Couinaud肝段在CT图像上的划分

为给肝内占位性病变的ＣＴ定位提供解剖学依据，利用２０例腹部连续横断层标本和１０例活体正常肝的ＣＴ图像，研究了Ｃｏｕｉｎａｕｄ肝段在ＣＴ图像上的划分。正中裂为下腔静脉左前壁至肝中静脉或胆囊的连线；左叶间裂的上部为左叶间静脉至下腔静脉左前壁的连线，门静脉左支脐部和肝圆韧带裂是其中、下部的天然标志；肝左静脉行于左段间裂内；右叶间裂为肝右静脉至下腔静脉左前壁的连线；肝门或门静脉右支是右段间裂的标志；背裂为下腔静脉右缘至静脉韧带裂右端或门静脉的连线。本文还探讨了易致错分肝段的一些因素。

Couinaud's Nomenclature of the Hepatic Segments: Shown by Computed Tomography with Cadaver Sections Correlation

To provide the anatomic data for CT localization of the hepatic tumor, the Couinands hepatic segments were investigated using 20 sets of serial cross sections of adult cadavers and CT images of 10 subjects. The medial fissure can be considered as the line drawn from the left anterior wall of the inferior vena cava (IVC) through the middle hepatic vein or gallbladder to the liver edge;the superior part of left interlobar fissure was the line drawn fron the left interlobar vein to the left anterior wall of IVC, the umbilical part of the left portal vein and fissure for ligamentum teres are the natural landmarks of the middle and inferior parts of the left interlobar fissure respectively; the left hepatic vein course in the left intersegmental fissure;the right interlobar fissure is the line drawn from the left anterior wall of IVC through the right hepatic vein to the liver edge;the porta hepatis or right portal vein acts as the landmark of the right intersngmental fissure;the dorsal fissure is the line drawn from the right margin of IVC to the right end of the fissure for ligamentum venosum or potal vein. The Paper also discusses some elements which easily lead to divide the hepatic segments wrongly.