基于64-MSCTA左半肝肝动脉的应用解剖

目的　应用64排螺旋CT血管成像探讨活体左半肝肝动脉在肝内配布情况，为肝脏疾病的诊疗提供形态学资料。  方法　采集120例受试者肝脏CT图像，经容积再现(VR)技术重建肝动脉。测量左半肝肝动脉相关数据进行统计分析。  结果　肝左动脉主干长度为（42.37±26.58）mm；肝左动脉主干起始处、中点（1/2处）、分叉处内径分别为（3.06±0.70 ）、（2.82±0.68）、（2.78±0.65）mm；肝左动脉在左半肝内的主要分支呈1支、2支、3支、4支型者分别为4.2%、63.3%、28.3%、2.5%，其中，左外叶支与左内叶支的夹角为（80.21±23.36）°，左外叶支主干长度和起始处内径分别为（42.80±29.11）mm、（2.25±0.70）mm，左内叶支长度和起始处内径分别为（42.90±22.70）mm、（1.66±0.64）mm；肝左动脉供应Ⅱ、Ⅲ、Ⅳ段者占64.1%，供应Ⅱ、Ⅲ段者占28.3%，迷走肝左动脉供应Ⅱ、Ⅲ段，Ⅱ段，Ⅱ、Ⅲ、Ⅳ段者分别占5.0%，3.3%，0.8%。  结论　64-MSCTA可真实、准确的提供活体肝左动脉的形态学资料；肝左动脉在肝内的分支分布较为复杂，在左半肝内以二分支（左外叶支和左内叶支）为主，主要参与Ⅱ、Ⅲ、Ⅳ肝段供血。

The applied anatomy of left hepatic artery under 64-MSCTA

Objective To investigate intrahepatic distribution of the left hepatic artery using 64-multi-slice computed tomography angiography(64-MSCTA),and provide morphological data for treating liver diseases.Methods CT images of 120 volunteers were collected and dealt with volume rendering techniques(VRT).The data of left hepatic artery were measured and analyzed statistically.Results The length of the left hepatic arterial trunk was about(42.37±26.58)mm;the inner diameter of its beginning,midpoint and distal end were(3.06±0.70),(2.82±0.68),and(2.78±0.65)mm,separately.The frequency of the single trunk,dimidiate branchees,trichotomous branches and quadripartite branches were 4.2%,63.3%,28.3%,2.5% respectively.The angle between endite branch and exite branch of left hepatic artery was about(80.21±23.36)°,While the length and the inner diameter of the starting point of exite branch were(42.80±29.11)mm and(2.25±0.70)mm,as well that of endite branch were(42.90±22.70)mm,and(1.66±0.64)mm,respectively.The frequency of left hepatic artery dispersed to segment Ⅱ,Ⅲ,Ⅳ or segment Ⅱ,Ⅲ were 64.1% and 28.3%,and the aberrant left hepatic artery distributed to segment Ⅱ,Ⅲ,Ⅱor Ⅱ,or Ⅲ,Ⅳ were 5.0%,3.3%,0.8%,respectively.Conclusions 64-MSCTA is feasible to provide accurate morphological information for the liver.The intrahepatic distribution of the left hepatic artery was complex,and the dimidiate branch of the left hepatic artery is common.The left hepatic artery chiefly distributes to segment Ⅱ,Ⅲ and Ⅳ.