目的:阐明肝胃韧带分隔网膜囊上隐窝(SRL5)的意义及内侧胃膈韧带的存在.方法:①观察肝的韧带的附着和相互移行情况及肝胃韧带、SRLS与左肝上后间隙、左肝上前间隙的通连关系.②观察腹部连续断层标本(横断层和矢状断层).③腹部螺旋CT扫描.结果:①通常教科书和文献所述的肝胃韧带实际上由肝膈韧带、肝食管韧带和肝胃韧带构成.②肝胃韧带位于静脉韧带裂内,后层在近胃小弯处反折至膈形成内侧胃膈韧带,并与内侧胃膈韧带分别作成SRLS的前界和左侧界.③肝胃隐窝与SRLS之间因隔以肝胃韧带而不相通.结论:肝胃韧带和内侧胃膈韧带分别构成SRLS的前界和左侧界分隔SRLS:一些教材所用的图,表达SRL5与左肝上后间隙相通的概念值得商榷.

Objective To evaluate CT features of intrahepatic bile duct abscess (IBDA) and its pathologic basis. Methods The CT imaging data of 31 consecutive cases of intrahepatic bile duct abscess proved by surgery or clinical treatments from October 1989 to February 1999 were retrospectively studied. The causes included acute obstructive suppurative cholangitis and retrograde infection due to different etiologies. For all the cases, the CT manifestations of liver abscess, bile duct abnormalities, and their relationship were observed respectively. Results Manifestations of liver abscess were revealed in all cases (31/31,100%). The CT manifestations of bile duct abnormalities included signs of etiologies caused bile duct obstruction and other signs including cholangiectasis (29/31, 93.5%), the dilated bile ducts communicated with (5/31,16.1%)or abut on (8/31,25.8%) the abscesses, and gas collection in bile ducts (10/31,32.2%). The signs showing the relationship between liver abscess and bile duct abnormalities were that the abscesses complied with the obstructive site and the dilated bile ducts (15/31,48.4%), and the liver abscesses located in different (7/31,22.6%) or same (4/31,12.9%) liver lobes or segments with gas collection in the dilated bile ducts. Conclusion The CT manifestations of IBDA included signs of liver abscess, abnormalities of bile ducts, and signs showing their relationship. CT scanning was helpful in making comprehensive and accurate diagnosis of IBDA.