Ultrasonographic anatomy of the caudate lobe.

The caudate lobe, like the other segments and lobes of the liver, can be defined anatomically as well as pathologically utilizing gray-scale ultrasonography. It is anatomically distinct from the left and right lobes as it has its own portal veins, hepatic arteries, hepatic veins, and bile ducts. Sonographically the limits of the caudate lobe can be defined using readily identifiable vascular landmarks such as the proximal left portal vein anteriorly, the inferior vena cava posteriorly, and the main portal vein inferiorly A wide variety of pathologic conditions that affect the caudate lobe, including cirrhosis, infection, and neoplastic lesions, can be demonstrated by ultrasonography.     

Sonographic anatomy of the caudate lobe veins

Because of their small size, the caudate lobe veins (CLV) are not routinely imaged with ultrasonography. We recently examined 4 patients with elevated central venous pressure in whom the CLV were easily identifiable. To our knowledge this is the first report of sonographic visualization of these veins. We suggest that visualization of the CLV may not be as rare as previously presumed, and based on our experience, we will propose a nomenclature system for these veins.     

肝尾状叶胆管肿瘤和结石的外科治疗方式探讨

目的:探讨肝门部胆管癌和尾状叶肝管结石术中对尾状叶的外科治疗方式.方法:时1995年1月至2005年1月期间的25例因肝门部胆管肿瘤和尾状叶肝管结石而行肝尾状叶手术的患者进行随访和总结.结果:25例均行手术治疗.手术方式包括行肝门部肿瘤及尾状叶切除3例;肝门部肿瘤及尾状叶联合左半肝切除1例:因胆管结石行尾状叶联合左半肝切除3例;尾状叶联合左外叶切除3例;左右肝管切开,肝内胆管及尾状叶胆管取石,T管引流11例:左右肝管切开成形,肝内胆管及尾状叶肝管取石,空肠RouX-Y内引流术4例.无手术死亡,4例肝门部胆管癌患者中3例存活超过1年,1例超过3年;21例尾状叶肝管结石患者结石复发率为4.8%(1/21).结论:肝门部胆管癌变常侵及尾状叶,其根治范围应包括肝尾状叶的切除:尾状叶肝管结石应切开左右肝管,力争术中取尽结石.     

静脉输液患者滴速的调查分析

目的 了解静脉输液患的滴速。方法 对841例静脉输液患的滴速进行现场调查，以输液卡上的滴速为标准，计算时间为1min，超过5gtt/min为过快，少于5gtt／min为过慢。结果 95．83％的患滴速正常，33.3％过快，0.83％过慢，存在发生急性肺水肿的危险。结论 静脉输液患的管理仍有待加强，各医院要重视对静脉输液患的滴速管理，防止发生严重的输液并发症。     

Three-dimensional reconstructed images using multidetector computed tomography in evaluation of the biliary tract

The recent development of multidetector computed tomography (MDCT) and the parallel escalation in the capabilities of the workstation allow the use of high-quality multiplanar and three-dimensional reconstruction images. As a noninvasive technique, MDCT dedicated to the biliary tract represents an alternative to magnetic resonance cholangiography. The usefulness of three-dimensional reconstructed images using MDCT in evaluating biliary tract abnormality is illustrated.     

Advances in the interventional therapy of hepatocellular carcinoma originating from the caudate lobe

Hepatocellular carcinoma originating from the caudate lobe, also known as segment I hepatocellular carcinoma, is difficult to treat because of its special location, complex vascular supply, and the proximity of important vessels, bile ducts, and organs. This research is conducted to examine the efficacy and safety of interventional therapy for hepatocellular carcinoma in the caudate lobe.ConclusionSuperselective chemoembolization and ablation techniques for the treatment of caudate lobe hepatocellular carcinoma still need to be improved. The combination of multiple interventional methods and the application of multiple imaging techniques can improve the effectiveness and safety of interventional therapy for hepatocellular carcinoma in the caudate lobe. Multidisciplinary treatment is also essential to improve the prognosis of patients with caudate lobe hepatocellular carcinoma.     

Giant hyperplasia of the caudate lobe of the cirrhotic liver: correlation with an anomaly of the caudate portal branch

Different imaging appearances of giant hyperplastic change of the caudate lobe of the liver are presented in a patient with liver cirrhosis. The mass like caudate lobe was isoechoic on ultrasound, hypodense on postcontrast computed tomography (CT), hyperintense on T1-weighted magnetic resonance, images and isointense on T2-weighted images. These imaging findings are similar to those of dysplastic nodule in cirrhotic liver. The caudate lobe received normal portal flow on CT during arterial portography, but superior mesenteric arteriography showed precocious or early division of the caudate portal branch. We suspect that caudate hyperplastic change may be correlated to anomalous caudate portal vein branch.     

