多层螺旋CT血管成像评估肝动脉解剖变异

目的探讨64层螺旋CT血管成像(CTA)对肝动脉正常解剖和变异的评估作用。方法上腹部多层螺旋CT三期扫描患者500例,将动脉期原始数据进行薄层重建。采用多平面重建(MPR),最大密度投影(MIP)和容积再现(VR)后处理技术,根据Michel′s分型标准对肝动脉解剖变异进行分析。结果500例患者中,Michel′sⅠ型300例(60.0%)肝动脉变异者为200例(40.0%)],Ⅱ型40例(8.0%),Ⅲ型42例(8.4%),Ⅳ型10例(2.0%),Ⅴ型28例(5.6%),Ⅵ型30例(6.0%),Ⅶ型18例(3.6%),Ⅷ型6例(1.2%),Ⅸ型8例(1.6%),Ⅹ型6例(1.2%);另外12例肝动脉变异不在Michel′s分型中(2.4%)。结论多层螺旋CT血管成像作为非损伤性检查方法对肝动脉解剖变异分型具有指导意义。

Evaluation of anatomic variations of the hepatic arteries with multi-slice CT angiography

Objective To evaluate anatomical variations of hepatic arteries using multi-slice computed tomographic angiography(MSCTA).Methods A total of 500 patients underwent 3-phase enhanced CT and the raw data of artery-phase were reconstructed including multiphase planar reformation(MPR),maximum intensity projection(MIP) and volume rending(VR) techniques.According to Michel’s classification,the anatomy of hepatic artery was evaluated.Results A total of 200(40.0%) hepatic artery anatomic variations was detected in 500 patients.The cases were classified as Michel′s type Ⅰ in 300 cases(60.0%),type Ⅱ in 40 cases(8.0%),type Ⅲ in 42 cases(8.4%),type Ⅳ in 10 cases(2.0%),type Ⅴ in 28 cases(5.6%),type Ⅵ in 30 cases(6%),type Ⅶ in 18 cases(3.6%),type Ⅷ in 6 cases(1.2%),type Ⅸ in 8 cases(1.6%),and type Ⅹ in 6 cases(1.2%).There were 12 hepatic artery anatomic variations which could not be included in the Michel’s classification.Conclusion MSCTA as a non-invasive method could effectively evaluate anatomic variations of hepatic arteries.