Application Of 3D Models Of Liver And Virtual Hepatectomy With MRI In Liver Surgery Planning

Objective To assess three-dimensional reconstruction of normal liver on the basis of MR image and measurement of hepatic volume to provide guidance for liver surgery.Materials and methods.The 3D models of normal liver and interior vessels were reconstructed by 3D-Doctor software on the basis of 2D MR image in 51 cases.The 3D images showed information of liver and hepatic vein, portal vein,inferior vena cava and short hepatic vein thoroughly.Hepatic volumes were measured by 3D Doctor software automatically.Results The 3D modes showed hepatic anatomical landmarks clearly.The branches of portal vein system,hepatic venou system and their relationship could be displayed distinctly.13 (13/51) cases accessory hepatic veins variations and 29(29/51) cases common trunk variations of middle hepatic vein and left hepatic vein variations were found in the 3D models..The total liver volume was 1208±23ml.Conclusions Three-dimensional images of normal liver were reconstructed to find hepatic interior vessels variations superduperly and effortlessly and Liver volume could be measured.All this could provide guidance for liver surgery. Objective To assess the impact of 3D models of Liver and virtual hepatectomy on the basis of MR image in Liver operation Planning.Materials and methods. The 3D models of liver,hepatic neoplasms and interior vessels were reconstructed with 3D-Doctor software on the basis of MR image in 23 cases.Hepatic neoplasm,hepatic vein system, portal vein system, inferior vena cava and short hepatic vein images were showed thoroughly in these 3D models.That the remnant liver had sufficient portal venous blood supply and hepatic venous drainage was firstly considered. Virtual liver resection could be intendedly performed. As| rFLV2-rFLV3|/rFLV2>20%,liver resection planning was changed to to reserve more liver volume. Total hepatic volume, tumor volume, remnant hepatic volume automatic and SFLVR were calculated hand-made.we paid close attention to middle hepatic vein and massive post post-right hepatic vein of remnant liver.Results The detail anatomic relationships of hepatic neoplasms and blood vessels were clearly showed in 3D models in 23 cases. Preoperative evaluation of virtual hepatectomy showed that hepatic neoplasms could be removed.15 (15/23) cases common hepatic resection were performed.8 cases(8/23)liver resection planning was changed because of variable middle hepatic vein, massive hepatic post-right vein or dissecting middle hepatic vein. Finally all hepatic neoplasms were completely removed in 23 cases. Only one biliary fistula and no hepatic failure happened in all cases after 2 maths.Conclusions Reconstructing 3D model of liver and virtual hepatectomy with MR can provide accurate 3D anatomy and remnant liver volume information in preoperative planning for safe liver resection and reduce the incidence of complications.