计算机3D技术研究围肝门部门静脉变异者胆管变异率

doi:10.13418/j.issn.1001-165x.2016.02.008

中国临床解剖学杂志 ›› 2016, Vol. 34 ›› Issue (2): 155-159.doi: 10.13418/j.issn.1001-165x.2016.02.008

计算机3D技术研究围肝门部门静脉变异者胆管变异率

孟翔飞¹，　段伟东¹，　王学栋²，　王宪强¹，　董家鸿²

1. 解放军总医院肝胆外科，北京 100853; 2. 北京清华长庚医院，北京 102218

收稿日期:2015-08-31 出版日期:2016-03-25 发布日期:2016-04-14
通讯作者: 董家鸿，教授，主任医师，博士生导师，E-mail: dongjiahong@mail.tsinghua.edu.cn
作者简介:孟翔飞（1980-），河南孟州人，医学博士，主要从事肝胆外科临床工作，E-mail:mengxf301@126.com
基金资助:
国家科技支撑计划支持项目（2012BAI06B01）

The research of the relationship between perihilarportal vein anatomical variations and biliary tract variations bythe computed 3D reconstruction

MENG Xiang-fei¹, DUAN Wei-dong ¹, WANG Xue-dong², WANG Xian-qiang ¹, DONG Jia-hong ²

1. Department of Hepatobiliary Surgery, PLA General Hospital, Beijing100853, China；2.Beijing Tsinghua Changgung Hospital, Beijing 102218, China

Received:2015-08-31 Online:2016-03-25 Published:2016-04-14

摘要/Abstract

摘要：

目的　研究围肝门部门静脉和胆管的变异形式，并确定两者之间的关联。方法　采用连续100例低位梗阻型黄疸患者的MDCT的数据，利用其薄层DICOM格式的图像使用Intrasense Myrian工作站进行肝脏、门静脉和胆管模型的三维重建。在计算机三维模型上研究门静脉和胆管的变异形式。结果　所有入选病例均成功进行肝脏、门静脉和胆管模型的三维重建，图形显示清晰且可在工作站上任意组合显示和任意旋转观察。围肝门部门静脉总体的变异率为21%，胆管的总体变异率为36%。门静脉正常组（n=79）与门静脉变异组（n=21）比较，胆管变异率分别为30.4%和57.1%（P<0.05），组间差异具有统计学显著意义。结论　围肝门部门静脉变异者胆管变异率升高，计算机3D重建是研究肝脏脉管解剖的优良工具。

关键词: 围肝门部解剖, 门静脉, 胆管, 计算机辅助外科, 三维重建

Abstract:

Objective 　To investigate the relationship between perihilar portal vein anatomy and perihilar biliary duct anatomy.　Methods　The research involved continuous 100 low-part obstructive jaundice cases. Each case accepted MDCT scan. The researcher reconstructed 3-dimensional models of liver, portal vein and biliary ducts for each case using Intrasense Myrian software. The detailed anatomy of portal vein and biliary ducts was observed in these computed 3D models.　Result　All involved cases were constructed successfully. The liver, portal vein and biliary tract models could be combined and rotated freely. The total variation rate of perihilar portal vein was 21% and of the biliary ducts was 36%. The biliary tract variation rate in portal vein normal anatomy group (n=79) and portal vein variation group was 30.4% and 57.1%, respectively (P<0.05).　Conclusion　The perihilar portal vein anatomical variations may predict more biliary tract variation. The computed 3-dimensional reconstruction is an effective tool to investigate the anatomy of liver vessels.

Key words: Perihilar anatomy, Portal vein, Biliarytract, Computer-assisted surgery, Three-dimensional reconstruction

孟翔飞,段伟东,王学栋,王宪强,董家鸿 . 计算机3D技术研究围肝门部门静脉变异者胆管变异率[J]. 中国临床解剖学杂志, 2016, 34(2): 155-159.

MENG Xiang-fei, DUAN Wei-dong, WANG Xue-dong, WANG Xian-qiang, DONG Jia-hong. The research of the relationship between perihilarportal vein anatomical variations and biliary tract variations bythe computed 3D reconstruction[J]. Chinese Journal Of Clinical Anatomy, 2016, 34(2): 155-159.

