3D 16-MSCT血管成像对门静脉及肝静脉解剖的研究

Study of the anatomy of portal vein and hepatic vein with 3D 16-MSCT angiography

目的:应用三维(3D)16-MSCT血管成像研究门静脉及肝静脉解剖。方法:100例正常人通过肘静脉以3ml/s速度注射90～120ml含碘对比剂,应用自动团注触发扫描技术,平均扫描时间门静脉期45～60s,肝静脉期90～120s,获得相应门静脉期、肝静脉期图像。所有数据采用1mm薄层重组,0.5mm薄层间距,然后传输到工作站进行VR、MIP图像重组。门静脉采用Couinaud和Atri的分型标准,肝静脉分别采用Nakamura、Marcos及Kawasaki的分型标准。结果:①门静脉Ⅰ型76例,Ⅱ型16例,Ⅲ型3例,Ⅳ型2例②肝右静脉Ⅰ型72例,Ⅱ型22例,Ⅲ型6例。肝中静脉Ⅰ型65例,Ⅱ型19例,Ⅲ型16例。Ⅳb段引流入肝中静脉42例,引流入肝左静脉58例。结论:3D16-MSCT血管成像是一种十分有用的方法,采用MIP和VR相结合的成像方式能清楚显示门静脉及肝静脉解剖。

Objective：To assess the anatomy of portal vein and hepatic vein with three dimensional 16-MSCT angiography.Methods：A total of 100 healthy subjects underwent upper abdominal MSCT examinations in our department.All subjects were administered 90～120ml of IV contrast material at an injection rate of 3ml/s.The scan delay time was 45～60s and 90～120s for portal venous and hepatic venous phase with automated bolus tracking,respectively.All data sets were reconstructed in 1-mm section and 0.5mm interval,and then were transferred to a workstation for maximum intensity projection（MIP）and volume rendering（VR） econstruction.The portal vein anatomy was classified according to Couinaud and Atri’s classification;the hepatic veinanatomy according to Nakamura’s,Marcos’s and Kawasaki’s classification.Results：① Normal portal vein anatomy was seen in 76 cases,type Ⅱin 16,type Ⅲ in 6,type Ⅳ in 2.②Nakamura’s TypeⅠof hepatic vein was presented in 72 cases;type Ⅱ in 22.type Ⅲ in 6.The branching pattern of the middle hepatic vein was type Ⅰin 65 cases,type Ⅱin 19,and type Ⅲ in 16.Segment IVb vein branched from the middle hepatic vein in 42 cases,and from the left hepatic vein in 58.Conclusion：3D 16-MSCTA is a significantly valuable tool which can provide complete and comprehensive information on the anatomy of portal vein and hepatic vein combined with MIP and VR image.