肝动脉解剖变异的640层容积CT血管成像研究

Study of Anatomic Variations of Hepatic Artery by 640-slice Dynamic Volume CT

目的:评价640层动态容积CT多期扫描动脉期数据血管成像对显示肝动脉解剖变异的准确性及可行性。方法:回顾性分析200例行640层CT上腹部多期增强扫描患者资料,并对其动脉期图像资料进行血管三维重建,结合容积再现(VR)、最大密度投影(MIP)、多平面重建(MPR)和曲面重建(CPR)观察患者肝动脉解剖变异,并进行统计、分析。按Hitta分型标准进行分类。结果:200例患者中正常肝动脉解剖者为156例,占78%(156/200),肝动脉变异者为44例,占22%(44/200)。44例肝动脉变异中属于Hitta分型的39例,其中Ⅱ型12例,占6%(12/200);Ⅲ型11例,占5.5%(11/200);Ⅳ型5例,占2.5%(5/200);Ⅴ型10例,占5%(10/200);Ⅵ型1例,占0.5%(1/200)。Hitta分型未包括在内者5例,占2.5%(5/200)。结论:640层动态容积CT可以清晰显示肝动脉解剖变异,为临床提供了充分的解剖信息,对肝脏病变的外科手术及介入治疗具有重要的临床意义。

Purpose： To evaluate the accuracy and feasibility of angiography with the artery-phase data of 640-slice dynamic volume CT multi-phase scan in demonstrating the anatomic variations of hepatic artery （HA）. Methods： The arterial phase data of 200 patients who underwent upper abdomen CT multi-phase scan with 640-slice dynamic volume CT were retrospectively analyzed. The data were post-processed with VITAL workstation. Three-dimensional CT angiography （3D-CTA） images, including volume rendering （VR）, maxmum intensity projection （MIP） and multiplanar reconstruction （MPR） and surface reconstruction （CPR） were reconstructed using post-processing techniques. Hepatic artery anatomy variation was classified with Hitta classification standard. The results were observed and statistically analyzed. Results： One hundred and fifty-six cases with normal anatomy of the hepatic artery were detected in 200 cases, accounting for 78% （156/200）, 43 cases with hepatic artery variation were detected in 200 cases, accounting for 22% （44/200）. Thirty-nine cases of the 43 cases belonged to Hitta typing, including 12 cases of type rI, accounting for 6% （12/200）; 11 cases of type 11I, accounting for 5.5% （11/200）; 5 cases of type IV, accounting for 2.5% （5/200）; 10 cases of type V, accounting for 5% （10/200）; 1 case of type VI, accounting for 0.5% （1/200）. Another 5 cases were not belonged to Hitta typing, accounting for 2.5% （5/200）. Conclusion： CT angiography with the artery- phase data of CT multi-phase scan in upper abdomen is feasible and useful to display anatomic variations of hepatic artery; 640-slice dynamic volume CT can clearly display the hepatic artery anatomical variations,and provide sufficient anatomical information for clinical, surgical and interventional therapy for the upper abdomen. It has important clinical significance.