Schenk A, Hindennach M, Radtke A, Malagó M, Schroeder T, Peitgen H-O
Fraunhofer MEVIS, Institute for Medical Image Computing, Bremen, Germany.
Transplant Proc. 2009 Jul-Aug;41(6):2515-7. doi: 10.1016/j.transproceed.2009.06.110.
We sought was to quantify and visualize the regeneration of the remnant liver after living donor liver transplantation using computed tomographic (CT) data.
For the evaluation of preoperative and follow-up data, we developed a software assistant that was able to compute the volume growth of the remnant liver and liver territories as well as visualize the individual growth of hepatic vessels over time. The software was applied to CT data of 20 donors who underwent right hepatectomy including the middle hepatic vein with at least 3 follow-up examinations in the first year after transplantation.
After donation of a right lobe graft, the remnant liver regenerated by an average 77% of the original volume within the first 3 postoperative months and to 86% within the first year. The growth of the left lateral segments was increased compared with that of segment IV in all cases. The visualization showed the growth of the portal vein and the hepatic veins. With the simultaneous display of pre- and postoperative results, it was possible to detect the formation of collaterals between truncated segment IVb veins and the veins of segment IVa or of the left lateral lobe.
The software-assisted analysis of follow-up data yielded additional insight into territorial liver regeneration after living donor liver transplantation and allowed for reliable detection of relevant hepatic vein collaterals using CT data.
我们旨在利用计算机断层扫描（CT）数据对活体肝移植后残余肝脏的再生进行量化和可视化。
为了评估术前和随访数据，我们开发了一款软件助手，它能够计算残余肝脏和肝区的体积增长，并可视化肝血管随时间的个体生长情况。该软件应用于20例接受右肝切除术（包括肝中静脉）的供体的CT数据，这些供体在移植后的第一年至少进行了3次随访检查。
捐献右叶移植物后，残余肝脏在术后前3个月内平均再生至原始体积的77%，在第一年内再生至86%。在所有病例中，左外侧段的生长均比IV段增加。可视化显示了门静脉和肝静脉的生长。通过同时展示术前和术后结果，可以检测到IVb段截断静脉与IVa段或左外侧叶静脉之间侧支循环的形成。
对随访数据进行软件辅助分析，可进一步深入了解活体肝移植后肝脏区域的再生情况，并能利用CT数据可靠地检测相关肝静脉侧支循环。
