Application Of Three-dimensional Visualization Technology In Preoperative Assessment Of Hilar Cholangiocarcinoma

Objective To investigate the applicable value of medical Image three-dimensional visualization system(MI-3DVS)in the preoperative assessment for hilar cholangiocarcinoma.Methods Retrospective analysis of 18 patients with hilar cholangiocarcinoma admitted in our hospital during March 2014 to April 2016,All patients initially underwent abdominal thin-slice CT scanning.The CT images were imported into Medical image three Dimensional Visualization System for 3D reconstruction.Then we evaluated longitudinal and vertical tumor infiltration,observed the ductal and vessel branching pattern,Calculated the hepatic liver volume.Based on the above information,preoperative assessment and surgical planning were completed.The preoperative diagnostic results were compared with the actual intraoperative findings.Results The accuracy rates of longitudinal tumor extension were 88.9%.The sensitivity,specificity,and accuracy rates were 80.0%、84.6%、83.3% for portal invasion and 75.0%、92.9%、88.9% for hepatic arterial invasion.The vascular and ductal branching pattern of all patients are consisted with intraoperative findings.The estimated liver volume and actual liver volume show highly correlation(p﹤0.01).The median operation time was 425±101.69 min and the intraoperative blood loss was 1050 ± 254.02)ml.Potentially curative resection was achieved in 16 of 17 patients.The incidence of surgical complications was 23%(3/13).Conclusions Three-dimensional visualization system may accurately,directly and dynamically display the hilar cholangiocarcinoma and its three-dimensional adjacent relation,which may be used to perform accurate preoperative evaluation for patients.