摘要
背景与目的:供肝动脉解剖变异较多,目前肝动脉解剖分型以Michels和Hiatt分型为主,但不断有新发现的解剖变异情况。既往分型不能满足临床需要。本研究通过影像学观察统计供肝动脉解剖变异情况,提出精准分型,为临床工作提供科学准确的依据。方法:回顾性分析2019年1月—2019年3月行腹部多层螺旋CT双期增强扫描患者的影像资料,观察供肝动脉状态,记录相关数据,并进行分类统计。结果:总共纳入1520例患者的CT影像资料,男967例,女553例。符合Michels分型者1504例(98.95%),16例(10.53‰)不符合Michels分型。符合Hiatt分型者1507例(99.14%),13例(8.55‰)不符合Hiatt分型。从肝总动脉(CHA)起源、副左肝动脉(ALHA)起源、供肝动脉类型3个方面对供肝动脉解剖进行分析,笔者提出了供肝动脉解剖分型的七分法(根据CHA起源)与五分法(根据左右供肝动脉的解剖变异及不同变异的组合情况)。七分法中Ⅰ型1471例(96.78%)、Ⅱ型25例(1.64%)、Ⅲ型7例(0.46%)、Ⅳ型5例(0.33%)、Ⅴ型4例(0.26%)、Ⅵ型4例(0.26%)、Ⅶ型4例(0.26%)。五分法中Ⅰ型1381例(90.86%)、Ⅱ型87例(5.72%)、Ⅲ型38例(2.50%)、ⅣⅥ型10例(0.66%);Ⅴ型4例(0.26%)。结论:本研究提出的供肝动脉解剖新分型方法囊括了各种可能的解剖变异,简化了既往研究将CHA和供肝动脉同时纳入分型的复杂情况,分型思路清晰,符合解剖实际与临床认知,可为临床工作提供理论依据与指导。
Background and Aims: There are many anatomical variations of the arteries supplying the liver. Currently, the anatomical classification methods of the liver arteries are mainly Michels’ classification and Hiatt’s classification. However, new types of anatomical variations have continually been discovered. So, previous classification systems cannot meet the clinical needs. This study was conducted to analyze the anatomical variations of the liver supplying arteries by imaging observation, so as to create an accurate classification method and provide precise scientific information for clinical work. Methods: The imaging data of patients undergoing biphasic contrast-enhanced scanning of abdominal multi-slice spiral CT from January 2019 to March 2019 were reviewed. The patterns of the arteries supplying the liver were observed, the relevant data were recorded and categorical analysis was performed. Results: The CT imaging data of 1 520 patients were selected, including 967 males and 553 females. Of the patients, 1 504 cases(98.95%) met Michels’ classification, and 16 cases(10.53‰) did not meet Michels’ classification;1 507 cases(99.14%) met Hiatt’s classification, and 13 cases(8.55‰) did not meet Hiatt’s classification. By analyzing the anatomical variations of the arteries supplying the liver from the aspects of the origin of the common hepatic artery(CHA), the origin of the accessory left hepatic artery(ALHA) and the types of the arteries supplying the liver, the authors proposed the seven-type classification(according to the origin of the CHA) and five-type classification(according to the anatomical variation of the left and right liver supplying arteries and the combination of different variations) for classifying the anatomical types of the arteries supplying the liver. In the seven-type classification, 1 471 cases(96.78%) were classified as type Ⅰ, 25 cases(1.64%) were type Ⅱ, 7 cases(0.46%) were type Ⅲ, 5 cases(0.33%) were type Ⅳ, 4 cases(0.26%) were type Ⅴ, 4 cases(0.26%) were type �
作者
王承宇
张志鹏
方真好
李贤初
李玺
尹俊达
邓圣军
杨浩
龙学颖
吴畏
WANG Chengyu;ZHANG Zhipeng;FANG Zhenhao;LI Xianchu;LI Xi;YIN Junda;DNEG Shengjun;YANG Hao;LONG Xueying;WU Wei(Department of Geriatric Surgery,Central South University,Changsha 410008,China;Department of General Surgery,Central South University,Changsha 410008,China;National Clinical Research Center for Geriatric Disorders,Central South University,Changsha 410008,China;Department of Radiology,Xiangya Hospital,Central South University,Changsha 410008,China;Department of General Surgery,Chenzhou First People's Hospital,Chenzhou,Hunan 423000,China)
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2020年第7期857-866,共10页
China Journal of General Surgery
关键词
肝动脉
解剖变异
体层摄影术
螺旋计算机
Hepatic Artery
Anatomic Variation
Tomography,Spiral Computed
