肝脏解剖与常见病影像诊断

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1、TheHepaticLesion:RadiologicAssessmentTheAffiliatredhospitalofNBUWangJIANHUAwoxingw@sina.com2014-12-29CASEObjectivesNormalliveranatomyImagingtechniquesCommondiseasesimagingdiagnosisDiffusediseasesFocaldiseasesAnatomyoftheliversegmentsTwodifferentaspects:morph

2、ologicalanatomyandfunctionalanatomy.C.Couinaud(1957)dividedtheliverintoeightfunctionallyindepedentsegments.Thisclassificationwillbepresentedherewithseveralillustrations.CouinaudclassificationDividestheliverintoeightfunctionallyindepedentsegments.Eachsegmenth

3、asitsownvascularinflow,outflowandbiliarydrainage.Inthecentreofeachsegmentthereisabranchoftheportalvein,hepaticarteryandbileduct.Intheperipheryofeachsegmentthereisvascularoutflowthroughthehepaticveins.PortahepatisSecondPortahepatisRighthepaticveindividestheri

4、ghtlobeintoanteriorandposteriorsegments.CrosstransversePortalveindividestheliverintoupperandlowersegments.Middlehepaticveindividestheliverintorightandleftlobes(orrightandlefthemiliver).ThisplanerunsfromtheinferiorvenacavatothegallbladderfossaLefthepaticveind

5、ividestheleftlobeintoamedialandlateralpart.Theimageonthefarleftisattheleveloftherightportalvein.Atthisleveltherightportalveindividestherightlobeoftheliverintosuperiorsegments(7and8)andtheinferiorsegments(5and6).Theleveloftherightportalveinisinferiortothelev

6、eloftheleftportalvein.Atthelevelofthesplenicvein,whichisbelowtheleveloftherightportalvein,onlytheinferiorsegmentsareseen(rightimage).Counterclockwise1CaudatelobeSegment1Segment4aSegment8Segment72Leftlateraluppersagment8Rightanterioruppersagment4Leftmedialsag

7、ment7RightposterioruppersagmentSegment2LeftlateraluppersagmentLeftlaterallowsegmentLeftmedialsegmentRightposterioruppersegmentRightanteriorupperdegmentRightanteriorlowdegmentRightposteriorlowsegmentLiveranatomyImagingtechniquesUS:firstchoice,screening,diffic

8、ulttocharacterizethelesionsCT:importanttechniqueMRI:problemresolvingtechniqueGoodmethodsofdecidingpositionandpredictingthenatureofthemassCTtechniques7090120CTenhancedtechniquesTheliverhasadualbl