应用64排螺旋CT血管造影技术观察肝动脉解剖变异类型
摘要
目的应用64排螺旋CT血管造影技术(CTA)观察肝动脉解剖变异类型,并探讨其影像学价值。方法回顾性收集400例患者行腹部CTA检查,进行容积再现(VR)、最大密度投影(MIP)、多平面重组(MPR)重建,结合横断面观察肝动脉及分支的解剖变异。结果 400例受检者中肝动脉及分支均清晰显示,属于正常解剖学类型356例,占89.00%;肝动脉起源变异44例,占11.00%。其中30例(7.50%)肝动脉解剖变异属于Michels分型:MichelsⅡ型5例,占1.25%;MichelsⅢ型10例,占2.50%;MichelsⅤ型2例,占0.50%;MichelsⅥ型2例,占0.50%;MichelsⅧ型5例,占1.25%:MichelsⅨ型6例,占1.50%。另Miclels分型之外肝动脉起源变异14例,占3.50%;其中两种及多种血管起源变异共存7例,占1.75%。结论 64排螺旋CTA能准确判断肝动脉及分支解剖变异,能为临床提供详细准确的影像学资料。
引文
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[2]张瑞池,贾翠宇,李雪琴,等.肝总动脉变异的多层螺旋CT血管造影表现.实用放射学杂志,2012,28:396-398,428.
[3]Binaghi S,Maeder P,Uske A,et al.Three-dimensional computed tomography angiography and magnetic resonance angiography of carotid bifurcation stenosis.Eur Neurol,2001,46:25-34.
[4]Squillaci E,Fanucci E,Sciuto F,et al.Vascular involvement in pancreatic neoplasm:a comparison between spiral CT and DSA.Dig Dis Sci,2003,48:449-458.
[5]Koops A,Wojciechowski B,Broering DC,et al.Anatomic variations of the hepatic arteries in 604 selective celiac and superior mesenteric angiographies.Surg Radiol Anat,2004,26:239-244.
[6]Thangarajah A,Parthasarathy R.Celiac Axis,Common Hepatic and Hepatic Artery Variants as Evidenced on MDCTAngiography in South Indian Population.J Clin Diagn Res,2016,10:TC1-5.
[7]Keles P,Yuce I,Keles S,et al.Evaluation of hepatic arterial anatomy by multidetector computed tomographic angiography in living donor liver transplantation.Biochem Genet,2016,54:283-290.
[8]Sakamoto Y,Fujikawa T,Tanaka A,et al.Successful radical resection of pancreatic head carcinoma in a patient with replaced right hepatic artery originating from posterior inferior pancreaticoduodenal artery:a case report.Surg Case Rep,2017,3:78.
[9]丁家明,李惠君.肝动脉变异及其临床意义.肝胆外科杂志,1998,6:58-60.
[10]杨峰,金忱,王强,等.CT血管成像对胰十二指肠切除术前肝动脉变异的检出价值.中华肝胆外科杂志,2013,19:645-648.
[11]Takahashi S,Murakami T,Takamura M,et al.Multidetector row helical CT angiography of hepatic vessels:depiction with dual-arterial phase acquisition during single breath hold.Radiology,2002,222:81-88.
[12]高瑞晖,关键,杨彬,等.成人腹腔干变异和病变的MSCT诊断和评估.影像诊断与介入放射学,2017,26:205-209.