Study On Multi-slice Spiral CT Three-Dimensional Angiography In Hepatic Vessels And Its Clinical Significance

ObjectivesThe multiple spiral computed tomography angiography (MSCTA) is adopted to display the anatomical structure of the hepatic artery, the portal vein and the hepatic vein, etc. Discussion the anatomical type and the mutation rate for the hepatic artery, the portal vein and the hepatic vein, and analysis the impact of MSCTA technology on the clinical significance of diagnosis and individualized treatment of liver diseases.MethodsA total of 450 cases were randomly selected and analyzed retrospectively from the patients for liver multi-phase enhanced scan at the Imaging Department of Xinxiang Central Hospital from January 2014 to February 2015. MSCTA was applied to all cases with the hepatic arterial phase, portal venous phase and hepatic vein vascular imaging. And the original image data of all patients were scanned smallest thin reorganization, EBW64 uploaded to the workstation, the obtained data is carried for the three-dimensional reconstruction of the hepatic artery, the portal vein and hepatic vein on the workstation, Two senior imaging experts were to review them, and cases with their unified opinion are enlisted as the study objects. The walking and the origin distribution of the hepatic artery, the portal vein and the hepatic vein were observed. The hepatic artery refers to Michels type, the portal vein anatomy typing is with Couinoud and Atri for reference; the hepatic vein anatomy typing is with Nakamura, Kawasaki for reference. The variable hepatic artery, portal vein and hepatic vein outside the common type included in the range of variation and typing, and the mutation rate is gathered. An analysis of the anatomical type and the mutation rate of the hepatic artery, the portal vein and the hepatic vein was conducted in comparison with the normal type to discuss its significance in the clinical diagnosis and individualized treatment of liver diseases.ResultsMSCTA hepatic arterial phase can clearly display the abdominal aorta, celiac artery scan range and its branches; the portal vein and hepatic vein phases can clearly display the portal vein system and the hepatic vein system. The statistical results of the hepatic artery anatomy typing show that in the 450 hepatic artery cases,254 cases (56.44%) are Michels type I,196 (43.56%) cases are anatomic variations, of which 121 cases (26.89%) are of origin mutation and 57 (12.67%) cases are of branch mutation. In the anatomic variations of hepatic artery cases,135 cases (30%) are of Michels subtypes, other 61 cases(13.56%) are not of the Michels type. Cases of MichelsⅦ,Ⅶ,Ⅹ type are not found. For Michels Ⅱ、MichelsⅢ、MichelsⅣ、 Michels Ⅴ、MichelsⅥ、MichelsⅨ, cases are respectively32 (7.11%),43 (9.56%),4 (0.08%), 26 (5.78%),19 (4.22), and 11 (2.44%). There is a poor consistency, the mutation rate is basically consistent with Michels, between the statistical results of the cases and Michels autopsy results. There are 5 types of intrahepatic portal vein 1～3 level in the 450 cases of the study.284 cases (63.11%) are of the normal type. Variation type Ⅰ, Ⅱ, Ⅲ and others are respectively 79 cases (17.56%),43 cases (9.56%),17 cases (3.78%) and 27 cases (6%). The mutation rate of Type Ⅱ is lower than the mutation rate of type Ⅰ, and it does not comply with Couinoud and Atri, etc, the total variation rate is 36.89%, and higher than Couinoud and Atri, etc. In this study of the 450 hepatic vein cases, for 64 cases (14.22%), the left hepatic vein, the central hepatic vein and the right hepatic vein are in the same plane.386 cases (85.78%) are those that the three veins are not in the same plane. For Nakamura type A, B, and C, cases are respectively 294 (65.33%),87 (19.33%),69 (15.34%), and there is big difference with Nakamura type B and C. For Kawasaki type Ⅰ and Ⅱ, cases are respectively 381 (84.68%) and 69 (15.34%), and there is big difference with Kawasaki.Conclusion1. Multilayer spiral CT angiography can clearly and accurately display intrahepatic vascular and its diseases, which provides important ways and means for us to study the vascular anatomy of small vessels in the liver.2. Types and mutation rates of intrahepatic vascular provide a morphological basis for preoperative evaluation and surgical treatment of clinical hepatopathy.