活体肝移植术前MSCT评估肝静脉

摘要

Objective To assess the value of MSCT in the evaluation of the anatomy and variation of hepatic veins for living donor liver transplantation (LDLT) donors and the significance of vessel variation in surgical operation. Methods A total of 238 subjects who wanted to be the donors of LDLT underwent MSCT plain and enhanced examination, and the hepatic veins were evaluated. Results Among all 238 subjects, according to Nakamura's classification of hepatic veins, 164 were type Ⅰ, 60 were type Ⅱ, 14 were type Ⅲ. The left hepatic vein (LHV) shared a common trunk with the middle one in 167 subjects. Branches of Ⅷ going along the cross section and diameter larger than 5 mm were detected in 105 subjects. The Ⅳ segment veins drained into MHV in 68, into LHV in 7 subjects. Right inferior hepatic vein with diameter larger than 3 mm was found in 108 subjects, while the distance between RHV and IRHV were larger than 4 cm in 55 subjects. Conclusion MSCT can offer details and exact information about the donors pre-operation, and is an important non-invasive method for the evaluation of hepatic veins of potential LDLT donors.%目的 探讨MSCT在评价活体肝移植供体肝静脉解剖及变异中的价值及各种血管变异对移植手术的影响.方法 对拟作为活体肝移植供体的238例受试者行MSCT检查,并对其肝静脉解剖及变异进行评估.结果 238例受试者中,Nakamura肝静脉分型Ⅰ型164例,Ⅱ型60例,Ⅲ型14例.167例肝左静脉(LHV)和肝中静脉(MHV)共干;105例存在直径大于5 mm的Ⅷ段分支经过肝切面汇入MHV;68例Ⅳ段肝静脉汇入MHV,7例汇入LHV,其余汇入LHV及MHV;108例共出现139支直径大于3 mm的右肝下副静脉,55例65支右肝下副静脉与肝右静脉(RHV)的距离大于4 cm.结论 术前MSCT可提供关于供体静脉的详细、准确的信息,是拟肝移植供体术前静脉评估的重要无创性检查方法.