Ibukuro K
Department of Radiology, Mitsui Memorial Hospital, Tokyo 101-8643, Japan.
Int J Gastrointest Cancer. 2001;30(1-2):87-104. doi: 10.1385/IJGC:30:1-2:087.
The development of recent technology, especially the helical computed tomography (CT) scan, allows us to observe small peripancreatic vessels which previously could be demonstrated only by angiography (1), and therefore make three-dimensional (3-D) volume rendered CT angiographic reconstruction possible (2). The neighboring structures as well as the pancreatic vessels are clearly visualized on the axial CT scan. Therefore, it is necessary to define the peripancreatic vessels on the axial images, as well as on angiography to make an accurate diagnosis of pancreatic disease so that we can also estimate the dynamic flow of the peripancreatic vessels. In this chapter, I would like to use the cadaver dissections of pancreatic vessels to explain each pancreatic vessel based on previous anatomic and radiologic references and finally demonstrate the clinical cases in terms of the pancreatic vessels. The pancreatic arteries and veins are explained based on the anatomic and radiologic references. Principal pancreatic vessels are demonstrated on cadaver dissection. The pancreas head is supplied by the anterior and posterior pancreaticoduodenal arteries forming arcades in the pancreaticoduodenal sulcus and is drained by the pancreaticoduodenal veins. The pancreas body and tail are supplied by the dorsal, inferior, and caudate pancreatic arteries, and are drained by the inferior and left pancreatic veins. Clinical applications in terms of the pancreatic vessels such as basis for interpretation of the angiography and the CT scan, treatment of pancreatitis and pancreatic cancer, detection of small insulinoma are stated.
近年来技术的发展，尤其是螺旋计算机断层扫描（CT），使我们能够观察到以前只有通过血管造影才能显示的胰周小血管（1），从而使三维（3-D）容积再现CT血管造影重建成为可能（2）。在轴向CT扫描上，相邻结构以及胰腺血管都能清晰显示。因此，有必要在轴向图像以及血管造影上明确胰周血管，以便准确诊断胰腺疾病，进而评估胰周血管的动态血流。在本章中，我将利用胰腺血管的尸体解剖，根据以往的解剖学和放射学参考文献来解释每条胰腺血管，并最终展示有关胰腺血管的临床病例。基于解剖学和放射学参考文献对胰腺动脉和静脉进行解释。在尸体解剖中展示主要的胰腺血管。胰头由胰十二指肠前、后动脉供血，这些动脉在胰十二指肠沟内形成动脉弓，由胰十二指肠静脉引流。胰体和胰尾由胰背动脉、胰下动脉和胰尾动脉供血，由胰下静脉和胰左静脉引流。阐述了胰腺血管在血管造影和CT扫描解读基础、胰腺炎和胰腺癌治疗、小胰岛素瘤检测等方面的临床应用。
