Three-dimensional Visualization Of Portal Vein Imaging And Its Relationship With Hepatic Metastasis In Colorectal Cancer

Part one: Anatomical study of portal vein system with 3D reconstructionObjective:1.Multi-slice spiral CT(MSCT)was used to scan the abdomen,3D reconstruction software was used to reconstruct the portal vein system,and the distribution and variation of portal vein system in the abdomen were analyzed.2.The anatomical structure of portal vein system was discussed.The related data were collected and analyzed by morphological observation and dissected from different angles combined with anatomy.Materials and methods:According to the criteria of inclusion and exclusion,100 cases of abdominal enhanced CT scans were collected from January 2017 to December 2017 in the first affiliated Hospital of China Medical University.There were 46 males and 54 females.All the examiners performed abdominal enhancement scanning with multi-slice spiral CT,and the obtained scanning image data were transmitted to PACS.The thin layer CT data stored in storage medium is imported into Myrian software in DICOM format,and the region of interest is carried out on Myrian software(ROI)three dimensional reconstruction.After segmenting different regions of 3D reconstructed ROI,different color marks were carried out for different regions,blood vessel structures and liver segments.The proportion of portal vein system was recorded according to the standard of intrahepatic vascular anatomical classification.Results:1.The portal vein system was mainly divided into 4 types.In this study,type I?II?III and IV accounted for 73%,11%,7% and 9% respectively.But the anatomical results are complex and variable.2.There was no significant difference in the volume of the whole liver among the different types,but there was no significant difference in the volume of the left,right and right anterior lobe of the liver among the other types.Conclusion:1.Based on the image data obtained from multi-slice spiral enhancement scanning,the portal vein system can be reconstructed by Myrian system.The three-dimensional reconstruction model of portal vein system is clear,three-dimensional and can be observed at any angle.It can be used for different evaluation and formulation of liver surgery,which creates more important significance for accurate liver surgery,and has great application value.2.The liver is divided into left,right anterior and right posterior lobes according to the three major branches of intrahepatic portal vein,which is reasonable from the morphological point of view,and proves that the liver is a symmetrical organ with the right anterior branch of portal vein as the main axis.Part two:The relationship between liver metastasis and portal vein system type in Colorectal CancerObjective:The second part of this study is based on the reconstruction of portal vein system in the first part,the classification of portal vein system and the demonstration of intrahepatic portal vein system symmetry.To analyze the relationship between the primary location of colorectal cancer and the distribution of hepatic metastasis,and the relationship between the location of hepatic metastasis and the type of portal vein system,and to provide anatomic basis for understanding the distribution of hepatic metastases of colorectal cancer.Materials and methods:The data of 73 patients with colorectal cancer with liver metastasis in the first affiliated Hospital of China Medical University were collected by retrospective study.According to the imaging data of the patients,the three-dimensional reconstruction of portal vein system was performed by using Myrian system.Based on the clinical and imaging data of patients with hepatic metastasis of colorectal cancer,the location,number and inferior mesenteric vein of primary location,CT images and surgical records of colorectal cancer were recorded(IMV)different situations of portal vein entry.The results were analyzed by SPSS software package.Results:According to the exclusion criteria,a total of 73 patients were included in the study,including 29 women and 44 men.There were 34 cases of right hemicolon,including 1cecal carcinoma,22 ascending colon cancers,7 colon flexure carcinoma and 4 transverse colon cancer,and 39 left hemicolon carcinoma,including 5 colon and spleen flexure carcinoma,7 descending colon cancer and 22 sigmoid colon cancer.5 cases of upper and middle rectal carcinoma;A total of 161 metastatic foci were counted during operation and confirmed by pathological examination.The transfer rate in the right hemi liver was 37.9%,while the transfer rate in the left hemi liver was 62.1%.In the right hemicolon cancer,metastatic foci were mainly located in 7 cases of Left lobe of liver with 11 metastatic foci,13 cases of right anterior lobe of liver with 28 metastatic foci,14 cases of right posterior lobe of liver with 22 metastatic foci and 61 metastatic foci.In the left hemicolon cancer,metastatic foci were mainly located in 23 cases of left lobe of liver with 52 metastatic foci,9 cases of right anterior lobe of liver with 27 metastatic foci,7 cases of right posterior lobe of liver with 21 metastatic foci and 100 metastatic foci.Conclusion:The location of primary tumor of colorectal cancer and the distribution of hepatic metastases have certain rules,so we can predict the location of metastasis according to the location of primary tumor.The results of this study support the presence of portal vein inflow and understanding of this phenomenon may help us to understand the spread of malignant tumors in the abdomen.