Fasel J H, Selle D, Evertsz C J, Terrier F, Peitgen H O, Gailloud P
Department of Anatomy, University Medical Center, Geneva, Switzerland.
Radiology. 1998 Jan;206(1):151-6. doi: 10.1148/radiology.206.1.9423665.
To evaluate qualitatively and quantitatively the current procedures for radiologic delineation of the segmental and subsegmental anatomy of the liver.
Vascular casts of 10 livers were examined with helical computed tomography (CT). Liver segmental and subsegmental anatomy were determined on the CT scans according to customary radiologic practice guidelines. CT anatomic findings were compared with authentic anatomic territories seen at anatomic examination. The differences were assessed quantitatively in five of the 10 livers.
For the marginal (cranial and caudal) portions of the liver, an average (+/- 1 standard deviation) of 17.3% +/- 6.5 of the hepatic area visualized on axial CT scans was attributed to an incorrect subsegment. For the central zones (those adjacent to the right and left branches of the portal vein), this error amounted to 51.6% +/- 19.9. Expressed in absolute numbers, the error amounted to 40 mm on axial CT scans.
The radiologic determination of portal venous territories within the liver must be revised. The indirect landmarks currently used are not reliable for proper delineation. Only procedures that account for the portal venous distribution pattern, including peripheral branches, will result in correct depiction of the complex and variable anatomic reality.
对目前肝脏节段和亚节段解剖结构的放射学描绘方法进行定性和定量评估。
对10个肝脏的血管铸型进行螺旋计算机断层扫描（CT）检查。根据常规放射学实践指南，在CT扫描上确定肝脏的节段和亚节段解剖结构。将CT解剖学发现与解剖检查中所见的真实解剖区域进行比较。在10个肝脏中的5个肝脏中对差异进行定量评估。
对于肝脏的边缘（头侧和尾侧）部分，在轴向CT扫描上显示的肝脏区域平均（±1标准差）有17.3%±6.5%归因于亚节段划分错误。对于中央区域（那些与门静脉左右分支相邻的区域），这个误差为51.6%±19.9%。以绝对数字表示，轴向CT扫描上的误差为40毫米。
肝脏内门静脉区域的放射学判定必须修正。目前使用的间接标志对于正确划分并不可靠。只有考虑门静脉分布模式（包括周边分支）的方法才能正确描绘复杂多变的解剖实际情况。
