基于64排螺旋CT扫描数据的肝血管解剖变异分析

Application of 64-slice spiral CT in the analysis of anatomic variation of hepatic vessels

目的:通过64排螺旋CT及肝脏CT诊断辅助分析系统对肝血管进行三维解读,观察分析肝血管的解剖和变异。方法:搜集200例行上腹部64排螺旋CT增强扫描无改变血管解剖结构的疾病检查者。利用IQQA-Liver肝脏CT解读软件对肝血管进行三维定量分析、显示及分支标记,并对血管解剖和变异进行分析。结果:IQQA-Liver分割及标记血管耗时短,且个体化血管3D定量模型形态逼真,立体感强,真实反映了肝血管的解剖结构和变异。正常肝动脉解剖134例(67%),变异肝动脉66例(33%)。正常门静脉解剖143例(71.5%),解剖变异57例(28.5%)。肝中、肝左静脉合并汇入下腔静脉148例(74%)。直径>3mm右后下肝静脉的显示率为36.5%(73/200)。结论:IQQA-Liver三维定量分析及成像可真实反映肝血管的形态结构,为肝脏的虚拟手术设计提供了可实时交互的血管解剖变异各种3D模型,为上腹部脏器介入治疗提供了活体解剖学数据。

Objective：To investigate the 3D interpretation of the anatomy and variation of hepatic vessels using 64- slice MSCT supplemented with analysis software. Methods：The upper abdominal enhanced MSCT images of 200 cases with no vascular abnormality were recruited. IQQAq.iver software was used to display and analyze the 3D images of hepatic ves- sels and their branches. The vascular segment, marking, anatomy and variation were evaluated. Results：The adopted software for showing vessel segmentation, marking and analysis was time-efficient, and resulted in individualized real-time interactive 3D vascular models revealing stereoscopic true structures which strikingly similar to the real figure of anatomy and varia- tion. Of the 200 cases, there were normal hepatic arteries （ 134 cases, 67% ）, hepatic artery variations （ 66 cases, 33 % ） ; nor- mal portal vein （143 cases, 71.5 %）, and portal vein variants （57 cases, 28. 5% ）. The left hepatic vein shared a common trunk with the middle one in 148 cases （74%）. The visualization rate of inferior posterior right hepatic vein with the diame- ter larger than 3ram was 36.5%（73 cases）. Conclusion：Variation of the hepatic vessels could be displayed by using IOOA liver software. The individualized 3D vascular models could be obtained, the anatomic variations of hepatic vessels were well depicted and provided sufficient real-time interaction to various types of anatomical variations for surgery and interventional therapy planning.