参考文献

[1] Koc Z, Oguzkurt L, Ulusan S. Portal vein variations: clinical implications and frequencies in routine abdominal multidetector CT[J]. Diagn Interv Radiol, 2007, 13(2): 75-80.
[2] Schmidt S, Demartines N, Soler L, et al. Portal vein normal anatomy and variants: implication for liver surgery and portal vein embolization[J]. Semin Intervent Radiol, 2008, 25(2): 86-91.
[3] Blumgart LH. Surgery of the liver, biliary tract, and pancreas.[M] (fourth edition). 2006. Elsevier. P16.
[4] Kawarada Y, Das BC, Taoka H. Anatomy of the hepatic hilar area: the plate system[J]. J Hepatobiliary Pancreat Surg, 2000, 7(6): 580-586.
[5] Varotti G, Gondolesi GE, Goldman J, et al. Anatomic variations in right liver living donors[J]. J Am Coll Surg, 2004, 198(4): 577-582.
[6] Yoshida J, Chijiiwa K, Yamaguchi K, et al. Practical classification of the branching types of the biliary tree: an analysis of 1,094 consecutive direct cholangiograms[J]. J Am Coll Surg, 1996, 182(1): 37-40.
[7] Song GW, Lee SG, Hwang S, et al. Preoperative evaluation of biliary anatomy of donor in living donor liver transplantation by conventional nonenhanced magnetic resonance cholangiography[J]. Transpl Int, 2007, 20(2): 167-73.
[8] Ohkubo M, Nagino M, Kamiya J, et al. Surgical anatomy of the bile ducts at the hepatic hilum as applied to living donor liver transplantation[J]. Ann Surg, 2004, 239(1): 82-86.
[9] Lee SE, Jang JY, Lee JM, et al. Selection of appropriate liver resection in left hepatolithiasis based on anatomic and clinical study[J]. World J Surg, 2008, 32(3): 413-418.
[10]Chen JS, Yeh BM, Wang ZJ, et al. Concordance of second-order portal venous and biliary tract anatomies on MDCT angiography and MDCT cholangiography[J]. AJR Am J Roentgenol, 2005, 184(1): 70-74.
[11]Kasahara M, Egawa H, Tanaka K, et al. Variations in biliary anatomy associated with trifurcated portal vein in right-lobe living-donor liver transplantation[J]. Transplantation, 2005, 79(5): 626-627.
[12]Kitami M, Takase K, Murakami G, et al. Types and frequencies of biliary tract variations associated with a major portal venous anomaly: analysis with multi-detector row CT cholangiography[J]. Radiology, 2006, 238(1): 156-166.
[13]Beermann J, Tetzlaff R, Bruckner T, et al. Three-dimensional visualisation improves understanding of surgical liver anatomy[J]. Med Educ, 2010, 44(9): 936-940.
[14]Radtke A, Sotiropoulos GC, Molmenti EP, et al. Computer-assisted surgery planning for complex liver resections: when is it helpful A single-center experience over an 8-year period[J]. Ann Surg, 2010, 252(5): 876-883.
[15]Muller-Stich BP, Lob N, Wald D, et al. Regular three-dimensional presentations improve in the identification of surgical liver anatomy - a randomized study[J]. BMC Med Educ, 2013, 13: 131.
[16]Balandraud P, Gregoire E, Cazeres C, et al. Right hepatolithiasis and abnormal hepatic duct confluence: more than a casual relation[J]. Am J Surg, 2011, 201(4): 514-518.
[17]Jarnagin WR. Blumgart's Surgery of the Liver, Biliary Tract and Pancreas[M]. 5th. 2012. Philadelphia. ELSEVIER SAUNDERS.
[18]Couinaud C. Liver anatomy: portal (and suprahepatic) or biliary segmentation[J]. Dig Surg, 1999, 16(6): 459-467.
[19]Radtke A, Sgourakis G, Sotiropoulos GC, et al. Vascular and biliary anatomy of the right hilar window: its impact on recipient morbidity and mortality for right graft live donor liver transplantation[J]. World J Surg, 2009, 33(9): 1941-1951.

