肝臟解剖分段課件

1、Sectional Anatomy and Segmentation of Liver Segmentation of the liverTwo categoriesCouinauds system (“segment”)(S1S8, Couinaud, 1989; S9, Couinaud, 1994) and the so-calledAmerican system (“sector”) (the lateral, medial or paramedian,anterior and posterior segments or sectors, and thecaudate lobe; Wi

2、lliams, 1995)Concept of Couinauds segment classification systemThe liver was divided into four segments by three vertical planes, and each segment was further subdivided into two subsegments by a transverse scissure. Each segment had a branch (or a group of branches) of the portal vein at its center

3、 and a tributary of a hepatic vein at its periphery正中裂portal fissureCouinauds systemBasement：Distribution of Glisson system and hepatic veins肝左半肝右半肝左外扇區(qū)左內(nèi)扇區(qū)右前扇區(qū)右后扇區(qū)左外上段（II）右前下段（V）右前上段（VIII）右后下段（VI）右后上段（VII）肝背扇區(qū)主肝 I & IX左外下段(III)IV左外葉左內(nèi)葉右前葉右后葉Portal VeinHepatic VeinMiddle Vein肝段的劃分方法正中裂 ： 肝中靜脈-膽囊窩中點

4、，分肝為左右半肝背 裂 ： 弧形線，分出尾狀葉左葉間裂：門脈左支臍部，肝圓韌帶， 分出左內(nèi)葉與左外葉左段間裂：肝左靜脈，分出左外上段（II段）與 左外下段（III段）右葉間裂：肝右靜脈，分出右前葉與右后葉右段間裂：又稱橫裂,肝門脈右支，分右半肝為上下段Sectional Anatomy of Cadaveric Liver&Computed tomography IIIIIIVVIIIVIIIIIIIVIIVIIIIVIIIIII脾IIIIVVIIIVIIIIIIIIIVIVIVAdrenal leftPV RIIIVIIVVgallbladderCBDPVDuodAdre RSpleen V

5、VIVIVVIVVIVIV Computed TomographyIntroduction of MeVisFunctional segmentation and volume analysisVIIIVIIIIVbVIIIIVbVIIVIIIIVaIIIIIVIIIRVMVLVVIIIVIIIVaIIIIIILVMVRVVIIVIIIVIIIIIDSIVaVIb左葉間裂門脈左支門脈右支IIIIIIVIaVIaVVIIIIVIIV門脈右支左葉間裂IIIIVaIVbVIIIVVIVII膽囊IIIVIaVIbVVIVIIVIbVVIVIIIIIVIVVIBoundaries between IVa

6、 and IVbSubsegment IVb lay anterior to the subsegment IVa Subsegments IVa and IVb was not superior and inferior, but posterosuperior and anteroinferior,respectively.The boundary is an oblique planeTributary of a hepatic vein (left medial middle vein) can serve as the anatomical landmark (62.7%)Boundaries between IVa and IVbBoundaries between IVa and IVbBoundaries between IVa a