Macdonald David Blair, Haider Masoom A, Khalili Korosh, Kim Tae Kyong, O'Malley Martin, Greig Paul D, Grant David R, Lockwood Gina, Cattral Mark S
Department of Medical Imaging, Princess Margaret Hospital, University Health Network, University of Toronto, 610 University Ave., Toronto, ON M5G 2M9, Canada.
AJR Am J Roentgenol. 2005 Jul;185(1):247-52. doi: 10.2214/ajr.185.1.01850247.
The objective of our study was to determine whether there is an association between portal venous or hepatic arterial branching patterns (or both) and biliary anatomic variants.
Two radiologists independently reviewed preoperative hepatic CT scans and intraoperative cholangiograms from 39 consecutive living liver donors. The portal venous and hepatic arterial anatomy was classified on the basis of the preoperative CT scans and the biliary anatomy was classified on the basis the intraoperative cholangiograms into one of two groups: conventional or anomalous. Variables were tested for association using Fisher's exact test.
Anomalous vascular branching variants were common, being present in 23 (59%) of 39 patients. Hepatic arterial anomalies were present in 18 (46%); portal venous anomalies, in seven (18%); and both, in two (5%). Biliary anomalies were present in 15 (38%) of the 39 patients. Of the 23 patients with anomalous vascular anatomy, seven (30%) had biliary anomalies. Of the 16 patients with conventional vascular anatomy, eight (50%) had biliary anomalies. There was no significant association between hepatic arterial anomalies, portal venous anomalies, or the combination of arterial and portal venous anomalies and anomalous biliary drainage.
Portal venous and hepatic arterial branching patterns do not correlate well with biliary anatomic variants. In patients with normal hepatic vascular anatomy, biliary anomalies are common.
本研究的目的是确定门静脉或肝动脉分支模式(或两者)与胆道解剖变异之间是否存在关联。
两位放射科医生独立回顾了39例连续活体肝供者的术前肝脏CT扫描和术中胆管造影。门静脉和肝动脉解剖结构根据术前CT扫描进行分类,胆道解剖结构根据术中胆管造影分为两组之一:传统型或异常型。使用Fisher精确检验对变量进行关联性测试。
异常血管分支变异很常见,39例患者中有23例(59%)存在。肝动脉异常有18例(46%);门静脉异常有7例(18%);两者都有的有2例(5%)。39例患者中有15例(38%)存在胆道异常。在23例血管解剖异常的患者中,7例(30%)有胆道异常。在16例血管解剖结构正常的患者中,8例(50%)有胆道异常。肝动脉异常、门静脉异常或肝动脉和门静脉异常的组合与异常胆道引流之间无显著关联。
门静脉和肝动脉分支模式与胆道解剖变异的相关性不佳。在肝血管解剖结构正常的患者中,胆道异常很常见。