三维数字虚拟肝脏对肝脏尾状叶外科应用解剖的研究

Surgical anatomy of hepatic caudate lobe based on 3D virtual human liver

目的对肝尾状叶的临床应用解剖进行揭示，为临床诊治提供指导。方法利用中国可视化人数据集，采用三维可视化技术，建立数字虚拟肝脏系统；对肝尾状叶进行应用解剖研究，确定其亚分段，边界，及空间范围等。结果成功建立了数字虚拟肝脏系统，具有多种交互功能及一定的虚拟手术功能；尾状叶左侧边界清晰，其腹侧、右侧边界模糊；经过静脉韧带裂的冠状斜切面可代表肝尾状叶的相对腹侧缘；经过第二肝门与胆囊窝底部的矢状斜切面可代表尾状叶的相对右侧缘；尾状叶可分为2个部分：左侧的Spiegel叶与右侧的腔静脉旁部，尾状突以及右后突属于腔静脉旁部。结论明确了尾状叶亚分段，边界，以及空间范围等解剖概念；三维虚拟肝脏系统的建立为数字解剖、虚拟手术的发展提供了平台，对肝外科具有实践指导意义。

Objective To provide practical anatomy of hepatic caudate lobe for clinical practice. Method Based on Chinese Visible Human 1-5 and assisted by technique of 3D visualization, the digitized 3D models of liver were reconstructed and the anatomy of caudate lobe was investigated. Results The right and ventral boundaries of caudate lobe were obscure. The coronal oblique plane through the confluence of hepatic veins and the fissura ligamenti venosi and the sagittal oblique plane through the end of right hepatic vein and the gallbladder fossa could stand for the relative ventral and right borders of the caudate lobe. The caudate lobe could be divided into 2 principal regions： the Spiegel lobe and the paracaval portion. Conclusion Our classification and the relative borders of the caudate lobe might he reasonable and practical. The 3D visualization is a convenient and accurate study method on clinical anatomy.