Clinical application of preoperative volumetric measurement for interventional precise embolization in the treatment of hypersplenism caused by liver cirrhosis.

OBJECTIVE

Volume measurement software is not routinely utilized in clinical practice before splenic artery embolization. To explore the function of such software measurement in this context, we conducted a retrospective study.

METHODS

We divided patients into two groups: 38 patients in Group A underwent three-dimensional reconstruction using Revolution CT, and 37 patients in Group B underwent imaging with normal CT technology. We compared the changes in liver function test results and haematological parameters between these two groups.

RESULTS

A total of 75 patients who underwent splenic artery embolization from January 2018 to January 2023 were included. The preoperative baseline data were not significantly different (all P values > 0.05). Both groups showed improvements in liver function and hypersplenism-related parameters. Within 2 weeks after surgery, Group A had significantly greater WBC (5.54 ± 1.92 × 10^9/L) and PLT (65.80 ± 20.12 × 10^9/L) counts than Group B (WBC: 4.14 ± 1.96 × 10^9/L; PLT: 52.70 ± 14.78 × 10^9/L; P < 0.05), indicating better control of hypersplenism. At 2 months postintervention, Group A demonstrated more favourable improvements in postintervention splenic volume (reduced from 1045 ± 122.9 cm³ to 489.5 ± 84.93 cm³), portal vein diameter (from 1.51 ± 0.19 cm to 1.28 ± 0.13 cm), and portal vein flow velocity (increased from 17.70 ± 5.25 cm/s to 23.56 ± 6.40 cm/s) than Group B. Moreover, a 53.2% splenic volume reduction was noted in Group A, which was significantly greater than the 31.4% reduction in Group B. Additionally, Group A had fewer adverse reactions, with lower liver/gastrointestinal toxicity (χ²=4.242, P = 0.039) and fever severity (χ²= 4.805, P = 0.028).

CONCLUSIONS

This study suggests that using Revolution CT prior to splenic artery embolization provides an effective method for managing hypersplenism, enhancing liver function, and reducing the risk of complications.