肝尾状叶及其血管的断层解剖学研究

为给肝尾状叶疾病的影像诊断和外科手术提供形态学依据，本文利用成人腹部连续横断层标本22例、矢状断层标本14例和冠状断层标本5例研究了肝尾状叶及其血管的断层解剖。肝尾状叶有5面，在外形上可分为固有肝尾状叶(Spigelian叶)、腔静脉旁部和尾状突三部分。固有肝尾状叶，在横断面上，14例(63．6％)伸出腔静脉后突，11例(50％)出现孤立乳头突现象；在矢状断面上，4例(28．6％)下端出现分叉。在15例(68．2％)横断层和12例(85．7％)矢状断层标本上，可见肝尾状叶鞘系，主要出现于肝门静脉左支横部层面。在断层标本上，可见1～3支尾状叶静脉，大部分汇入下腔静脉肝后段的中、下份。粗大的肝右后下静脉分别见于10例(45.5％）横断层、4例(28.6％）矢状断层和l例冠状断层标本上。此外，文内还详细探讨了肝尾状叶在横、矢、冠状断面上的识别、毗邻及其在影像诊断和在肝切除术中的意义。

Sectional Anatomy of Hepatic Caudate Lobe and Its Blood Vessels

To provide morphological data for the imaging diagnosis and hepatic caudate lobectomy, the sectional anatomy of the hepatic caudate lobe and its blood vessels were investigated in 41 adult cadavers. Of these cadavers, 22 were cut horizontally, 14 were cut sagittally,5 were cut frontally .On its contour, the caudate lobe has 5 surfaces and was divided into three parts, the caudate lobe proper (Spigelian lobe), paracaval portion,and caudate process.On the horizontal sections in 14(63.6% )cases,the caudate lobe had the retrocaval process. The papillary process appeared separate from the rest of the liver on the horizontal sections in 11 (50%) cases.The lower portion of the caudate lobe appears bifurcated on the sagittal sections in 4 (28.6%) cases. On the horizontal sections in 15(68.2%) cases and sagittal sections in 12(85.7%) cases, the Glissan pedicles of the caudate lobe were visualized and mainly appeared on the section through the transverse portion of the left portal vein. 1-3 caudate lobe veins were seen on the sections in all cases, they mostly drained into the middle and lower portions of the retrohepatic inferior vena cava.The thicker inferior right hepatic veins appeared on the horizontal sections in 10 (45. 5%) cases ,sagittal sections in 4 (28.6%) cases and frontal section in 1 case.This paper also studies the identification and adjacency of the caudate lobe on the transverse, sagittal and frontal sections in detail and discusses their significance in the imaging diagnosis and caudate lobectomy.