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目的观察右门静脉第3级分支与右肝静脉的前后关系,阐明右肝静脉是否与右纵裂相一致,能够作为右前段和右后段的分界标志。方法观察连续100例门静脉显示良好无严重肝硬化的螺旋CT动脉性门静脉造影(CTAP)影像并行三维重建,对清楚显示右门静脉与右肝静脉关系的69例,对照观察三维CTAP和轴位CTAP影像。结果右门静脉第3级分支与右肝静脉关系的分析表明,在S8与S7之间近右膈顶的部分,右纵裂多数(54/64,84%)位于右肝静脉之背侧;在S5与S6之间,右纵裂经常(46/69,67%,约2/3)位于右肝静脉的腹侧。结论右肝静脉不是可靠的分界右前段和右后段的标志。门静脉的第3级分支是确定肝段的关键标志,提示应以门静脉第3分支P5～P8确定相应的肝段S5～S8,避免以右肝静脉为标志对肝段或肝肿瘤的错误定位。
Objective To observe the anteroposterior relationship between the third grade of the right portal vein and the right hepatic vein and clarify whether the right hepatic vein is consistent with the right longitudinal crack and can be used as the demarcation mark of the right anterior segment and the right posterior segment. Methods A total of 69 consecutive patients with right portal vein and right hepatic vein were examined by CTCT in 100 consecutive patients with severe cirrhosis who showed no serious cirrhosis. Three-dimensional CTAP and axial CTAP images were observed. . Results The analysis of the relationship between the third grade of the right portal vein and the right hepatic vein showed that the majority of the right longitudinal part (54 / 64,84%) was located on the dorsal side of the right hepatic vein Between S5 and S6, right longitudinal splint (46/69, 67%, about 2/3) is often located on the ventral side of the right hepatic vein. Conclusion The right hepatic vein is not a reliable marker of right anterior and posterior segments. The third branch of the portal vein is the key to identify the liver segment, suggesting that the third branch of the portal vein P5 ~ P8 to determine the corresponding segment of the liver S5 ~ S8, to avoid the right hepatic vein as a marker for liver or liver tumor misposition.