Résumé
Objective@#To study the segment of liver according to the large amount of three-dimensional(3D) reconstructive images of normal human livers and the vascular system, and to recognize the basic functional liver unit based on the anatomic features of the intrahepatic portal veins.@*Methods@#The enhanced CT primitive DICOM files of 1 260 normal human livers from different age groups who treated from October 2013 to February 2017 provided by 16 hospitals were analyzed using the computer-aided surgery system.The 3D liver and liver vascular system were reconstructed, and the digital liver 3D model was established.The vascular morphology, anatomical features, and anatomical distributions of intrahepatic portal veins were statistically analyzed.@*Results@#The digital liver model obtained from the 3D reconstruction of CAS displayed clear intrahepatic portal vein vessels of level four.Perform a digital liver segments study based on the analysis of level four vascular distribution areas.As the less anatomical variation of left hepatic portal vein, the liver was classified into four types of liver segmentation mainly based on right hepatic portal vein.Type A was similar to Couinaud or Cho′s segmentation, containing 8 segments(537 cases, 42.62%). Type B contained 9 segments as there are three ramifications of right-anterior portal vein(464 cases, 36.82%). The main difference for Type C was the variation of right-posterior portal vein which was sector shape(102 cases, 8.10%). Type D contained the cases with special portal vein variations, which needs three-dimensional simulation to design individualized liver resection plan(157 cases, 12.46%). These results showed that there was no significant difference in liver segmental typing between genders(χ2=2.179, P=0.536) and did not reveal any significant difference in liver segmental typing among the different age groups(χ2=0.357, P=0.949).@*Conclusions@#The 3D digital liver model can demonstrate the true 3D anatomical structures, and its spatial vascular variations.The observation of anatomic features, distribution areas of intrahepatic portal veins and individualized liver segmentation achieved via digital medical 3D visualization technology is of great value for understand the complexity of liver anatomy and to guide the precise hepatectomy.
Résumé
Objective To provide credible anatomic data and information for clinical diagnosis and surgery of hand by measuring the length of metacarpal bone and phalanges of hands on X-ray films and to study their mathematical relations.Methods The X-ray films of hands on posteroanterior position were taken in 186 healthy college students (M90,F96).The length of each metacarpal and phalange were measured.All the data were calculated by SPSS software.Results The mathematical relations of each metacarpal and phalange bone were obtained .It was found that there were sexual differences in the ratio of first to second,second to fourth,second to fifth and third to fourth metacarpal length,the ratio of first to second,first to fourth and second to fifth proximal phalangeal length,the ratio of second to fifth,third to fifth and fourth to fifth middle phalangeal length and the ratio of first to second and first to third distal phalangeal length.Conclusion The results of this mathematical relations are of great significant in orthopaedic surgery of hand.