The Anatomy And Clinical Application Research Of 3D 64-MSCT Angiography On The Portal Vein And Hepatic Vein

Objective Following the recent advancement of liver transplantation and malignant tumor resection operation, liver morphology and preoperative vascular imaging studies have been the focal point. Non-invasion, fast scan speed, large scan area and high spatial resolution result in the broad clinical application of multislice spiral CT. The study aimed at using the 64-slice spiral CT enhancement scanning data to reconstruct 3-dimensional liver portal and hepatic vein, and to analyze the clinical value of three dimensional contrast-enhanced MSCT angiography in liver disease diagnosis. Methods 215 non-cirrhosis subjects and 55 cirrhosis patients underwent 64- slice spiral CT hepatic portography and venography. 3-D maximum intensity projection (MIP) and volume rendering(VR) of the portal hepatic venous structures were created . The diameter of main portal vein (MPV), left portal vein (LPV), right portal vein (RPV), splenic vein (SV), superior mesenteric vein (SMV), left hepatic vein (LHV), middle hepatic veins (MHV), right hepatic vein (RHV) at cross-section profile or multiplanar reformation (MPR) were measured. Independent samples test was used for comparisons of MPV, LPV, RPV, SV, SMV, LHV, MHV, RHV between the non-cirrhosis group and the cirrhosis group. The count number of the inferior right hepatic vein (IRHV) and the caudal hepatic vein (CHV) were processed with chi-square test. If P<0.05, there was statistical difference between the two groups. Results All the portal veins in every subjects showed well, but hepatic veins of 8 in 55 cirrhosis subjects showed fuzziness . Mean values of the MPV, LPV, RPV, SV, SMV, LHV, MHV, RHV in non-cirrhosis were 11.74±1.63mm, 8.26±1.58mm, 9.39±1.67mm,, 7.17±1.48mm, 9.84±1.68mm, 6.90±2.15mm, 6.27±1.50mm, 7.24±2.47mm, respectively. Mean values of the MPV, LPV, RPV, SV, SMV, LHV, MHV, RHV in cirrhosis were 14.29±1.90mm, 9.61±1.67mm, 10.52±2.15mm, 8.94±2.26mm, 11.74±1.75mm, 6.75±1.75mm, 6.31±1.81mm, 6.60±2.38mm, respectively. Independent samples test was used for comparisons of MPV, LPV, RPV, SV, SMV between the two groups, P<0.05, there was statistical difference. Independent samples test was used for comparisons of LHV, MHV, RHV between the two groups, P>0.05, there was no statistical difference. 27 cases in 270 were found variation of portal vein. 13 cases are typeⅡ, 12 cases are typeⅢ, and 2cases are typeⅣ.75 cases were found variation of hepatic vein, and 14 cases have both variations. IRHV was demonstrated in 153/270(56.7%), CHV was demonstrated in 68/270(25.2%). Conclusions Portal and hepatic vein can be displayed accurately by 3D 64-MSCT angiography , which could measure diameter or other information about the veins at any cross-section. Meanwhile, more anatomic information could be provided for hepatic segments resection and liver transplantation directively. Portal and hepatic vein diseases could be diagnosed by 3D 64-MSCTA accurately and directly also.