国人胆道三维重建解剖变异应用研究  

Application of three-dimensional visualization technology in the anatomical variations of hilar bile ducts in Chinese population

作　　者：江剑宏 段仁鹏 李晓锋[1] Jiang Jianhong;Duan Renpeng;Li Xiaofeng(Department of General Surgery,Guangdong Second Provincial General Hospital,Guangzhou 510317,Guangdong Province,China)

机构地区：[1]广东省第二人民医院民航院区外一科,广州510317

出　　处：《中国临床解剖学杂志》2024年第1期1-4,共4页Chinese Journal of Clinical Anatomy

基　　金：广东省医学科研基金项目(A2021101)。

摘　　要：目的通过三维重建国人胆道系统,研究国人胆道走行及其解剖变异特点。方法利用海信计算机辅助手术系统对100例梗阻性胆道疾病患者的腹部CT数据进行三维重建,得到胆道三维模型,观察肝内胆道系统的走形,根据黄氏分型法(右后叶胆管、右前叶胆管与左肝管的汇入方式)以及是否存在副肝管对胆道进行分型。结果成功重建100例国人的胆道三维模型,观察到胆道有7种类型,54%(54例)拥有典型的胆道解剖结构(Ⅰ型);46%(46例)有解剖变异,其中10%(10例)为Ⅱ型,14%(14例)为Ⅲ型,10%(10例)为Ⅳ型,2%(2例)为Ⅴ型,2%(2例)为Ⅵ型,此外有8%(8例)存在副肝管,其中6例同时伴有其他变异。结论通过三维重建模型,能清晰识别国人胆道系统走形及变异特点,发现新的胆道变异类型,有助于指导临床诊疗。Objective This study is aimed to explore the walking of biliary system and the characteristics of anatomic variation,by reconstructing the three-dimensional model of biliary system in Chinese people.Methods According to the abdominal CT data of 100 patients who suffer from obstructive disease of biliary tract,three-dimensional models were reconstructed by using the Hisense computer-aided surgery(CAS)system,and were used to analyze the movement of intrahepatic biliary system.The biliary tract was classified according to Huang’s classification,that is the confluent mode of right posterior bile duct,right anterior bile duct and left hepatic duct,and the presence or absence of accessory hepatic duct.Results The three-dimensional models of bile ducts were successfully reconstructed in 100 Chinese patients.Seven types of biliary ducts can be observed.54 cases(54%)had typical biliary tract anatomy(type I).46 cases(46%)had anatomical variations,of which 10 cases(10%)were type II variants,14 cases(14%)were type III variants,10 cases(10%)were type IV variants,2 cases(2%)were type V variants,and 2 cases(2%)were type VI variants.In addition,8 cases(8%)had accessory hepatic ducts,of which 6 cases were accompanied by other variants.Conclusions The path and variation characteristics of biliary system can be identified clearly,by reconstructed Chinese biliary system in three dimensions.To discover news types of biliary tract variation can guide clinical diagnosis and treatment.

关 键 词：三维重建 胆道系统 胆道变异 

分 类 号：R445.3[医药卫生—影像医学与核医学]