Background

It is known that there are varying frequencies of hepatic portal vein branching patterns found in the literature. Studies use different methods and classifications to evaluate the anatomy of the portal vein, which limits accurate comparison between studies and the determination of true frequency of branching patterns in different populations. The aim of the present study was to investigate the intrahepatic branching of the portal vein in corrosive samples using different methods – somatoscopic and computed tomography (CT) and compare with similar studies as well as compare the reclassified data according to the most popular classifications used in the literature.

Methods

A total of 105 liver corrosion specimens from the 1960–1980 period (51 male and 54 female individuals; min-max age variation – 21–90 y., M=59,46 y.) were investigated. The branching patterns of the hepatic portal vein (HPV), left (HPV-LB) and right branch of hepatic portal vein (HPV-RB), and their segmental branches were examined and scanned by CT. Standard HPV ramification was considered, when HPV divided into HPV-LB and HPV-RB, HPV-RB bifurcated to the anterior and posterior branches, and further segmental ramification into the superior and inferior branches was considered standard. We compared the HPV main branch length and diameter measurements between manual and CT method. A review of the literature was performed on portal vein branching variations.

Results

The standard HPV ramification pattern was detected in 85.7% of the cases in both somatoscopic and CT evaluation. Variations related to the main branches were HPV trifurcation – 7.6%, posterior branch of right branch of hepatic portal vein from HPV – 4.8% and 5.7%, HPV quadrifurcation 1.9% and 1% respectively, in somatoscopic and CT evaluation. There was a significant difference between HPV-LB length and diameter in CT and manual measurements. According to the literature, more variations are seen using the CT method versus somatoscopic corrosion cast evaluation. The varying frequency in studies may be explained by a lack of one unanimous classification of branching patterns (some authors do not consider segmental variations as standard HPV ramification) and different evaluation methods.

Conclusion

Somatoscopic evaluation of the branching patterns of the hepatic portal vein in corroded specimens and their CT reconstructions did not differ significantly (which allows relatively accurate comparison of old specimens with newer data). However, the ability to evaluate the reconstructed 3D images of the specimens allowed a more accurate assessment of segmental branching and measurements of lengths and diameters. Standard HPV branching (according to a self-developed classification) in this study was 85.7%. Depending on the classification, the rate of standard branching in the same corrosive samples varied from 63.8% to 84.8% of all cases, indicating that the lack of a unified and stable classification makes it difficult to compare the results of different studies. Deviations from standard branching are very important in surgical procedures and liver transplantation.

中文翻译：

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根据不同肝脏评估方法的肝门静脉分支模式和分支类型分类

背景

已知文献中存在不同频率的肝门静脉分支模式。研究使用不同的方法和分类来评估门静脉的解剖结构，这限制了研究之间的准确比较以及不同人群分支模式真实频率的确定。本研究的目的是使用不同的方法（体视镜和计算机断层扫描（CT））研究腐蚀性样本中门静脉的肝内分支，并与类似的研究进行比较，并根据最流行的分类比较重新分类的数据。文献。

方法

研究人员对 1960 年至 1980 年期间的总共 105 个肝脏腐蚀样本（51 名男性和 54 名女性；最小-最大年龄变化 - 21-90 岁，M=59,46 岁）进行了研究。采用CT检查扫描肝门静脉(HPV)、肝门静脉左支(HPV-LB)、右支(HPV-RB)的分支形态及其节段性分支。当HPV分为HPV-LB和HPV-RB时，HPV-RB分叉为前支和后支，进一步分段分叉为上支和下支被认为是标准的HPV分枝。我们比较了手动方法和 CT 方法之间的 HPV 主分支长度和直径测量。对门静脉分支变化的文献进行了回顾。

结果

在体视镜和 CT 评估中，85.7% 的病例检测到标准 HPV 分支模式。在体镜和CT评估中，与主要分支相关的变异为HPV三叉——7.6%，来自HPV的肝门静脉右支后支——4.8%和5.7%，HPV四叉分别为1.9%和1%。CT和手工测量的HPV-LB长度和直径有显着差异。根据文献，与体视腐蚀铸件评估相比，使用 CT 方法可以看到更多的变化。研究频率的不同可能是由于缺乏一种一致的分支模式分类（一些作者不认为节段变异是标准的 HPV 分支）和不同的评估方法。

结论

对腐蚀标本中肝门静脉分支模式的体视评估及其 CT 重建没有显着差异（这允许旧标本与新数据的相对准确比较）。然而，评估样本重建 3D 图像的能力可以更准确地评估节段分支以及长度和直径的测量。本研究中的标准HPV分支（根据自行开发的分类）为85.7%。根据分类的不同，相同腐蚀样品中的标准支化率在所有情况下从 63.8% 到 84.8% 不等，这表明缺乏统一和稳定的分类导致很难比较不同研究的结果。偏离标准分支在外科手术和肝移植中非常重要。