使用多排探测器计算机断层扫描通过三维门静脉造影分析肠系膜静脉的解剖变异。

Analysis of anatomic variants of mesenteric veins by 3-dimensional portography using multidetector-row computed tomography.

作者信息

Sakaguchi Takanori, Suzuki Shohachi, Morita Yoshifumi, Oishi Kosuke, Suzuki Atsushi, Fukumoto Kazuhiko, Inaba Keisuke, Kamiya Kinji, Ota Manabu, Setoguchi Tomohiko, Takehara Yasuo, Nasu Hatsuko, Nakamura Satoshi, Konno Hiroyuki

机构信息

Second Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Japan.

出版信息

Am J Surg. 2010 Jul;200(1):15-22. doi: 10.1016/j.amjsurg.2009.05.017. Epub 2010 Jan 15.

DOI:10.1016/j.amjsurg.2009.05.017

PMID:20074695

Abstract

BACKGROUND

It is important to be aware of mesenteric venous variants to perform peripancreatic surgery. We investigated the usefulness of 3-dimensional (3-D) portography.

METHODS

Vessels were reconstructed using computer software in 102 patients undergoing multidetector-row computed tomography (MDCT) scheduled for gastrointestinal or hepatobiliary-pancreatic surgery.

RESULTS

The superior mesenteric vein (SMV) was composed of single and double trunks around the splenoportal confluence in 78 and 24 patients, respectively. The inferior mesenteric vein joined the splenic vein (68.5%), SMV (18.5%), and splenoportal confluence (7.6%). The left gastric vein joined the splenic vein (46.3%), portal vein (39.0%), and splenoportal confluence (14.7%). Seventy-nine patients showed a gastrocolic trunk, mostly composed of the right gastroepiploic vein and veins from the colonic hepatic flexure. Intraoperative findings were identical to 3-D diagnosis in 68 gastrectomized and 9 pancreatectomized patients.

CONCLUSION

Although mesenteric venous tributaries are complex, 3-D portography is helpful for surgeons to safely perform peripancreatic surgery.

摘要

背景

在进行胰腺周围手术时，了解肠系膜静脉变异情况很重要。我们研究了三维（3-D）门静脉造影的实用性。

方法

使用计算机软件对102例计划进行胃肠或肝胆胰手术的接受多排螺旋计算机断层扫描（MDCT）的患者的血管进行重建。

结果

在脾门静脉汇合处周围，肠系膜上静脉（SMV）分别由单干和双干组成，单干者78例，双干者24例。肠系膜下静脉汇入脾静脉（68.5%）、SMV（18.5%）和脾门静脉汇合处（7.6%）。胃左静脉汇入脾静脉（46.3%）、门静脉（39.0%）和脾门静脉汇合处（14.7%）。79例患者显示有胃结肠干，主要由胃网膜右静脉和结肠肝曲的静脉组成。68例接受胃切除术和9例接受胰腺切除术的患者的术中发现与三维诊断结果一致。