肝叶长轴垂直斜面形态结构及潜在临床影像诊断价值

目的:观察标本肝叶长轴垂直斜断面及肝表面形态结构,探讨肝叶长轴垂直斜断面潜在的临床影像诊断意义。方法:对37例成人尸肝经左叶上、下段,方叶和右叶长轴、且垂直于横轴面之斜断面以及肝表面标志进行命名,对其形态进行观察,并研究其相应长轴和短轴与肝表面结构的联系。结果:肝表面标志形态:网膜结节以半椭球型为主,占86·5%;方叶后区以平坦型为主,占83·8%;右肝下极丘型,占91·9%;肝嵴线型、平坦型分别占81·1%和11%。各叶斜断面形态与特点:均由前后两个近似三角形组成,各断面前三角形顶点之连线与肝膈面最膨隆带区重叠;肝左叶上、下段长轴斜断面后三角形顶点均100%与网膜结节重叠;方叶长轴斜断面后三角形顶点有16·2%不落在方叶后区上;右叶长轴斜断面后三角形顶点为丘型右肝下极占91·9%,顶点在右肝嵴线上占8%,两者重叠率均为100%。结论:肝各叶斜断面形态均由前后两个近似三角形组成,其两个三角形顶点分别落在肝腹侧和脏侧最隆起肝表面标志结构上,诸断面能够良好的反映上述肝表面标志形态大小的变化。

Morphologic characteristics of liver lobes in oblique sagittal section and its potential clinical value

Objective: To investigate the oblique sagittal section in major axses of the liver lobes and hepatic surface markers (SM) in visceral surface, and to explore its potential significance in clinical image diagnosis. Methods: The corresponding major and minor axses of oblique sagittal section in the right hepatic lobe, upper and inferior segement of left hepatic lobe, and quadrate lobe in 37 cases were designated and surveyed. The surface markers designated in visceral surface and in diaphragmatics surface were obtained. The relationship of the sections and SMs was evaluated. Results: Liver SMs were classificated according to shapes: (1) omental tuberosity, semi-ellipsoid type 86.5%; comma type 8.1%; conic type 5.4%. (2) posterior zone of quadrate lobe: evenness type 83.8%; eminence type 8.1%; introcession type 8.1%. (3) inferior pole of liver right lobe: cumulus type 91.9%; evenness type 8.0%. (4) ridge line: filate type 81.1%; evenness type 11.0%; trinacriform type 8.0%. Morphorlogy of sagittal section oblique in liver lobes: all those consist of two triangles, one anterior, another posterior. The apical angles of the anterior triangles were arrayed approximately horizontal, which were within the eminent zone of facies diaphragmatica hepatis; those of the posterior triangles in the upper and inferior segement of the left hepatic lobe all overlaped variant omental tuberosity of left hepatic lobe; while 16.2% of apical angles of the posterior triangle in quadrate lobe section were beyond posterior zone of quadrate lobe (of which 8.1% was introcession type, 2.7% eminence type, 5.4% evenness type). With regard to apex angle of post triangle in the right hepatic lobe, there were two cases: (1) cumulus type: 100% of the angle points were coincide with inferior pole of liver right lobe, the possibility of which being 91.9%; (2) evenness type: 100% of the angle points overlapped the ridge line, the possibility of which being 8%. Conclusion: Liver oblique sagittal sections are made up of two similar triangles, of which the apex angle points fall onto the surface markers of liver. The sections can satisfactorily reflect the surface marker.