The MSCTA Techniques And The Application In Analyse The Anatomy And Variations Of The Intrahepatic Portal Vein And Hepatic Veins

Background In recent years, liver surgery has made rapid development, living donor liver transplantation has been recognized as the most promising technical methods to resolve the global shortage of donor sources .surgery is performed mainly along a specific section where is located in the right of middle hepatic vein, whereas The hepatic vein and portal vein anatomy variation may lead to changes in program operation, We know intrahepatic vein anatomy and variation is very important before pre-operative. Multislice spiral CT use high-speed,high-resolution scanning to provide a full liver volume imaging . Three-dimensional image of the hepatic vein, portal vein anatomy can provid an important basis and guidance for the formulation and implementation of the operation.Objective To explore the feasibility of 16 multislice spiral CT in evaluating hepatic veins to optimize the scan delay time, Furthurmore, to analyze the anatomy and variations of the intrahepatic portal vein and hepatic veins in normal chinese.Methods live contrast enhanced CT scan were performed in 70 patients at 30s,40s,50s,60s,70s,80s,90s after the initiation of injection. The CT value of the hepatic vein trunks,portal vein and liver were measured. The rest 50 patients only get liver contrast enhanced CT scan . All data were processed using post-processing software of maximum intensity projection, volume rendering, multi-planar reformation and the results of there post-processing techniques were compared. The qualitative assessment standards include the obvervable grade of intrahepatic venous branchs,the clearness of blood vessel margin, Furthermore, the anatomy and variations of the intrahepatic portal vein and hepatic veins are statistical analysed.Results The time-density curves of hepatic vein and liver were successfully obtained in 70 patients.⑴,Delay time of the 30s, 40s, 50s when compared with the other groups were statistically significant differences (P =0.00<0.05);⑵,Delay time of the 60s when compared with other groups: there is statistical significance between 60s and 70s groups (P = 0.00 <0.05 ); there is no significant difference between 60s and 80s, 60s and 90s(P values were 0.10,0.59 respectively);⑶,They have statistically significant difference between 70s and 80s, 70s and 90s, 80s and 90s(P values were 0.02,0.00,0.04 respectively). ⑷,Combined with the CT value of hepatic parenchyma,hepatic vein and liver parenchyma when the different delay time, 70s can be drawn as the best scan delay time.2,The rates of typeⅠ,typeⅡ,typeⅢand typeⅣof intrahepatic portal vein are 99cases(82.5%),11cases ( 9.16% ),7cases(5.83%),3cases ( 2.5% ) respectively..The rates of Nakamura typeⅠ,typeⅡ,typeⅢof hepatic vein are 81cases ( 67.5% ),27cases ( 22.5% ),12cases(10%)respectively. The rates of Marcos typeⅠ,typeⅡ,typeⅢof hepatic vein are 80cases(66.67%),22cases(18.33%),18cases(15%)respectively.There is common trunk in 85.83% of all the cases.Conclusion hepatic and portal vein were clearly demonstrated with MSCTA. MSCTA could visualize the anatomical features of hepatic and portal vein.The optimal image of the intrahepatic portal veins and hepatic veins can provide details of segmentation and vascular anatomy to facilitate clinical treatment , especially for liver transplantation.