计算机3D技术研究围肝门部门静脉变异者胆管变异率

The research of the relationship between perihilarportal vein anatomical variations and biliary tract variations bythe computed 3D reconstruction

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

Metrics

本文评价

推荐阅读 0

[1]	江剑宏, 段仁鹏, 李晓锋. 国人胆道三维重建解剖变异应用研究[J]. 中国临床解剖学杂志, 2024, 42(1): 1-4.
[2]	陈瑞欣, 苗靖榆, 张翼, 柳澄, 孟海伟, 刘树伟. 肝静脉引流形式的双源CT三维成像研究[J]. 中国临床解剖学杂志, 2023, 41(6): 647-651.
[3]	徐浩铜, 徐万宇, 吴毅, 何明静, 雷秀兵, 田伏洲. 慢性胰腺炎脾门假性囊肿分类及其与SPH关系的影像学研究[J]. 中国临床解剖学杂志, 2023, 41(6): 652-656.
[4]	李佳伟, 高明杰, 仝玲, 刘清华, 康志杰, 张凯, 王海燕, 李筱贺. 内蒙古地区蒙古族人群髋臼数字解剖学研究[J]. 中国临床解剖学杂志, 2023, 41(4): 390-394.
[5]	丁冉, 郑雪峰, 丁自海, 吴涛. 胆囊静脉是如何回流的？ ——临床解剖学研究[J]. 中国临床解剖学杂志, 2023, 41(3): 249-253.
[6]	廖晓霜, 鲁辉, 刘融, 魏在荣, 周健, 陈伟, 蒋海芳, 聂开瑜. 基于三维测量的颞浅动脉干解剖学研究[J]. 中国临床解剖学杂志, 2023, 41(3): 263-269.
[7]	吴世源, 何浩强, 陈正和, 牟永告, 李严兵, 黄文华, 钟世镇. 多模态融合技术三维重建岩上静脉[J]. 中国临床解剖学杂志, 2023, 41(3): 270-276.
[8]	何艾岭, 王清, 李广州. 骨质疏松性椎体压缩骨折患者腰椎椎基静脉孔的CT影像解剖学研究[J]. 中国临床解剖学杂志, 2023, 41(3): 283-287.
[9]	周芮灵, 李盈, 黄迪情, 赵增江, 丁慧, 张慧, 陈伟. 256排螺旋CT三维重建右半肝门静脉和肝静脉及其解剖关系的临床应用研究[J]. 中国临床解剖学杂志, 2023, 41(2): 150-155.
[10]	杨静怡, 胡昕, 姚洁, 徐洲, 杨智, 陈志, 吴毅. 基于中国数字化人体的支气管树三维模型构建及纤维支气管镜手术模拟仿真[J]. 中国临床解剖学杂志, 2023, 41(1): 1-7.
[11]	李梓瑜, 李琨, 郭燕, 越洒, 曲星月, 刘宇航, 张凤珍, 王星, 徐以发, 李志军, 李筱贺, 张少杰. 数字儿童颅底及颈部可视化模型建立研究[J]. 中国临床解剖学杂志, 2022, 40(6): 639-643.
[12]	冯培勋, 李桂军, 赵永红, 程明亮, 李立国. 基于结构光三维重建的成人第3指蹼间隙的形态学分型及临床意义[J]. 中国临床解剖学杂志, 2022, 40(6): 644-648.
[13]	李泽宇, 肖钊明, 刘畅, 吴坤成, 许广威, 骆宝华, 骆世文, 马梓玮, 骆建恒, 贺善礼, 梁海彬, 曾伊琳, 欧阳钧. 精囊腺和射精管3D打印模型制作[J]. 中国临床解剖学杂志, 2022, 40(3): 366-368.
[14]	胡定祥, 李长辉, 陈亮, 马晨曦, 黄河, 郑瑞清. 基于CT三维重建的肩胛骨关节盂形态学分型及临床意义[J]. 中国临床解剖学杂志, 2022, 40(2): 150-153.
[15]	刘蓬然, 申澳, 吕静, 陈宇飞, 袁剑, 廖胜辉, 刘立宏. 三维立体可视化测量国人肱骨近端解剖学参数[J]. 中国临床解剖学杂志, 2022, 40(1): 10-16.