关键词: CT三维重建, 肝癌, 肝切除术, 肿瘤体积

Abstract: Objective To evaluate the application of computed tomography (CT) three-dimensional reconstruction in the assessment of tumor volume before resecting primary liver cancer (PLC). Methods One hundred and twenty patients with PLC who were treated with laparoscopic liver resection from January 2015 to January 2020 were enrolled in these study. According to different preoperative evaluation methods, they were divided into a control group (with two-dimensional CT, 60 cases) and an observation group (with CT three-dimensional reconstruction, 60 cases). The operation condition including the estimated lesion volume, actual lesion volume, estimated resection liver volume, actual resection volume, residual liver volume, operation time, hospitalization time, intraoperative blood loss and postoperative complications were compared between these two groups of patients. The postoperative parameters of liver function including alanine aminotransaminase (ALT), total bilirubin (TBIL), aspertate aminotransferase (AST) levels were also analyzed. Results All patients in these two groups were successfully completed laparoscopic hepatectomy, with no case of death or conversion to open surgery. The volume of pre-resected liver and the actual volume of resected liver in the observation group were significantly lower than those in the control group (P<0.05), and the remaining liver volume was significantly larger than that of the control group (P<0.05). There was no significant difference in the estimated and actual volume of the lesion between these two groups (P>0.05), so as to the pre-resected liver volume and the actual resected liver volume (P>0.05). However, the pre-resection liver volume in the control group was significantly larger than the actual resection liver volume (P<0.05). The hospitalization time of the observation group was significantly shorter, and the intraoperative blood loss was significantly less than those of the control group (all P<0.05). There was no significant difference between these two groups in terms of the operation time and the incidence of postoperative complications (P>0.05) . At 7 days after operation, the liver function indexes of the observation group were significantly lower than those before operation (P<0.05), and significantly lower than those of the control group (P<0.05). Conclusion Compared with traditional CT imaging technology, CT three-dimensional reconstruction can provide a more accurate preoperative assessment for tumor volume before surgery, thus reducing intraoperative bleeding and shortening the patient’s hospital stay.

Key words: CT three-dimensional reconstruction, Liver cancer, Hepatectomy, Tumor volume