引用本文:孟翔飞,潘颖威,段伟东.肝动脉解剖学的计算机3D影像研究及其在活体肝移植中的意义[J].中国临床新医学,2020,13(12):1194-1198.
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肝动脉解剖学的计算机3D影像研究及其在活体肝移植中的意义
孟翔飞,潘颖威,段伟东
100853 北京,中国人民解放军总医院第一医学中心肝胆胰外科医学部,中国人民解放军总医院肝胆外科研究所,全军数字肝胆外科重点实验室
摘要:
[摘要] 目的 采用计算机3D重建模型,研究肝动脉的解剖和肝脏第4段动脉的解剖,并讨论其在活体肝移植中的意义。方法 采用该中心99例低位梗阻性黄疸病例的DICOM格式的薄层增强CT影像,以Intrasense Myrian工作站进行肝脏、肝动脉、门静脉、胆管的3D模型重建,并对肝动脉和A4进行描述性解剖学研究。结果 99例均成功完成肝脏、肝动脉、门静脉和胆管的3D重建。按照改良的Hiatt分型,肝动脉的解剖类型1型79例(79.8%),2型14例(14.1%),3型3例(3.0%),4型2例(2.0%),5型1例(1.0%)。Couinaud分段第4段动脉参考Jin等的分型分为3型,1型38例(38.4%),2型52例(52.5%),3型9例(9.1%)。结论 肝动脉及A4均存在各种变异形式,对活体肝移植具有重要影响。计算机3D重建是评估肝脏脉管解剖的良好工具。术前利用计算机3D重建进行个体化解剖学评估有利于手术设计和手术安全。
关键词:  肝动脉  局部解剖学  肝脏移植  计算机三维重建
DOI:10.3969/j.issn.1674-3806.2020.12.03
分类号:R 657.3
基金项目:
Computer 3D imaging study of hepatic artery anatomy and its significance in living donor liver transplantation
MENG Xiang-fei, PAN Ying-wei, DUAN Wei-dong
Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center of the General Hospital of the People′s Liberation Army, Institute of Hepatobiliary Surgery of the General Hospital of the People′s Liberation Army, Key Laboratory of Digital Hepatobiliary Surgery of the People′s Liberation Army, Beijing 100853, China
Abstract:
[Abstract] Objective To study the anatomy of hepatic artery and the artery of Couinaud segment 4 by using computer three-dimensional(3D) reconstruction model, and discuss its significance in living donor liver transplantation. Methods Ninety-nine cases of low obstructive jaundice in our center were performed with thin-slice enhanced computed tomography(CT) images in DICOM format. The 3D models of liver, hepatic artery, portal vein and bile duct were reconstructed by Intrasense Myrian workstation, and the descriptive anatomy of hepatic artery and A4 was studied. Results The 3D reconstruction of liver, hepatic artery, portal vein and bile duct was completed in all the 99 cases. According to the modified Hiatt classification, there were 79 cases(79.8%) of hepatic artery anatomy type 1, 14 cases(14.1%) of type 2, 3 cases(3.0%) of type 3, 2 cases(2.0%) of type 4 and 1 case(1.0%) of type 5. According to Jin′s classification, the artery of Couinaud segment 4 was divided into 3 types: 38 cases(38.4%) of type 1, 52 cases(52.5%) of type 2, and 9 cases(9.1%) of type 3. Conclusion There are various anatomical variations in hepatic artery and A4, which has important influence on living donor liver transplantation. Computer 3D reconstruction is a good tool to evaluate the anatomy of hepatic vessels. Preoperative computer 3D reconstruction for individualized anatomical evaluation is beneficial to surgical design and the patient′s safety.
Key words:  Hepatic artery  Regional anatomy  Liver transplantation  Computer three-dimensional reconstruction