正常门腔间隙前后径大小及其影响因素的CT影像学研究

目的 探讨影响成人肝脏尾状叶下缘平面门腔间隙(PCS-IHCL)前后径大小的因素。方法 收集2011年1月—2016年7月潍坊医学院附属医院影像中心行腹部增强CT检查无椎体及门腔间隙(PCS)病变的64例患者的临床资料进行回顾性分析。其中男35例、女29例,年龄23～64(46.8±10.8)岁。在轴位增强CT图像上,测量PCS-IHCL最小前后径、门静脉最大前后径、下腔静脉最大短径、最大淋巴结前后径、邻近椎体最大横径、肝脏尾状叶最大前后径以及脐部水平的腹壁脂肪厚度,分析PCS-IHCL最小前后径与其他测量数值的相关性,并得出回归方程。结果 在轴位CT图像上,PCS-IHCL最小前后径为(0.345±0.246) cm;门静脉最大前后径为(1.277±0.126) cm,下腔静脉最大短径为(1.633±0.339) cm,邻近椎体最大横径为(4.214±0.455) cm;PCS-IHCL水平,PCS内共有11例显示有13个淋巴结,最大淋巴结前后径为(0.627±0.100) cm。PCS内肝脏尾状叶的最大前后径为(2.325±0.533) cm,脐部水平的腹壁脂肪厚度为(1.594±0.601) cm。PCS-IIHCL最小前后径与性别、年龄、门静脉的最大前后径、下腔静脉的最大短径、最大淋巴结前后径及邻近椎体的最大横径均无相关性(P值均＞0.05);与肝脏尾状叶前后径及腹壁脂肪的厚度呈正相关(t=4.649、2.403,P值均<0.05)。以PCS-IHCL最小前后径(＾Y)为应变量,以PCS内肝脏尾状叶的最大前后径(X₁)、脐部腹壁脂肪厚度(X₂)为自变量,得回归方程为:＾Y=-0.689+0.180X₁+0.122X₂,R²=0.472。结论 PCS-IHCL具有自身的解剖特点,肝脏尾状叶的最大前后径和腹壁脂肪含量是影响PCS-IHCL最小前后径的主要因素。在CT图像上注重PCS-IHCL的观察和测量,对PCS内病变及邻近脏器病变的诊断和治疗具有指导意义。

CT analysis of influencial factors on normal anteroposterior diameter of portacaval space

Objective To analyze the influencial factors of the anteroposterior diameter (APD) of the portacaval space (PCS) through inferior margin of the hepatic caudate lobe (PCS-IHCL) on the CT images.Methods Abdominal CT images of 64 patients without vertebral body and PCS lesions in the Affiliated Hospital of Weifang Medical University from January 2011 to July 2016 were collected and analyzed retrospectively. In this study, there were 35 males and 29 females, aged 23-64 years, mean 46.8 years. Emphasis was placed on the following findings based on the axial contrast-enhanced CT images: the minimal APD of the PCS-IHCL, the maximal diameter of APD of the portal vein and the inferior vena cava, APD of the lymph nodes and the maximal transverse diameter of the adjacent centrum, the thickness of the fat layer in the navel and the maximal APD of the hepatic caudate lobe in the level of inferior vena cava's left border. The relativity between the minimal APD of the PCS-IHCL and other data were analyzed and the correlation was studied using linear regression analysis.Results According to the axial CT images,the minimal APD of the PCS-IHCL was (0.345±0.246) cm; the maximal APD of the portal vein was (1.277±0.126) cm; the maximal APD of the inferior vena cava was (1.633±0.339) cm; and the maximal diameter of the adjacent centrum was (4.214±0.455) cm; there were 11 cases showing 13 lymph nodes, the maximal diameter was (0.627±0.100) cm. The maximal diameter of the hepatic caudate lobe in the PCS was (2.325±0.533) cm, and the thickness of fat in the navel was (1.594±0.601) cm. The APD of the PCS-IHCL had no correlation with gender, age, the maximal diameter of APD of the portal vein and the inferior vena cava,APD of the lymph nodes and the maximal transverse diameter of the adjacent centrum(all P values＞0.05), but had correlated positively to the thickness of the fat layer in the navel and the APD of the hepatic caudate lobe (t=4.649, 2.403, all P values<0.05). Set the minimal APD of the PCS-IHCL(＾Y) as the dependant variable, the maximal APD of the hepatic caudate lobe (X₁) and the thickness of the fat layer in the navel (X₂) as the independent variable, the regression equation was: ＾Y=-0.689+0.180X₁+0.122X₂, R²=0.472.Conclusions PCS-IHCL has its unique anatomical features. The influencial factors of the APD of the PCS-IHCL are the maximal APD of the hepatic caudate lobe and the abdominal fat content. Focusing on the observation and measurement of PCS-IHCL on CT images, which has guiding significance in the diagnosis and treatment of diseases in PCS and adjacent organs.