三维CTAP对肝脏尾状叶腔静脉旁部的观察

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目的描述和分析门静脉副前上支的走行和分布,并结合临床病例探讨其归属和临床价值。方法对连续100例门静脉显示良好无严重肝硬化的螺旋CT动脉性门静脉造影(CTAP)影像行三维重建,结合观察三维CTAP和连续轴位CTAP影像,对其中20例清楚显示一支较大的起自右前支的P点和A点之间,分布于右肝静脉和中肝静脉根部之间的区域称为门静脉副前上支(AASB)的分支,分析AASB与右前上内侧支P8d与门静脉尾状叶腔静脉旁支(PCPB)间的相互关系。同时回顾性复习14例经CTAP检查左门静脉横部栓塞或右前支栓塞的影像表现,进一步探讨AASB的临床意义。结果100例中有20例观察到有AASB存在。AASB与P8d同时存在的可能性明显小于AASB与PCPB或P8d与PCPB同时存在的可能性(Ρ<0.05),但后2组间同时存在的可能性无显著差别(P>0.05),推测AASB可能是变异的P8d。说明在20%的病例该区域肝实质的门静脉血供来自AASB。结论提示在解释该区域的影像表现和进行手术切除或栓塞治疗时应注意AASB的存在。 Objective To describe and analyze the movement and distribution of the anterior branch of the anterior portal vein and to explore its attribution and clinical value in combination with clinical cases. Methods Three hundred and thirteen spiral CT angiography (CTAP) images of portal vein with good portal vein without serious cirrhosis were performed in three consecutive cases. Three-dimensional CTAP images and continuous axial CTAP images were observed. Among them, 20 cases clearly showed a large The area between the right anterior branch of PAS and point A, located between the root of the right hepatic vein and the middle hepatic vein, is called the branch of the anterior branch of the portal vein (AASB). The relationship between AASB and the anterior superior superior medial branch P8d and portal vein tail Interval Between Vena Cava Palate (PCPB). At the same time, retrospective review of 14 cases of CTAP examination of the left portal vein embolization or right anterior embolism of the image performance, to further explore the clinical significance of AASB. Results AASB was observed in 20 out of 100 cases. The possibility of simultaneous presence of AASB and P8d was significantly less than the possibility of simultaneous presence of AASB and PCPB or P8d and PCPB (P <0.05), but there was no significant difference between the two groups (P> 0.05) Is mutated P8d. This shows that hepatic parenchymal portal blood is supplied from AASB in 20% of the cases. The conclusions suggest that attention should be paid to the presence of AASB in interpreting the imaging findings in this area and in surgical resection or embolization.
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