肝臟分段(中英文對照版)

門靜脈分支在肝臟內的分枝和分佈,伴隨著肝動脈和膽管的分支,遵循一個相當恆定的組織機構,儘管放射科醫生和外科醫生應該考慮變異的存在。

原文:

The division and distribution ofthe branches of the portal vein within the liver, accompanied by ramificationsof the hepatic artery and the bile ducts, follows a quite constantorganization, although variants[9, 10]should be taken into account by radiologists and surgeons.

因此,可以在肝臟內描述一些肝區或肝段,這是Couinaud的經典描述;這些部分擁有獨立於鄰近區域的血液供應和膽道引流,允許部分切除該器官。門靜脈是主要的傳入血管,它分為兩支,分別供應肝臟的右側和左側。在器官的內臟表面,有一條線表示左右兩個區域,從膽囊狀窩到下腔靜脈的左邊緣(Cantlie’s線)。兩個主要的門靜脈分支依次分為二級分支:如圖所示,左分支發出一隻側枝、一隻旁枝和一隻尾葉枝;右分支口徑較大,分為側支和旁支,各有前支和後支。四個扇區以如下的方式被劃分:兩個右側扇區,左側扇區和中間扇區,然後這兩個區域又可以進一步分為兩個左側區和中間區。在這些區域中,三條肝靜脈沿著稱為門裂的垂直面走行:右門裂、主(中)門裂、左門裂。門脈分支的進一步細分,每一節產生兩段;靜脈分佈於更侷限的實質部分,沒有交換吻合。因此,我們描述了肝臟的八個功能獨立的段(圖1.4)。

肝臟分段(中英文對照版)


原文:

It is therefore possibleto describe within the liver some hepatic territories or sectors, classicallydescribed by Couinaud [11]; these sectors possess blood supply and biliarydrainage independent of neighboring territories, allowing a partial surgicalresection of the organ. The portal vein, the main afferent vessel, divides intotwo branches that supply the right side and the left side of the liver. On thevisceral surface of the organ, a line identifies the left and rightterritories, going from the cystic fossa to the left margin of the inferiorvena cava (Cantlie’s line). The two main portal branches in turn divide intosecondary branches: schematically, the left branch gives rise to a lateral anda paramedian branch, and a branch for the caudate lobe; the right branch, oflarger caliber, divides into the lateral and the paramedian branches, eachgiving front and rear branches. Four sectors are thusdistinguished: two right sectors, lateral and medial, and two left lateral andmedial sectors. Among these sectors the three hepatic veins run followingvertical planes called portal fissures: right portal fissure, main (middle) portalfissure, left portal fissure. The further subdivision of the portalbranches gives rise to two segments for each sector; veins distribute to morerestricted parts of the parenchyma, without exchanging anastomoses. Thus, wedescribe eight functionally independent segments of the liver [12](Fig. 1.4).

I段:它對應於尾狀葉。與IV段相比,它位於更背部位置,與II段相鄰,而在右側,它包裹著下腔靜脈。根據不同的分類,在該段內可識別出兩個或三個區域,接受血管主要來自門靜脈左支,部分也來自右支。傳出靜脈直接流入下腔靜脈。膽管通常流入左肝管,非常接近右肝管的匯合點。

原文:

Segment I. It correspondsto the caudate lobe. It is in a dorsal position compared to segment IV , andadjacent to segment II, while on the right it enfolds the inferior vena cava.According to different classifications, two or three territories can berecognize within the segment, receiving vessels mainly from the left branch ofthe portal vein, and partly also from the right one. The efferent veins draindirectly into the inferior vena cava. The bile ducts usually flow into the lefthepatic duct very close to the point of confluence with the right one.

Ⅱ段:位於左肝門裂的外側,位於肝左葉的上外側位置。

原文:

Segment II. It is locatedlaterally to the left portal fissure in a superior-lateral position in the leftlobe of the liver.

Ⅲ段:位於臍裂左側,位於肝左葉下外側位置。它從一到兩個左門靜脈分支接受血液,但也可以從一個小的右分支接受血液。它會流入肝左靜脈。

原文:

Segment III. It is on theleft of the umbilical fissure, in an inferior-lateral position of the left lobeof the liver. It receives blood from one to two left portal branches, but itcan also receive from a small right branch. It drains into the left hepaticvein.

Ⅳ段位於尾狀葉前、臍裂右側、門靜脈主裂或中裂內側。它由門靜脈右支供血,偶爾也有小的左支供血,然後引流到中肝靜脈。區分上部和下部,分別為IVa和IVb。

原文:

Segment IV . Located infront of the caudate lobe, at the right of the umbilical fissure and mediallyto the main or middle portal fissure. It is supplied with blood from the rightbranch of the portal vein and only occasionally also from a small left branch,and drains into the mean hepatic vein. An upper and a lower part aredistinguished, respectively IVa and IVb.

V段:位於肝中靜脈和右肝靜脈之間的前下方位置,血液從肝實質流出。它由右門脈分支供血。

原文:

Segment V . It is inanterior-inferior position, between the middle and right hepatic veins, wherethe blood drains from the parenchyma. It is vascularized by the right portalbranches.

VI段:它對應於右外側或後下部。它從門靜脈右外側支接受血液,然後引流到肝右靜脈。

原文:

Segment VI. It correspond tothe lower part of the lateral or posterior right sector. It receives blood fromthe right lateral branch of the portal vein and drains into the right hepaticvein.

VII段。位於第VI段上方,由門靜脈右上外側支供血,引流至肝右靜脈。

原文:

Segment VII. Located abovesegment VI, it is supplied by lateral upper right branches of the portal veinand drains into the right hepatic vein.

VIII段位於第V段上方的前位,由內側段靜脈的上支供應,同時遵循第V段的引流方式

原文:

Segment VIII. It is inanterior position above segment V , supplied by upper branches of the vein ofthe medial sector, while it follows the drainage modalities of the segment V.



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