中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (18): 3305-3309.doi: 10.3969/j.issn.1673-8225.2012.18.017

• 器官移植基础实验 basic experiments of organ transplantation • 上一篇    下一篇

亚毫米CT观察肝外胆管的供血小动脉*★

王显龙1, 2，方驰华3，全显跃2，杨  剑3，贾洪顺2，梁  波2，肖  莉4，江永焰2   

  1. 1南方医科大学，广东省广州市 510515；南方医科大学珠江医院， 2影像中心，3肝胆一科，广东省广州市  510282；4广东省育才幼儿园二院，广东省广州市  510080
  • 收稿日期:2012-01-25 修回日期:2012-03-05 出版日期:2012-04-29 发布日期:2012-04-29
  • 通讯作者: 方驰华，主任医师，教授，南方医科大学珠江医院肝胆一科，广东省广州市 510282
  • 作者简介:王显龙★，男，1980年生，湖南省永兴县人，汉族，南方医科大学在读硕士，主治医师，讲师，主要从事腹部影像诊断与肝胆胰脾外科数字化仿真手术研究。wxlxiaobao@yahoo.com.cn
  • 基金资助:

    2011国家自然基金面上项目(81170458)。

Sub millimeter CT observations of the blood supplying arterioles of extrahepatic bile duct

Wang Xian-long1, 2, Fang Chi-hua3, Quan Xian-yue2, Yang Jian3, Jia Hong-shun2, Liang Bo2, Xiao Li4, Jiang Yong-yan2   

  1. 1Southern Medical University, Guangzhou  510515, Guangdong Province, China; 2Imaging Center,    3 First Department of Hepatology, Zhujiang Hospital of Southern Medical University, Guangzhou  510282, Guangdong Province, China; 4Yucai Kindergarten of Guangdong Province, Guangzhou  510080, Guangdong Province, China
  • Received:2012-01-25 Revised:2012-03-05 Online:2012-04-29 Published:2012-04-29
  • Contact: Fang Chi-hua, Chief physician, Professor, First Department of Hepatology, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, Guangdong Province, China
  • About author:Wang Xian-long★, Studying for master’s degree, Attending physician, Lecturer, Southern Medical University, Guangzhou 510515, Guangdong Province, China; Imaging Center, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, Guangdong Province, China wxlxiaobao@yahoo. com.cn
  • Supported by:

    Key Project of 2011 National Natural Science Foundation, No.81170458*

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摘要：

背景：亚毫米CT扫描速度极快，有效减少了运动伪影，分辨力极高，可以观察到内径在1 mm以下的小动脉。
目的：采用亚毫米CT观察肝外胆管的供血小动脉。
方法：纳入因各种原因需行上腹部亚毫米CT血管造影患者54例，利用连续薄层源图像观察，辅以多平面重组、最大密度投影、容积再现，观察小动脉起源、支数、分布优势，同时测量胆总管直径。
结果与结论：54例图像中胆总管均为1支，走行无特殊，其中51例能观察到胰十二指肠上动脉，伴行于胆总管下段；其中7例胰十二指肠上动脉与胰十二指肠下动脉吻合成动脉弓，亦伴行下段胆总管；上段供血小动脉中11例为胆囊动脉近段，14例发自右肝动脉，2例发自肝固有动脉，1例发自肝总动脉，1例发自左肝动脉。下段胆管供血小动脉占优势者39例，上段供血小动脉占优势者10例，其余5例较为均衡。54例胆总管内径4-24(11.0±5.8) mm。表明胆总管上段供血脆弱，因此该区术中不宜盲目分离、结扎小血管；对于胆石症与肝胰良恶性占位的中老年患者，术前行上腹部CT血管造影检查是有必要的。
关键词：胆总管；动脉；血供；计算机断层成像(CT)；血管造影
doi:10.3969/j.issn.1673-8225.2012.18.017

关键词: 胆总管, 动脉, 血供, 计算机断层成像(CT), 血管造影

Abstract:

BACKGROUND: Sub millimeter CT scan has the advantages of extremely high speed, reducing the motion artifacts and high resolution; it can be used to observe the arterioles with the diameter less than 1 mm.
OBJECTIVE: To observe the blood supplying arterioles of extrahepatic bile duct by sub millimeter CT.
METHODS: Fifty-four cases that need to perform the sub-millimeter CT angiography on the abdomen due to various reasons were selected, a continuous thin source image observation was used combined with multi-planar reconstruction, maximum intensity projection and volume rendering to observed the arteriolar origin, count and distribution dominance, as well as the bore of the common bile duct.
RESULTS AND CONCLUSION: There were 54 images and one common bile duct in each image and there was no special running. The superior pancreaticoduodenal artery could be observed in 51 cases, accompanied by the inferior segment of common bile duct; in 7 cases, the superior and the inferior pancreaticoduodenal artery anastomosed to be artery arch, also accompanying inferior segment of common bile duct; in the superior blood supplying arterioles, 11 cases were cystic artery proximal segment, 14 patients from the right hepatic artery, 2 patients from the hepatic artery, 1 patient from the common hepatic artery and 1 patient from left hepatic artery. Thirty-nine cases of lower segment of bile duct blood supplying arterioles were in advantage, 10 cases of upper segment of bile duct blood supplying arterioles were in advantage and the remaining 5 cases were in balance. The inside diameter of the common bile duct of the 54 cases were 4-14 (11.0±5.8) mm. The inferior common bile duct supplying arteries are fragile, so the blind separation and the ligation of small blood vessels are not favorable during the operation. For cholelithiasis and liver and pancreatic malignant and benign space-occupying lesions in elderly patients, preoperative abdominal CT angiography examination is necessary.

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