肝脏解剖分段PPT课件

.,SectionalAnatomyandSegmentationofLiver,.,Segmentationoftheliver,TwocategoriesCouinaudssystem(“segment”)(S1S8,Couinaud,1989;S9,Couinaud,1994)andtheso-calledAmericansystem(“sector”)(thelateral,medialorparamedian,anteriorandposteriorsegmentsorsectors,andthecaudatelobe;Williams,1995),.,ConceptofCouinaudssegmentclassificationsystem,Theliverwasdividedintofoursegmentsbythreeverticalplanes,andeachsegmentwasfurthersubdividedintotwosubsegmentsbyatransversescissure.Eachsegmenthadabranch(oragroupofbranches)oftheportalveinatitscenterandatributaryofahepaticveinatitsperiphery,.,.,正中裂portalfissure,.,Couinaudssystem,.,Couinaudssystem,Basement：DistributionofGlissonsystemandhepaticveins,肝,左半肝右半肝,左外扇区左内扇区右前扇区右后扇区,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）,肝背扇区,主肝,I&IX,左外下段(III)IV,左外叶,左内叶,右前叶,右后叶,.,PortalVein,.,PortalVein,门脉脐部,.,.,HepaticVein,MiddleVein,.,肝段的划分方法,正中裂：肝中静脉-胆囊窝中点，分肝为左右半肝背裂：弧形线，分出尾状叶左叶间裂：门脉左支脐部，肝圆韧带，分出左内叶与左外叶左段间裂：肝左静脉，分出左外上段（II段）与左外下段（III段）右叶间裂：肝右静脉，分出右前叶与右后叶右段间裂：又称横裂,肝门脉右支，分右半肝为上下段,.,ConceptofCantliesline,Cantliesline(theprincipalborderormainlobarfissure)isgenerallybelievedtobealongthehilarbifurcationoftheportalvein,thefossaforthegallbladder,theleftmarginorthemidlineoftheIVCandtheterminalportionoftheMHVoralineslightlyrightoftheMHV,.,.,SectionalAnatomyofCadavericLiver&Computedtomography,.,VIII,VII,IV,III,II,LevelofHVsintoIVC,LHV,MHV,RHV,胃,肺,.,II,III,IV,VIII,VII,I,.,III,I,VII,VIII,IV,II,I,III,脾,.,I,II,IV,VIII,VII,III,.,I,III,VI,V,IV,Adrenalleft,PVR,.,III,VI,IV,V,gallbladder,CBD,PV,Duod,AdreR,SpleenV,.,VI,V,IV,.,V,VI,IV,.,V,IV,VI,.,VI,V,.,V,VI,.,ComputedTomography,.,.,.,.,.,.,.,IntroductionofMeVisFunctionalsegmentationandvolumeanalysis,.,VIII,.,VIII,IVb,.,VIII,IVb,VII,.,VIII,IVa,III,II,VII,I,RV,MV,LV,.,VIII,VII,IVa,III,II,I,LV,MV,RV,.,VII,VIII,V,II,III,DS,IVa,VIb,左叶间裂,门脉左支,门脉右支,.,I,II,III,VIa,VIa,V,VIII,IV,IIV,门脉右支,左叶间裂,.,III,IVa,IVb,VIII,V,VI,VII,胆囊,.,III,VIa,VIb,V,VI,VII,.,VIb,V,VI,VII,III,.,VI,V,.,VI,.,BoundariesbetweenIVaandIVb,SubsegmentIVblayanteriortothesubsegmentIVaSubsegmentsIVaandIVbwasnotsuperiorandinferior,butposterosuperiorandanteroinferior,respectively.TheboundaryisanobliqueplaneTributaryofahepaticvein(leftmedialmiddlevein)canserveastheanatomicallandmark(62.7%),.,BoundariesbetweenIVaandIVb,.,BoundariesbetweenIVaandIVb,