输液滴速计数器的设计与应用

目的 设计输液滴速计数器,评价其应用效果。 方法 输液滴速计数器由输液器卡扣、显示器、启动/模式切换按钮、电池、蜂鸣器、红外线感应区等组成。在试验室中,将该计数器测得的输液滴速与输液泵设定的输液滴速进行比较,评价该计数器滴数计数的准确率。采用便利抽样法,选取2020年3月—5月在上海市某三级甲等综合医院急诊科输液的200例患者作为应用对象,按患者输液时座位的序号分为试验组103例、对照组97例。试验组使用计数器进行计数,对照组使用人工计数的方式进行计数。比较两组预计输液完成时间与实际输液完成时间的差值,静脉炎、外渗、导管堵塞、回血的发生率,患者满意率。收集护士使用该计数器的满意率。 结果 在试验室检测中,该计数器滴速计数的准确率为99.6%,计数器显示滴数与输液泵设置滴数比较,差异无统计学意义 (P=0.829) 。临床应用过程中,试验组预计输液完成时间与实际输液完成时间的差值小于对照组,回血发生率低于对照组,患者满意率高于对照组,差异具有统计学意义 (P<0.05) 。护士满意率为96.1%。 结论 输液滴速计数器的准确性较高,使用该计数器有利于控制输液滴数,降低回血的发生率,提高患者满意率。     

Importance of the mode of intravenous administration on cephotaxime concentration in bile. A comparison of bolus, drip infusion and bolus plus drip infusion

Success of antibacterial therapy depends on many factors, among which the level reached at the site of infection is important. Drug concentration in tissues and body fluids can be related to the mode of administration. The aim of the present work was to study the levels of cephotaxime (CFX) in bile, after intravenous administration of 1 g by bolus, drip infusion and bolus plus drip infusion. The drug was detected by a microbiological method. The results indicate that passage of CFX from blood into bile is a carrier-mediated process, and bolus, in the case of CFX, is the best mode of administration.     

肝尾叶与右叶径线及比值变化与非酒精性脂肪性肝病的关系

目的探讨肝尾叶与肝右叶的各径线及比值的变化与非酒精性脂肪性肝病之间的关系。方法选择在我院诊断为非酒精性脂肪性肝病变的病例147例及普通健康体检者227人为研究对象,分别测量其肝尾叶上下径、前后径、横径及肝右叶横径、最大斜径,计算肝尾叶横径与肝右叶的横径和肝尾叶上下径与肝右最大斜径比值,分析其与非酒精性脂肪性肝病之间的关系。结果健康成人肝尾叶与不同程度的脂肪肝病人肝尾叶的上下径、前后径、横径及肝右叶横径、最大斜径均在统计学上显著性差异（P<0.05）,在各径线中重度脂肪肝>中度脂肪肝>轻度脂肪肝>正常肝脏;轻、中、重度脂肪肝肝尾叶横径与肝右叶横径比值,以及肝尾叶上下径与肝右叶最大斜径比值均比较接近,无显著性差异。结论肝尾状叶与右叶各径线变化与非酒精性脂肪性肝病轻重程度密切相关,肝尾叶与右叶径线的（P>0.05）比值变化与非酒精性脂肪肝病轻重程度关系不密切。     

Evaluation of biliary ductal anatomy in potential living liver donors: comparison between MRCP and Gd-EOB-DTPA-enhanced MRI

Abdominal Radiology - To compare magnetic resonance cholangiopancreatography (MRCP) and Gd-EOB-DTPA-enhanced MRI in the evaluation of the biliary anatomy in potential living liver donors (LLDs). A...     

Giant hemangioma of the caudate lobe of the liver with surgical treatment: A case report

BACKGROUNDCaudate lobe hemangioma of the liver is relatively rare. Due to the unique anatomical location of the caudate lobe, the caudate lobectomy accounts for only 0.5% to 4% of hepatic resection, which is difficult to operate and takes a long time, and even has many postoperative complications.CASE SUMMARYA 34-year-old female presented with a 1 year history of intermittent pain in the right side of the waist without obvious inducement. All laboratory blood tests were within normal limits. Indocyanine green 15 min retention was rated 2.9%, and Child-Pugh was rated A. Computed tomography and magnetic resonance imaging diagnosed giant hemangioma of the caudate lobe with hemangioma of left lobe of liver. After discussion, surgical treatment was performed, which lasted 410 min, with intraoperative bleeding of about 600 mL and postoperative pathological findings of cavernous hemangioma. There were no obvious postoperative complications, and the patient was discharged 10 d after surgery.CONCLUSIONCaudate lobectomy is difficult due to its special anatomical location. Under the condition of fully exposing the anatomy of the first porta hepatis, the second porta hepatis, the third porta hepatis, the fourth porta hepatis and middle hepatic vein and combining with the Pringle maneuver, caudate lobectomy can be performed in a precise and safe process.     

Evaluation of the coronary venous system using electron beam computed tomography

New therapeutic strategies in interventional cardiology and electrophysiology involve the coronary veins. This study examines the potential usefulness of electron beam computed tomography to obtain detailed noninvasive definition of the coronary venous anatomy and of arteriovenous relationships. Electron beam computed tomography allows acquisition and three-dimensional reconstruction of tomographic images of the beating heart with high spatial and temporal resolution. Contrast-enhanced, thin-section electron beam computed tomographic coronary arteriographic images of 34 patients (21 men and 13 women, age 60 ± 10 years) were analyzed. The visibility of the coronary veins and their spatial relationship to the coronary arteries were assessed qualitatively on two- and three-dimensional displays. The coronary sinus was visible in 91%, the great cardiac vein in 100%, the middle cardiac vein in 88%, at least one vein overlying the lateral surface of the left ventricle in 97%, the anterior interventricular vein in 97%, and the small cardiac vein in 68%. A left marginal and a left posterior vein were seen in 44%, one of the two in 38%, and neither in 3%. The course of the anterior interventricular vein was parallel to the left anterior coronary artery in 79% and a crossover between the two vessels at an obtuse angle occurred in 12%. Contrast-enhanced electron beam computed tomography imaging of the heart noninvasively provides information on the coronary venous system and arteriovenous relationships that may help guide new interventional procedures.