3D-reconstruction of right portal vein

Lee, Hong Ki; Nam, Young Soo; Park, Hwon Kyum; Paik, Hong Kyu; Lee, Won Jae; Lim, Hyo Keun; Lee, Kwang Soo

Abstract

BACKGROUND/PURPOSE: Thorough knowledge of hepatic anatomy is essential in liver surgery. Recent development of computer technology has allowed three-dimensional (3D) reconstruction of radiological images. We evaluated the right portal veins by 3D-reconstruction and determined the numbers and directions of the segmental branches to provide a readily understandable portal branching pattern.
METHODS
CT arterial portography(CTAP) data from 11 hepatoma patients were reconstructed threedimensionally in a computer workstation. The images were rotated from top(U90) to bottom(D90) and from right lateral(R90) to left lateral (L90), and the 3rd portal branches were matched and their course was determined.
RESULTS
The direction of right portal trunk was right(R) 105(5/7 patients) - R 90(2/7 patients) and 0 - up(U) 15 in 5/7 patients(pt). The most common directions of R anterior trunk, VIII, V, R posterior trunk, VII, VI segmental portal branches were R60(6/10 pt) & U15(5/10), R 135(5/10) & U60(5/10), R30-75 & down(D)15-60(9/10), R105-120(6/10) & D15-30(8/10), R165(6/11) & U15(6/11), R105(6/11) & D30-45(8/11). The numbers of VIII & V branches visualized were 1(4),2(6),3(1) & 1(5),2(5),3(1). The numbers of VI branches were 1(5),2(4),4(1). The VII branch always branched into lateral and medial branches. Simple branching patterns were obtained on posterior segmental branches. The anterior segmental branches were somewhat variable.
CONCLUSION
3D-reconstruction of portal veins allowed accurate assessment of segmental branches and their spatial relationship was readily understandable. It would be helpful in planning and simulation of surgery.