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目的探讨64层螺旋 CT 肝静脉成像技术显示正常人肝静脉变异的可行性。方法选取75例行腹部 CT 检查的无肝脏疾病患者,进行肝静脉成像扫描。观察肝静脉回流、肝静脉引流肝段的情况,并按3种解剖分型(Nakamura、Marcos 及 Kawasaki 分型)分别对肝静脉进行分型。结果肝右静脉单独汇入下腔静脉,肝左静脉和肝中静脉先汇合后再注入下腔静脉,占86.7%(65/75);肝右静脉、肝中静脉及肝左静脉分别单独汇入下腔静脉,占13.3%(10/75)。肝右静脉 Nakamura 分型:A 型占49.4%(37/75),B 型占37.3%(28/75),C 型占13.3%(10/75)。肝中静脉 Marcos分型:A 型占56.0%(42/75);B 型占24.0%(18/75);C 型20.0%(15/75)。肝左静脉 Kawasaki 分型:Ⅰ型占40.0%(30/75);Ⅱ型占60.0%(45/75)。结论正常人肝静脉变异率较高,多层螺旋 CT 静脉成像可提供细微的静脉系统分支图像。
Objective To explore the feasibility of using 64-slice spiral CT hepatic venous imaging to demonstrate normal hepatic vein variability. Methods Seventy-five patients without hepatic disease undergoing abdominal CT examination were enrolled in this study. Hepatic venography was performed. The hepatic veins were observed by hepatic venous return and hepatic venous drainage. The hepatic veins were separated by three types of anatomy (Nakamura, Marcos and Kawasaki classification). Results The right hepatic vein was introduced into the inferior vena cava only. The left hepatic vein and the middle hepatic vein were confluence and then injected into the inferior vena cava, accounting for 86.7% (65/75). The right hepatic vein, the middle hepatic vein and the left hepatic vein, Into the inferior vena cava, accounting for 13.3% (10/75). The right hepatic vein Nakamura classification: A type accounted for 49.4% (37/75), B type accounted for 37.3% (28/75), C type accounted for 13.3% (10/75). Marcos classification of the middle hepatic vein: type A accounted for 56.0% (42/75); type B accounted for 24.0% (18/75); type C 20.0% (15/75). Hepatic left venous Kawasaki classification: type Ⅰ accounted for 40.0% (30/75); type Ⅱ accounted for 60.0% (45/75). Conclusion The variation rate of hepatic vein in normal people is high. Multi-slice CT venography can provide subtle venous system branch images.