Sectional Imaging Anatomy Of Intrahepatic Biliary Duct

Objectives:To investigate the intrahepatic bile ducts running, distribution, type and variation ofconvergence, and the three-dimensional spatial relationship between intrahepatic bile ductand its tributaries and the corresponding intrahepatic portal vein and its branches, toprovide practical imaging anatomical basis for imaging precise positioning diagnosis ofintrahepatic bile duct and its surrounding structures and lesions and all sorts of hepaticsurgical operation.Materials and methods:Selection of Chinese adults in6cadavers (male5, female1), to obtain thickness8mmupper abdominal continuous sectional specimens using electric band saw by isometricmethod; the other selected1Chinese adult male cadavers after acquisition MRI data,interception of cadaveric upper abdomen, using low temperature frozen layer millingmethod, the use of cutting accuracy for0.001mm SKC500CNC milling machine, fromanterior to posterior, access to0.2mm thick upper abdominal continuous thin coronalsectional image.Selection of10healthy volunteers (8male,2female patients), Signa HDe1.5T by GE MRI scanners and AW4.4image processing workstation, access to upperabdominal transverse T1weighted images, T2weighted images, coronal T2fat suppressionand different angles MRCP images from selected clinical30cases; different etiologicalcauses of intrahepatic bile ducts in different degree of expansion, and intrahepatic bile ductanatomy clearly identified clinical patients, has also adopted the MRI scanner and imageprocessing workstation, access to upper abdominal transverse T1, T2weighted images,coronal T2weighted images and different angles of the MRCP image, and obtain thecoronary an enhanced LAVA portal venous phase images.System study of intrahepatic bileducts running, distribution, type and variation of convergence, and to explore theintrahepatic bile duct and its tributaries and the corresponding intrahepatic portal vein andits branches between the three-dimensional spatial relationship. Focusing on the left, right porta hepatis, right anterior lobe porta hepatis, right posterior lobe porta hepatis, in leftlongitudinalis sulcus the left branch of the portal vein in sagittal section peripheralintrahepatic bile duct and the corresponding sectional and imaging anatomy of the hepaticportal vein and its branches between concomitant relationship.Results:Strengthening LAVA portal venous phase MR images of the intrahepatic portal veinand its branches showed high signal and intrahepatic bile duct and its tributaries were lowsignal, can be clearly identified intrahepatic bile duct and its tributaries and thecorresponding intrahepatic portal vein and its branches between concomitant relationship.The dilated intrahepatic bile duct in patients with peripheral vascular and parenchymalinvasion can be clearly displayed.Intrahepatic bile duct confluence is the most common form of the upper segment of theright anterior lobe often have two large bile duct branches respectively from the uppersegment of the right anterior lobe of the ventral and dorsal part, downward merged into theupper segment of the right anterior lobe of bile duct, the smaller bile duct of lower part ofright anterior lobe abouchement into the right anterior lobe bile duct; right posterior duct iscomposed of right posterior upper bile duct and right posterior lower bile duct coursingforward and posterior to right hepatic duct confluence. Left upper bile duct and left bileduct in the left branch of the portal vein to the left sagittal section of synthetic left laterallobe of the bile duct, the left sagittal part right and left medial lobe of the bile ducts of theleft hepatic duct, hepatic left, right duct out of the porta hepatis after the synthesis ofhepatic duct.The first hepatic portal on the right side of a typical right hepatic duct from the rightanterior duct and the right posterior duct formed by the confluence of the right posteriorlobe, close to the horizontal orientation of bile duct after right to move on in the hepaticportal vein of right anterior branch of the posterior medial left bank, right anterior duct inthe portal vein in right anterior branch of the medial by left down. Right hepatic duct inliver right branch of portal vein after synthesis from right to left over after the line.Rightanterior lobe of the bile duct is often accompanied by corresponding portal vein branch ofthe medial, and right posterior lobe of the bile ducts are often accompanied by portal veinbranch of the corresponding upper.Left hepatic duct at the hepatic portal vein of left corner on the concave side aftersynthesis, running from the hepatic portal vein of left transverse portion of the front, sidelobe below, from left to right.Left upper bile duct and left bile duct is constantly running from the hepatic portal vein of left sagittal part (cranial), the two bile duct in liver leftbranch of the portal vein to the left of the synthesis of sagittal left lateral lobe bile duct andthe two duct respectively in the left sagittal part right, on the left arrow shape of inner, leftbranch of the portal vein in the corner of the concave side and left medial lobe of the bileducts of the left hepatic duct. Hepatic left lateral lobe of the proper hepatic artery branchconstant running from the hepatic portal vein of left sagittal part (caudal).Conclusion:(1) strengthening LAVA portal venous phase MR images combined with MRCP canwell estimate the intrahepatic bile duct of the fine anatomy and corresponding intrahepaticportal vein branches between concomitant relationship. Strengthening LAVA portal venousphase MR images of the intrahepatic biliary system lesions on peripheral vascular invasionof intrahepatic portal vein branches invasion situation can be clearly displayed.(2) the right part of first porta hepatis is the identification of right hepatic ductconfluence of right hepatic duct type and variation of the key part, is also looking for andidentifying the right anterior lobe duct and the right posterior duct ideal site.The firsthepatic portal on the right side of a typical right hepatic duct from the right anterior ductand the right posterior duct formed by the confluence of the right branch of the portal veinin liver, above and behind the line from right to left, the first after hepatic portal and lefthepatic duct confluence.Right anterior lobe of the bile duct is often accompanied bycorresponding portal vein branch of the medial, and right posterior lobe of the bile ductsare often accompanied by a corresponding right after portal vein branch of the upper lobe.(3) the left part of porta hepatis is the recognition of left hepatic duct confluence typesand common variant of the ideal location, left hepatic duct at the hepatic portal vein of leftcorner on the concave side after synthesis, running from the hepatic portal vein of lefttransverse portion of the front, side lobe below, from left to right, the first after hepaticportal and the right hepatic duct confluence.(4) left longitudinalis sulcus is the ideal site to identify left lateral hepatic bile duct andleft medial lobe bile duct. Left portal vein sagittal part (cranial) is left outside the left upperbile duct and bile duct walking constant position, the two bile duct confluence in thehepatic portal vein of left sagittal section of cranial side of the right, in the sagittal sectionof medial and left medial lobe of the bile duct confluence, or left outside, left upper bileduct bile duct, common bile duct of the left lobe of left hepatic duct. The left lateral lobe ofthe proper hepatic artery branch constant running from the hepatic portal vein of leftsagittal part (caudal).