| Objective: To find the difference of 3D imaging anatomy of hepatic vessels between the normal and hepatic fibrosis or cirrhosis with imaging measurements, and to discuss the vascular abnormality of hepatic fibrosis and cirrhosis. Methods: the imaging data of enhanced CT and/or MRI(50 healthy subjects, 140 cases hepatic fibrosis and 40 hepatic cirrhosis were confirmed pathologically from January, 2013 to October, 2014) were obtained and analyzed. 16 parameters of diameters and angles of hepatic arteries, portal veins, hepatic veins were measured, based on the measurements, all subjects were separated into normal group, group of hepatic fibrosis(K1:S1+S2+S3+S4), group of hepatics cirrhosis(K2); Furthermore, K1 group were divided into mild liver fibrosis group(F1: S1+S2) and severe liver fibrosis group(F2: S3+S4) according to their clinical stages. Means and standard deviations of each group were calculated and t-test was employed to get differences among groups, P value must be less than 0.05. Result: All the normal measurement are follow:diameter of proper hepatic artery: 0.33±0.09, left hepatic artery: 0.20±0.05, right hepatic artery: 0.25±0.07, Portal venous trunk: 1.28±0.17, left branch of hepatic portal: 0.94±0.14, right branch of hepatic portal vein: 1.06±0.21, sagittal part of theleft branch of portal vein: 0.83±0.11, left hepatic vein: 0.73±0.20, intermediate hepatic vein: 0.70±0.18, right hepatic vein: 0.77±0.24; angle of left and intermediate hepatic vein: 62.2±15.4, angle of right and intermediate hepatic vein: 54.8±12.8. axial angle of portal vein: 140.1±21.1, coronal angle of portal vein: 132.6±21.2, sagittal angle of portal vein: 100.5±36.3?1. K groups: diameters of the left, intermediate and right hepatic vein, coronal angle of the portal vein, sagittal angle of the portal vein, angle of the left and intermediate hepatic vein between K0 group and K1 group have statistical differences(P=0.014?0.036?0.022?0.004?0.001?0.001); Differences of diameters of the proper hepatic artery, right hepatic artery, right branch of hepatic portal vein, sagittal angle of portal vein between K1 group and K2 group are statistically significant(P=0.018?0.043?0.005?0.016).2. S groups: diameter of the right branch of hepatic portal vein between S2 and S3 group is significantly different(P=0.04).3. F groups: coronal angle of the portal vein, angle of the left and intermediate hepatic vein, diameter of the left hepatic vein between F0 and F1 group(P=0.04?0.008?0.009), angle of the right and intermediate hepatic vein, diameter of the intermediate hepatic vein, diameter of the right branch of hepatic portal vein between F1 and F2 group(P=0.001?0.01?0.03), sagittal angle of the portal vein between F2 and F3 group(P=0.006) are statistically different. Conclusions:To obtain the normal measurements of the diameters of hepatic artery, vein and portal vein and the portal vein angle between the left and right, it will provide the anatomic basis for judging the effects of chronic liver disease on the blood vessels. In the course of hepatic fibrosis, the hepatic artery is no change, the right portal vein is gradually diminishing and the left is expanding, hepatic vein is gradually diminishing; In the hepatic cirrhosis, the hepatic artery and portal vein are enlargement, and the hepatic vein further diminish. Morphologically, hepatic vessels in early stage of hepatic fibrosis become shorter, thinner and wider; in late stage they are shorter, narrower and thicker; in hepatic cirrhosis, vessels are shorter, narrower and thicker. In the early stage of hepatic fibrosis, left lateral segment is absolutely enlarged, but relative in late stage; the right lobe and left medial segment is slightly enlarged in early stage but significantly diminished in late stage; the total liver volume increases in the early stage but shrinks later. |
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