Analysis Of Portal Vein Classification Based On Hisense Computer-assisted Surgery System

Objective Precision liver resection requires minimal liver damage during liver surgery to achieve the most complete liver resection.Before surgery,it is important to determine the type of liver blood vessels and the relationship between tumors and blood vessels due to the variations in liver blood vessels.The three-dimensional reconstruction of the enhanced abdominal CT image using Hisense computer-assisted surgery system can visually show the variation of blood vessel.By analyzing and typing the reconstructed liver portal vein structure,provide a theoretical basis for the individualized treatment of accurate liver surgery.Methods The enhanced CT images examination of upper abdominal at the Affiliated Hospital of Qingdao University were collected from July 2013 to July 2018.The enhanced CT primitive DICOM files of 965 normal human livers from different age groups were analyzed.A three-dimensional reconstruction of the liver and its vascular were performed using the Hisense Computer Assisted Surgery system.The variation and types of the main portal vein were analyzed statistically.Results The digital liver model obtained from the three-dimensional reconstruction of Hisense CAS displayed clear intrahepatic portal vein vessels of level four even the fifth and sixth portal veins.By analyzing shape,the main portal vein(MPV)can be divided into 6 types: Type Ⅰ(806 cases,83.52 %)is that the MPV is divided into left portal vein(LPV)and right portal vein(RPV),and then the RPV is further divided into right anterior section(RAS)and right posterior section(RPS);Type Ⅱ(70 cases,7.25%)the MPV is divided into the RPS at the hepatic hilum,and then continued upward into the RAS and LPV;type Ⅲ(8 cases,0.83%)the MPV is divided into the LPV and The RPS and the RAS coming from the transverse portion of the LPV;type Ⅳ(74 cases,7.67%)trifurcated type,the MPV is directly divided into the RPS,RAS,and LPV;type Ⅴ(6 patients,0.62%)quadrant type,the MPV is divided into the right posterior superior branch and the right posterior inferior branch at the hepatic hilum,and then continued upward into the RAS and the LPV;Type Ⅵ(1 case,0.10)is lacking of LPV.Conclusion The anatomy of the liver portal vein is complex and diverse.It is necessary to identify the type of blood vessels in the individual.The three-dimensional digital liver model can demonstrate the true 3D anatomical structures,its spatial vascular variations and accurately measure the area and volume of each branch vessel.The accurate understanding of individual blood vessel classification before surgery is conducive to the accurate implementation of liver surgery in the context of precision medicine.