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目的为胰病变的断层影像诊断和外科治疗提供实用的形态学依据。方法在30例成人上腹部连续冠状断层标本及2例尸体腹部和5例健康成人上腹部磁共振(MRI)冠状图像上,研究冠状断面上胰的分部、毗邻和大小。结果在经肝门静脉左支角部的断面(A10)上胰颈首先出现,胰尾消失在经左右肾窦后份和脾门的断面(A20)上。在连续冠状断面上,胰集中出现于下腔静脉后缘前54 mm和后12 mm的范围内。在经肠系膜上静脉的断面(A12)上,胰颈位于肠系膜上静脉的前方,其最大上下径和最大左右径分别为20.93±3.61 mm和10.09±3.31mm。在经肝门静脉主干的断面(A13)上,胰头位于肝门静脉主干右下方和十二指肠降部的左前方,其最大上下径和最大左右径分别为46.58±6.44 mm和35.56±6.57 mm。在经下腔静脉前份和左肾静脉的断面(A15)上,胰体的左侧份位于脾静脉前方和左肾血管的上方,其最大上下径和最大左右径分别为28.16±5.31 mm和51.27±11.80 mm。在经下腔静脉后份和主动脉裂孔的断面(A17)上,胰尾位于左肾外上方、脾门和胃底之间,其最大上下径和最大左右径分别为21.13±2.06 mm和34.11±6.03 mm。结论在冠状断面上,肠系膜上静脉是识别胰颈的标志,下腔静脉和左肾静脉分别是识别胰头和胰体的标志,脾动、静脉和左肾是识别胰尾的标志。
Objective To provide a practical morphological basis for the diagnosis and surgical treatment of pancreatic lesions by tomography. Methods Sections, adjacent and size of the pancreas in the coronal section were studied on 30 cases of adult upper abdomen continuous coronal specimens, 2 cases of cadaver belly and 5 cases of healthy adult upper abdomen magnetic resonance (MRI) coronal images. Results The pancreatic neck appeared first in the section of the left branch of the hepatic portal vein (A10). The tail of the pancreas disappeared in the cross section of the left and right renal sinus (A20) and the splenic portal (A20). In the continuous coronal section, the pancreas was concentrated in the range of 54 mm anterior and 12 mm posterior to the trailing edge of the IVC. In the superior mesenteric vein cross-section (A12), the pancreatic neck is located in front of the superior mesenteric vein, and its maximum diameter and maximum diameter are respectively 20.93 ± 3.61 mm and 10.09 ± 3.31 mm. In the section of the main portal vein (A13), the head of the pancreas is located at the lower right of the trunk of the hepatic portal vein and the left front of the descending part of the duodenum. The maximum diameter and the maximum diameter of the pancreas are 46.58 ± 6.44 mm and 35.56 ± 6.57 mm . In the anterior inferior vena cava and the left renal vein (A15), the left side of the pancreas is located in front of the splenic vein and above the left renal artery with the maximum and minimum diameters of 28.16 ± 5.31 mm and 51.27 ± 11.80 mm. The posterior part of the inferior vena cava and the aorta hole (A17) showed that the tail of the tail was located above the left kidney, between the spleen and the fundus, and its maximum diameter and maximum diameter were 21.13 ± 2.06 mm and 34.11, respectively ± 6.03 mm. Conclusions The superior mesenteric vein is a sign of identifying the neck of the pancreas in the coronal section. The inferior vena cava and the left renal vein are the markers for identifying the pancreatic head and body of the pancreas. Splenic artery, vein and left kidney are the markers for identifying the tail of the pancreas.