64层螺旋CT三维重建活体肝静脉的研究及临床意义

目的:探讨64层螺旋CT应用于正常人活体体肝静脉研究的可行性,观察三维重建肝静脉的一般形态及走行规律.方法:153例正常受试者经肘正中静脉注射造影剂后,使用64层螺旋CT进行上腹部扫描,图像采集后经容积再现(volume rendering,VR)技术重建肝静脉.结果:重建图像清晰,可显示出6～8级血管及与周围组织间的关系.其中153例肝静脉的分型结果如下:①3分支型,占35.3%(54例);②中左共干型,占41.8%(64例);③中左合干型,占20.9%(32例);④中右共干型,占2.0%(3例).结论:64层螺旋CT可以作为研究活体肝静脉形态的有效手段,三维重建能更准确、全方位地显示肝静脉的正常解剖类型和发现变异,而且图像清晰,对于活体肝静脉的研究有较好的临床应用价值.

3D-reconstruction of hepatic vein by 64-Slice Spiral Computed Tomography and its significance

Objective: To explore the feasibility of 64-Slice spiral computed tomography (CT) on reconstructing hepatic vein according to its morphology and distribution. Methods: After injecting contrast materials through median cubital vein, 153 voluneers underwent contrast-enhanced CT angiography of epigastric zone utilizing 64-Slice spiral computed tomography. Images were collected and dealt with the technique of volume rendering (VR),and then hepatic vein were reconstructed into 3D-images. Results: On reconstructed images, the vessels of the 6th and the 8th level, and their surrounding structures can be identified.According to the reconstruction images of 153 eases, hepatic.vein can be divided as follow types: ①Trifurcate type with the pencentage of 35.3％ (54eases): left, middle and right hepatic veins drained into the inferior vena eava separately; ②Common trunk type of middle and left veins, 41.8％ (64 cases): right hepatic vein drained into the inferior vena cava, however, left and middle hepatic veins confluened before their draining into the inferior vena cava; ③Common trunk type of left and right hepatic vein, 20.9％ (32eases): left and middle hepatic veins confluenced before their draning into the inferior vena cava; ④Common trunk type of middle and right veins, 2.0％ (3cases): middle and right hepatic veins confluenced before the draining. Conclusions: 64-Slice spiral computed tomography would be a useful skill to exhibit and reconstraet hepatic vein and the surrounding vessels, which is a valuable reference for clinical application.