强[1] 唐辉[1] 江鹏[1] 

机构地区：[1]广州医科大学附属肿瘤医院肝胆肿瘤外科,广东省广州市510095

出　　处：《世界华人消化杂志》2013年第32期3479-3485,共7页World Chinese Journal of Digestology

摘　　要：目的:研究3D技术指导下个体化肝静脉分型,改变传统肝段切除肿瘤的方法为个体化、数字化切除.方法:收集50例因肝癌住院患者术前64排螺旋CT数据,运用三维重建软件进行肝脏三维重建,观察重建后的肝静脉的变异情况并对其分型,指导肝癌个体化切除.结果:肝静脉总体分型:A型:54.0%(27/50),B型:46.0%(23/50).肝右静脉分型:A型:72.0%(36/50),B型:20.0%(10/50),C型:4.0%(2/50),D型:4.0%(2/50).肝右静脉亚型:Ⅰ型:34.0%(17/50),Ⅱ型:56.0%(28/50),Ⅲ型:6.0%(3/50),Ⅳ型:8.0%(4/50).肝中静脉分型:A型:78.0%(39/50),B型:20.0%(10/50),C型:2.0%(1/50).肝左静脉分型:A型:82.0%(41/50),B型18.0%(9/50).结论:通过对肝静脉三维成像,对肝静脉的变异进行分型,对于肝脏手术中可保留更多正常肝组织,减少术后并发症的发生.AIM： To conduct 3D imaging-guided individual- ized typing of hepatic veins to provide a basis for digitalized liver segment resection. METHODS： Fifty hospitalized liver cancer pa- tients who underwent 64-row spiral CT preop- eratively were included. 3D reconstruction of the liver was performed of reconstructed hepatic to observe the variation veins and typing them. RESULTS： Hepatic veins were overall classified into two types： A （27/50, 54%） and B （23/50, 46%）. The right hepatic vein were classified into four types： A： （36/50, 72%）, B （10/50, 20%）, C （2/50, 4%）, and D （2/50, 4%）. The right hepaticvein was classified into four subtypes： I （17/50, 34%）, II （28/50, 56%）, III （3/50, 6%）, and IV （4/50, 8%）. The middle hepatic vein was classified into three types： A （39/50, 78%）, B （10/50, 20%）, and C （1/50, 2%）. The left hepatic vein was classi- fied into two types： A （41/50, 82%） and B （9/50, 18%）. CONCLUSION： 3D imaging-guided individual- ized hepatic vein typing can help retain more normal liver tissue and reduce the occurrence of postoperative complications in liver surgery.

关 键 词：肝静脉 解剖 肝切除 三维成像 

分 类 号：R735.7[医药卫生—肿瘤]