The Study on Sectional Anatomy and Imaging of Accessory Hepatic Veins

摘要

Objective: To evaluate the distribution and clinical value of accessory hepatic veins (AHV) by combining the thin sectional anatomy data, liver dissection specimens with ultrasonography and spiral computed tomography images. Methods: (1) Choose two Chinese adult cadavers as specimen and utilize the digital freezing milling technique, the serial transverse and coronal sections (0.1mm) of liver were acquired to investigate the AHV number, trace, caliber and the angle between AHV and the IVC. (2) Choose 26 non-pathologic livers which were fixed by formalin randomly, dissect IVC along the median line of back wall to observe the AHV caliber, observe the source, trace and the number of AHV by the anatomy magnifier, and investigate the angle between the long shafts of AHV and IVC. (3) Choose 800 samples of checkup randomly and take the ultrasound exams to investigate the joined position, number, caliber of AHV and the angle between the shafts of AHV and IVC. (4) Choose 80 cases without liver pathological changes randomly for reinforced CT exam to investigate the anatomy of AHC and the angle between AHC and IVC. And choose 9 samples to do 3D reconstruction. Results: (1) There are 9 AHV in liver on the transverse sections. The average caliber is 0.06± 0.05mm. There are 2 AHV which is right angle between IVC and AHV, and 7 AHV which is acute angle, which distribute from the section through first porta hepatic to the second portal hepatic. There are 3 AHV on the coronal sections. The average caliber is 0.10±0.04mm. There are 1 AHV which is right angle between IVC and AHV, and 2 AHV which is acute angle. (2) There are 272 AHV in 26 specimen, average 10.42±8.1 (2~24) AHV/person. The average caliber is 0.29±0.22 (0.1~1.0)cm. There are 195 AHV which is acute angle between IVC and AHV, average 7.51± 5.61/person. The average caliber is 0.26±0.10cm, account for 72% in total. There are 77 AHV which is right angle between IVC and AHV, average is 2.91±1.79, and average caliber is 0.38±0.18cm, 28% in total. (3) There are 568 AHV in 800 samples, average 0.72± 0.38 (0-3). The average caliber is 0.35~0.16cm, the angle between IVC and AHV is right angle or close to right angle ,505/568), average 0.61±0.28/person. The average caliber is 0.36±0.17cm. There are 63 AHV which is acute angle between IVC and AHV, average is 0.11±0.08/person, and average caliber is 0.26±0.12cm, 11% in total. There are 230 samples of inferior right hepatic vein in 800, caliber is 0.30~0.81cm. The average caliber is 0.40±0.19cm. (4) There were only 29 inferior right hepatic veins in 24 cases of the 80 spiral CT scan images, average caliber was (0.3±0.14)cm. And no small AHV displayed. Conclusion: (1) The digital freezing milling technique improved the human liver sectional anatomy to the level of sub-millimeter and provided the foundation for three dimensional reconstructions of AHV and IVC. (2) The large number of normal Chinese AHV varies obviously. (3) The ultrasound and spiral CT have angle selectivity on displaying AHV. The ultrasound can display part of AHV which is right angle between IVC and AHV. The ultrasound is better than spiral CT in displaying the small caudate lobe veins.