Enkhbold Ch, Shimada M, Utsunomiya T, Ishibashi H, Yamada S, Kanamoto M, Arakawa Y, Ikemoto Z, Morine E, Imura S
Hepatogastroenterology. 2013 Nov-Dec;60(128):1861-4. doi: 10.5754/hge13536.
BACKGROUND/AIMS: Three-dimensional CT has become an essential tool for successful hepatic surgery. Up to now, efforts have been made to simultaneously visualize hepatic vasculature and bile ducts. Herein, we introduce a new one-stop shop approach to hepatic 3D-anatomy, using a standard enhanced MDCT alone.
A 3D-reconstruction of hepatic vasculature was made using data from contrast enhanced MDCT and SYNAPSE VINCENT software. We identified bile ducts from axial 2D image, and then reconstructed the 3D image. Both hepatic vasculature and bile duct images were integrated into a single image and it was compared with the 3D image, utilized with MRCP or DIC-CT.
The first branches of both the right and left hepatic ducts were hand-traced and visualized for all 100 cases. The second branches of these ducts were visualized in 69 cases, and only the right second branch was recognized in 52 cases. Anomalous variations of bile ducts, such as posterior branch joining into common hepatic duct, were recognized in 12 cases. These biliary tract variations were all confirmed by MRCP or DIC-CT.
Our new one-stop shop approach using the 3D imaging technique might contribute to successful hepatectomy as well as reduce medical costs and radiation exposure by omission of MRCP and DIC-CT.
背景/目的：三维CT已成为肝脏手术成功实施的重要工具。到目前为止，人们一直在努力同时显示肝血管和胆管。在此，我们介绍一种仅使用标准增强型MDCT进行肝脏三维解剖的一站式新方法。
利用对比增强MDCT和SYNAPSE VINCENT软件的数据对肝血管进行三维重建。我们从轴向二维图像中识别胆管，然后重建三维图像。将肝血管和胆管图像整合到一张图像中，并与使用MRCP或DIC-CT的三维图像进行比较。
100例患者的左右肝管第一分支均经手工追踪并显示。这些胆管的第二分支在69例中显示，仅右第二分支在52例中被识别。12例患者发现胆管异常变异，如后分支汇入肝总管。这些胆道变异均经MRCP或DIC-CT证实。
我们采用三维成像技术的新一站式方法可能有助于肝切除术的成功实施，同时通过省略MRCP和DIC-CT降低医疗成本和辐射暴露。
