腹腔镜下右半结肠癌根治术术前CTA评价Henle干变异的价值  

Evaluation of henle trunk variation by CT angiography before laparoscopic right colon cancer resection

作　　者：王庆国[1] 秦俭[1] 李念云 解学乾[1] WANG Qin-guo;QIN Jian;LI Lian-yun(Department of Radiology,the First Affiliated People's Hospital of Shanghai Jiaotong University,Shanghai 200080,China)

机构地区：[1]上海交通大学附属第一人民医院放射科,上海200080

出　　处：《放射学实践》2021年第8期1038-1041,共4页Radiologic Practice

摘　　要：目的:采用CT血管成像对Henle干解剖变异进行评估,为腹腔镜下右半结肠癌根治术提供参考。方法:搜集在本院行腹腔镜下右半结肠癌根治术的70例患者的病例资料。所有患者术前一周内行全腹CTA检查,对Henle干解剖类型、大小、Henle干汇入外科干角度及外科干长度进行评估。结果:70例中,66例(94.3%)患者成功行Henle干CT三维图像重组,1例患者Henle干受转移淋巴结侵犯无法进行三维重组,3例患者因既往行胃肠手术而导致Henle干无法评估。根据引流到Henle干的静脉数目,将66例成功行Henle干CT三维重组的患者分为4种类型:0型(无结肠引流静脉)、Ⅰ型(一条结肠引流静脉)、Ⅱ型(两条结肠引流静脉)和Ⅲ型(三条结肠引流静脉),出现率分别为9.10%(n=6)、68.18%(n=45)、19.70%(n=13)和3.00%(n=2)。Henle干的管径为(4.93±1.19)mm,长度为(15.82±8.18)mm,Henle干汇入外科干的角度为95.68°±21.34°,外科干长度为(38.68±8.26)mm。结论:CT血管成像及三维图像重组可较准确的显示Henle干及其主要属支,可为腹腔镜下右半结肠癌根治术提供有价值的解剖信息。Objective:To evaluate the anatomical variations of Henle trunk using three-dimensional computed tomography angiography(CTA),thus to provide valuable information for laparosco-pic right colon cancer resection.Methods:The clinical data of 70 patients who accepted laparoscopic right colon cancer resection in our hospital were collected retrospectively.All patients underwent CT angiography examination one week before operation.The anatomical type,size,length and the angle between Henle trunk and surgical trunk were evaluated.Results:Of the 70 patients,66 cases(94.3%)obtained successful CT three-dimensional reconstruction images of Henle trunk.Henle trunk failed to be 3D reconstructed in one patient due to the invasion of metastatic lymph nodes;unable to be evaluated in three cases due to previous gastrointestinal surgery.According to the number of veins drained to Henle′s gastric and colonic trunk,68 cases of Henle trunk were successfully reconstructed based on CTA data before operation,and its anatomic findings were divided into four types:type 0(without colonic drainage vein)in 6 cases(9.10%),typeⅠ(one colonic drainage vein)in 45 cases(68.18%),typeⅡ(two colonic drainage veins)in 13 cases(19.70%),and typeⅢ(three colonic drainage veins)in 2 cases(3.00%).The diameter of Henle trunk was(4.93±1.19)mm,the length of Henle trunk was(15.82±8.18)mm,the angle of Henle trunk with surgical trunk was 95.68°±21.34°,and the length of surgical trunk was(38.68±8.26)mm.Conclusion:Three-dimensional CT angiography can provide valuable anatomical information of Henle trunk and main branches in laparoscopic right colon cancer radical operation,and provide important reference for the selection of operation procedures.

关 键 词：体层摄影术 X线计算机 血管成像 Henle干 结肠癌 

分 类 号：R814.42[医药卫生—影像医学与核医学] R735.3[医药卫生—放射医学]