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目的探讨CT仿真内窥镜(CTvirtual endoscopy,CTVE)在精确区分肝门静脉变异类型中的应用价值。方法对CT门静脉血管成像(CTportal angiology,CTPA)病例中筛选出MIP、VR显示为肝门静脉主干3分叉的15例病人和右支主干显示为3分叉的17例病人用CTVE分析。重点分析3分叉处的管腔结构,例如肝门静脉主干处,右前支-左支(RAPV-LPV)短共干或者是右前支-右后支(RAPV-RPPV)短共干很容易被误认为主干3分叉。以评价CTVE在分辨短共干与3分叉中的价值,纠正原始方法观察分支的欠缺。结果肝门静脉主干3分叉中60%(9例)经CTVE分析为短RAPV-LPV共干或短RAPV-RPPV共干。17例右支主干3分叉中,35%(6例)为右支主干先分出右后上支,然后分为右后下支和右前支,12%(2例)例为正常解剖(I型变异)。经CTVE分析后,32例病人只有47%(15例)是真正3分叉,阳性率仅为0.47,统计学有显著差异。结论由于短共干分支外观上极易与真正3分叉混淆,而CTVE可以真实显示腔内分叉的顺序,从而清晰鉴别3分叉与短共干。此方法可用于肝门静脉解剖的研究,纠正原始方法的不足,获得更加准确的数据。
Objective To investigate the value of CT virtual endoscopy (CTVE) in differentiating hepatic portal vein variability accurately. Methods MIPs were screened from CT portal angiography (CTPA). Fifteen patients with VR showed a bifurcation of the hepatic portal vein and 17 patients with a right branch with a three-forked trunk were analyzed by CTVE. Focusing on the lumen structures at the 3 bifurcation, such as the proximal hepatic portal vein, RAPV-LPV short co-stem, or RAPV-RPPV short co-stem can easily be mistaken Think trunk 3 forks. To evaluate the value of CTVE in resolving short total dry and 3 forks, and to correct the lack of observation of the original method. Results 60% (9 cases) of the hepatic portal vein bifurcation were analyzed by CTVE as either short RAPV-LPV or short RAPV-RPPV. Of the 17 cases, 35% (6 cases) were divided into the right posterior branch and the right anterior branch in 35% (6 cases), the right branch and the right branch respectively, and 12% (2 cases) were normal anatomy Type I variation). After CTVE analysis, only 47% of 32 patients (15 cases) were truly 3-pronged, the positive rate was only 0.47, statistically significant differences. Conclusion Due to the appearance of short total dry branches easily confused with true 3 bifurcation, CTVE can truly show the order of bifurcation in the lumen and clearly identify the 3 bifurcation and the short stem. This method can be used to study the hepatic portal vein anatomy, correct the deficiencies of the original method, and obtain more accurate data.