肝脏Ⅰva、Ⅳb亚段间分界的临床影像解剖学研究

发布时间：2018-05-30 15:46

本文选题：亚段 + 分界　；参考：《大连医科大学》2010年硕士论文

【摘要】： 目的：通过研究在体肝脏的CT重建图像,确定肝脏左内侧叶Ⅳa、Ⅳb亚段间的分界及走行在两亚段之间的肝静脉属支。方法：采用容积再现(volume rendering, VR)和最大密度投影(maximum intensity pro-jection, MIP)两种方法,对49例在体肝脏CT扫描图像进行肝内血管的三维重建,寻找肝脏左内侧叶IVa、IVb两亚段间分界及走行在段间裂内的肝静脉属支及其汇入部位。结果：作为两亚段分界标志的肝静脉属支,在VR和MIP两种重建图像上的出现率分别为14.29%和87.75%,因此采用MIP法重建出的三维图像对于寻找肝内细小血管分支更适用。该支肝静脉属支的汇入部位可分为以下三种情况：①汇入肝中静脉主干有24例,占55.81%；②汇入肝中静脉左根有1 6例,占37.21%；③汇入肝左静脉有3例,占6.98%。结论：通过CT三维重建图像可以确定肝脏IVa、IVb两亚段间分界,并且走行在该分界位置的肝静脉属支可作为两亚段间的分界标志。本研究的结果可以为临床上涉及肝脏左内侧叶IVa、IVb亚段的肝脏外科手术提供形态学依据。
[Abstract]:Objective: to study the CT reconstruction images of the liver in vivo and determine the dividing line between the four and four b subsegments of the left medial lobe of the liver and the branches of the hepatic vein running between the two subsegments. Methods: volume rendering (VRV) and maximum intensity pro-jection (MIPP) were used to reconstruct intrahepatic vessels in 49 cases of liver by CT scanning. To find the boundary between the two subsegments of the left medial lobe of the liver, and to find the branches of the hepatic vein and their entrances in the intersegmental fissure. Results: the occurrence rate of hepatic vein branch in VR and MIP reconstruction images was 14.29% and 87.75%, respectively. Therefore, the 3D images reconstructed by MIP method were more suitable for finding the branches of small vessels in the liver. The confluence site of this branch can be divided into the following three situations: 1 into the main trunk of the middle hepatic vein: 24 cases, accounting for 55.81%, 16 cases into the left root of the middle hepatic vein, 3 cases into the left hepatic vein, and 3 cases into the left hepatic vein, accounting for 6.98%. Conclusion: the boundary between the two subsegments can be determined by 3D CT reconstruction, and the hepatic vein branch walking at this boundary can be used as the dividing mark between the two subsegments. The results of this study may provide a morphological basis for the surgical operation of the left medial lobe of the liver involving the IVaI IVb subsegment of the left medial lobe of the liver.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R322;R813

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