Department of Radiology, Toho University Ohashi Medical Center, 2-22-36 Ohashi Meguroku, Tokyo, Japan.
Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Abdom Radiol (NY). 2019 Mar;44(3):886-893. doi: 10.1007/s00261-018-1825-4.
This study aimed to retrospectively evaluate the caudate branches (CBs), which are bile ducts originating from the caudate lobe (CL), using drip infusion cholangiography with computed tomography (DIC-CT).
The confluence patterns of CBs were evaluated in 185 adult patients undergoing DIC-CT. The following bile duct features were evaluated: (a) number of depicted CBs; (b) identification of the caudate portion from which the CBs were derived; (c) identification of the confluence site of a CB; and (d) whether there was a difference in the confluence site of the CBs depending on the position of the right posterior hepatic duct (RPHD) and the portal vein (PV).
DIC-CT enabled detection of a total of 640 bile ducts from the CL in 185 patients, and the total number of CBs from the Spiegel lobe (SP), the paracaval portion, and the caudate process (CP) were 347 (54.2%), 112 (17.5%), and 181 (28.2%), respectively. In the SP, over 60% of CBs joined the left hepatic duct system (LHDS). The positional relationship between the RPHD and the PV was divided into a supra-portal course (n = 168) and an infra-portal course (n = 17). The number of CBs joining the LHDS was significantly different between a supra-portal course and an infra-portal course (p = 0.0484).
CBs were depicted by DIC-CT in 98.9% of the subjects, and a detailed evaluation was possible. The number of CBs joining the LHDS was associated with the position of the RPHD and the PV.
本研究旨在通过计算机断层扫描下滴注胆管造影术（DIC-CT）对发自尾状叶（CL）的胆管即尾状叶分支（CBs）进行回顾性评估。
对 185 例行 DIC-CT 的成年患者的 CB 汇合模式进行评估。评估了以下胆管特征：（a）描绘的 CB 数量；（b）识别 CB 源自的尾状叶部分；（c）CB 汇合部位的识别；（d）是否存在因右后肝管（RPHD）和门静脉（PV）的位置不同而导致 CB 汇合部位不同的情况。
DIC-CT 共在 185 例患者中检测到来自 CL 的 640 条胆管，来自 Spiegel 叶（SP）、旁腔部和尾状突的 CB 总数分别为 347（54.2%）、112（17.5%）和 181（28.2%）。在 SP 中，超过 60%的 CB 汇入左肝管系统（LHDS）。RPHD 和 PV 之间的位置关系分为门静脉上（n=168）和门静脉下（n=17）。汇入 LHDS 的 CB 数量在门静脉上和门静脉下之间存在显著差异（p=0.0484）。
DIC-CT 可显示 98.9%的受试者的 CB，且可进行详细评估。汇入 LHDS 的 CB 数量与 RPHD 和 PV 的位置有关。
