多排螺旋CT诊断肝动脉解剖变异的研究进展

Research progress on hepatic artery anatomic variation with multi-detector spiral CT

临床中有许多腹部疾病要采取手术治疗的方式。既往外科手术主张大切口、彻底切除病灶,如今随着科技日新月异的变化,数字医学亦取得巨大进展,外科医生对人文医学理念的积极探索得以实现,精准外科时代到来。腹部外科逐步提倡微创手术,以最小创伤获得最优疗效。然而,腹腔脏器血管不但解剖结构复杂,而且变异很多,无疑给精准外科带来很大挑战。因此,术前全面评估病变与周围组织的关系,尤其是病变部位的血运情况,就显得更加重要。肝动脉生理解剖变化很大,变异率高,且类型多样,常与手术涉及的脏器、血管、组织相互关联,术前准确了解肝动脉变异对上腹部精准医疗计划的实施非常重要。近年来,多排螺旋CT血管成像以微创、操作简单、速度快、成像范围大、可回顾性分析等特点广泛应用于肝动脉解剖变异研究。本文对肝动脉解剖变异研究现况做一综述,并强调其在临床实践中的重要性。

Surgical resection is the main treatment for many abdominal diseases. In the past,surgical operations advocated large incisions and thorough excision of lesions. Nowadays,with the rapid changes of science and technology,digital medicine has also made great progress,and humanistic medical concepts have changed and progressed accordingly. Active exploration by abdominal surgeons has been realized and the era of precision surgery has arrived. Abdominal surgery has gradually advocated minimally invasive operation,with the least cost to obtain the best outcome. However,abdominal organs and blood vessels not only have complex anatomical structures,but also have many variations,which undoubtedly bring great challenges to precision surgery. Therefore,a comprehensive preoperative evaluation of the relationship between the lesion and the surrounding tissues,especially the vascular circulation of the lesion is more important. The physiological changes of hepatic artery are great,with a high variation rate and various types,which are often correlated with other abdominal organs,vessels,tissues. Accurate understanding of the variation of hepatic artery before surgery is very important for the implementation of upper abdominal precision medical plan. In recent years,multi-slice spiral CT angiography has been widely used in the study of hepatic artery anatomic variation due to its features of minimally invasive procedure,simple operation,fast speed,wide imaging range and retrospective analysis. This paper reviews the research status of hepatic artery anatomic variation and emphasizes its importance in clinical practice.