Hepatic Venous Drainage: How Much Can We Learn From Imaging Studies? Anatomic-Functional Classification Derived From Three-Dimensional Computed Tomography Reconstructions
Hepatic Venous Drainage: How Much Can We Learn From Imaging Studies? Anatomic-Functional Classification Derived From Three-Dimensional Computed Tomography Reconstructions
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肝静脉引流：我们可以从影像学研究中学到多少？
DOI：
10.1097/tp.0b013e3181dd6bac
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发表时间：
2010
期刊：
影响因子：
6.2
通讯作者：
Malago M
中科院分区：
文献类型：
--
作者：
Radtke A;Sotiropoulos GC;Sgourakis G;Molmenti EP;Schroeder T;Saner FH;Beckebaum S;Broelsch CE;Broering DC;Malago M
背景：在活体供肝移植和扩大肝切除中，“静脉优势”的知识对于预防严重的静脉充血是必不可少的。目的：我们的研究目的是描述我们提出的肝静脉引流的解剖-功能分类。方法：连续140名活体供肝候选人接受了三维CT重建和三维虚拟肝切除术。在引流体积或区域上定义了五种不同的静脉优势类型。识别并分类了“危险”配置。结果：无论是否存在下(副)肝静脉(IHV)，大多数(83.5%)患者的全肝和右半肝(RHH)以右肝静脉(RHV)为主。肝中静脉(MHV)占全肝(TL)的15.5%，RHH占27%。左肝静脉几乎总是(92%)在左半肝占优势。当IHV引流量较大时，如果不重建IHV，以TL为主的RHV/IHV复合体将导致以RHH为主的MHV(平均59.5%RHH)。结论我们提出的解剖-功能分类为了解肝静脉优势模式提供了有价值的见解。静脉充血的高危RHH静脉引流模式包括：(1)TLMHV占优势；(2)RHV/IHV复合体占优势，IHV引流量大。
Background.The knowledge of “venous dominance” is essential to prevent serious venous congestion in live donor liver transplantation and extended liver resections.Aims.The purpose of our study was to delineate our proposed anatomic-functional classification of hepatic venous drainage.Methods.One hundred forty consecutive live liver donor candidates underwent three-dimensional computed tomography reconstructions and three-dimensional virtual hepatectomies. Five different venous dominance types were defined on drainage volumes or territories.“Risky” configurations were identified and classified.Results.The right hepatic vein (RHV) was dominant for the entire liver and right hemiliver (RHH) in most (83.5%) cases irrespective of the presence of inferior (accessory) hepatic veins (IHVs). The middle hepatic vein (MHV) was dominant for the total liver (TL) in 15.5% of cases and for the RHH in 27% of cases. The left hepatic vein was almost always (92%) dominant for the left hemiliver. When associated with a large IHV drainage volume, a RHV/IHV complex dominant for the TL led to a RHH dominant MHV (mean 59.5% RHH) if the IHV was not reconstructed.Conclusions.Our proposed anatomic-functional classification provides a valuable insight into hepatic vein dominance patterns. RHH venous drainage patterns at “high risk” for venous congestion include (1) a dominant MHV for the TL and (2) a dominant RHV/IHV complex with a large IHV drainage volume.
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DOI：
--
发表时间：
1958
期刊：
影响因子：
--
作者：
C. Couinaud;C. Nogueira
通讯作者：
C. Nogueira
[放射学中的虚拟现实]。
DOI：
--
发表时间：
1997
期刊：
Duodecim lääketieteellinen aikakauskirja
影响因子：
--
作者：
I. Suramo;T. Talala;V. Karhula;S. Lähde;J. Oikarinen
通讯作者：
J. Oikarinen
影响因子：
25.7
作者：
Tanaka, K;Yamada, T
通讯作者：
Yamada, T
右肝移植活体肝移植中肝静脉重建的指征。
影响因子：
0.9
作者：
T. Kubota;S. Togo;H. Sekido;R. Shizawa;K. Takeda;D. Morioka;K. Tanaka;I. Endo;H. Shimada
通讯作者：
H. Shimada
计算机模拟右活体肝切除术中肝中静脉的分支模式和引流区域
影响因子：
8.8
作者：
J. Neumann;J. Neumann;M. Thorn;L. Fischer;Max Schöbinger;T. Heimann;B. Radeleff;Jan Schmidt;H. Meinzer;M. Büchler;P. Schemmer
通讯作者：
P. Schemmer