肝中动脉的影像学解剖特点与活体供肝移植的相关性

Image anatomic features of the middle hepatic artery and its relevance to living donor liver transplantation

目的探讨在活体供肝移植中逐步受到重视的肝中动脉的解剖特点，以指导临床活体供肝移植的成功开展。方法分析70例研究对象的64排螺旋CT资料，重点观察肝中动脉的解剖特点及变异情况。结果肝中动脉在肝门部从其起源动脉发出后，走行于肝外，然后逐渐转至脐裂内门脉矢状部内侧，发出分支，主要供应肝4段。70例研究对象中，有49例（70％）存在肝中动脉。其中肝中动脉发自肝右动脉29例，占所有肝中动脉（n=49）的59．2％；发自肝左动脉17例，占34．7％；发自其它动脉3例（肝右前动脉、胃十二指肠动脉、肝固有动脉各1例），占6．1％。结论肝中动脉的存在率高达70％，术前了解其解剖变异情况对于活体供肝移植手术方案的制定有重要指导作用。

Objective To investigate anatomic features of the important middle hepatic artery （MHA） to guide living donor liver transplantation （LDLT）. Methods 64-slice computer tomography materials from 70 cases were studied to find out the anatomic features of the MHA. Results The MHA arose at the hepatic hilum, walked outside the liver, turned medial towards the sagittal part of the left portal vein inside the umbilical fissure, and sent out branches primarily for segment 4. Fortynine of 70 （70%） cases had the MHA. Among the 49 cases, there were 29 （59. 2%）, 17 （34. 7%）, and 3 （6. 1%） cases who had the MHA originating respectively from the right hepatic artery （normal or replaced）, the left hepatic artery （normal or replaced）, and other arteries （the right anterior hepatic artery, gastroduodenal artery and proper hepatic artery）. Conclusion The existence rate of the MHA is 70% high. Preoperative information about anatomic features of the MHA from each case will play a significant role in surgical planning of LDLT.