van Leeuwen M S, Noordzij J, Fernandez M A, Hennipman A, Feldberg M A, Dillon E H
Department of Radiology, University Hospital Utrecht, The Netherlands.
AJR Am J Roentgenol. 1994 Dec;163(6):1395-404. doi: 10.2214/ajr.163.6.7992736.
The purpose of this study was to evaluate the segmental anatomy of the right hemiliver and to assess whether the right hepatic vein and right portal trunk are accurate indicators of the position of the right and transverse scissurae, respectively.
We examined 26 patients with spiral CT using 5-mm slices, reconstructed at 2-mm intervals. Three-dimensional renderings of the portal and hepatic venous structures were created. The portal ramification pattern and relationship between the hepatic veins and portal system were evaluated.
In the right hemiliver, an anterosuperior sector and a posteroinferior sector were present in all patients. In addition, in nine patients, a total of 15 accessory portal sectors were present, each arising directly from the portal bifurcation or the right portal trunk. Further subdivision of the portal sectors showed marked individual variability, with no prevailing branching pattern. The scissura between the anterosuperior and posteroinferior sectors showed an angled orientation--its cranial part was tilted posteriorly (average, 58.4 degrees) and its caudal part was tilted anteriorly (average, 2.8 degrees)--relative to the coronal plane. In 24 patients, portal branches crossed the plane of the right hepatic vein. No transverse scissura could be seen in the anterosuperior or posteroinferior sector.
The right hemiliver could be divided into anterosuperior and posteroinferior sectors in all patients studied. Many patients have accessory sectors. Further subdivision into portal segments can be described only after the individual portal branching pattern has been studied. The right hepatic vein is an inaccurate indicator of the position of the right scissura. No clear transverse scissura can be seen in the right hemiliver.
本研究旨在评估右半肝的节段性解剖结构，并评估右肝静脉和右门静脉主干是否分别是右肝裂和横裂位置的准确指示标志。
我们对26例患者进行了螺旋CT检查，扫描层厚5mm，重建间隔2mm。创建了门静脉和肝静脉结构的三维图像。评估了门静脉分支模式以及肝静脉与门静脉系统之间的关系。
在所有患者的右半肝中，均存在一个前上扇区和一个后下扇区。此外，在9例患者中，共有15个副门静脉扇区，每个副门静脉扇区均直接起源于门静脉分叉或右门静脉主干。门静脉扇区的进一步细分显示出明显的个体差异，没有普遍的分支模式。前上扇区和后下扇区之间的肝裂呈角状取向——相对于冠状面，其头侧部分向后倾斜（平均58.4度），尾侧部分向前倾斜（平均2.8度）。在24例患者中，门静脉分支穿过右肝静脉平面。在前上扇区或后下扇区未见横裂。
在所有研究的患者中，右半肝均可分为前上扇区和后下扇区。许多患者有副扇区。只有在研究了个体门静脉分支模式后，才能描述门静脉段的进一步细分。右肝静脉不是右肝裂位置的准确指示标志。在右半肝中未见清晰的横裂。
