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目的探讨右半肝内门静脉的走行、分布规律及门静脉肝裂和肝静脉的关系,进而为肝段的划分提供断层解剖学依据。方法使用30例上腹部连续断层标本(10例横断面、20例冠状面)以及20例多层螺旋CT图像和三维图像,探讨右半肝内门静脉的分支类型和常见变异以及肝内门静脉和肝静脉之间的关系。结果50例标本和图像中,右半肝内门静脉均可分为前上和后下两组分支。76%(38/50)的门静脉右前支的分支向后分布至肝右静脉后方的部分区域。40%(20/50)的门静脉右后支的起始部向尾侧发出的第一分支分布至肝右静脉前的部分区域。门静脉右前支的分布区域,越过肝中静脉偏向左侧,在15例无门静脉右支主干的标本和图像中尤其明显。肝右前叶无明显横裂存在。门静脉的亚段分型有显著的个体差异,且无优势分支类型。结论右半肝可分为右前上叶和右后下叶,两叶之间为一弯曲的“裂隙”。肝右前上叶有一恒定的纵裂存在。肝右静脉不是右叶间裂的准确定位标志,尤其在其上份和下份。肝中静脉不是正中裂的准确识别标志,尤其在门静脉右支主干缺如的人群中。
Objective To explore the movement and distribution of portal vein in the right hepatic vein and the relationship between hepatic portal vein and hepatic vein, and to provide the anatomical basis for the segmentation of hepatic segments. Methods 30 cases of upper abdominal continuous-phase specimens (10 cases of cross-sectional, 20 cases of coronal) and 20 cases of multi-slice spiral CT images and three-dimensional images to explore the right hepatic portal vein branches and the common types of mutations and intrahepatic portal vein and liver The relationship between the veins. Results 50 cases of specimens and images, the right hepatic portal vein can be divided into two groups before and after the branch. 76% (38/50) of the branches of the right anterior branch of the portal vein were distributed back to the area behind the right hepatic vein. 40% (20/50) of the portal vein after the beginning of the right posterior branch of the tail issued to the first branch distribution to the right part of the right hepatic vein. The distribution area of the right anterior branch of the portal vein, over the left hepatic vein deviated to the left, was particularly evident in 15 specimens and images without the right portal branch of the portal vein. Right anterior lobe of the liver without significant transverse existence. There were significant individual differences in sub-type of portal vein with no dominant branch type. Conclusion The right hepatic lobe can be divided into right anterior upper lobe and right posterior lobe, a curved “fissure” between the two lobes. Right anterior lobe of the liver there is a constant longitudinal split existence. The right hepatic vein is not an accurate sign of the location of the right lobar cleft, especially on its upper and lower limbs. The middle hepatic vein is not an accurate identification of the median fissure, especially in the right portal branch of the missing population.