The application of three-dimensional reconstruction in the evaluation of vascular system of primary liver cancer before TACE intervention

Abstract

Abstract: Objective To investigate the application value of maximum density projection (MIP) and volume reconstruction (VR) of three-dimentional (3D) reconstruction in vascular system evaluation of primary liver cancer (PLC) before transcatheter arterial chemoembolization (TACE).Methods A total of 72 PLC patients who underwent TACE treatment from January 2020 to January 2022 were selected and included in the study. All patients received multi-slice spiral computed tomography (MSCT) and angiography (DSA) examinations before treatment. The images obtained by MSCT were reconstructed by MIP and VR. Finally, the results of DSA were used as the gold standard to compare the grading of hepatic artery, extrahepatic artery, tumor feeding artery, tumor blood vessel, and portal vein in MIP, VR of 3D reconstruction and DSA.Results The display rates of MIP, VR and DSA in the results of grade 1 and grade 2 hepatic artery display were all 100%, and there was no significant difference in the number of displayed cases (χ²=0.000、0.000, P>0.05); Among the results of grade 3 hepatic artery display, 69 cases were shown by MIP (95.8%), 72 cases were shown by DSA (100.0%), which were significantly higher than that of 41 cases shown by VR (56.9%)(χ²=61.226, P<0.05). In the results of hepatic artery of grade 4 and above, 34 cases (47.2%) displayed by MIP, which were significantly higher than that of 13 cases (18.1%) displayed by VR, and 62 cases (81.6%) displayed by DSA, which were significantly higher than that of 34 cases (47.2%) displayed by MIP. (χ²=67.154, P<0.05). MIP showed celiac trunk in 72 cases (100.0%), superior mesentery in 67 cases (93.1%), splenic artery in 72 cases (100.0%), common hepatic artery in 72 cases (100.0%), gastroduodenal artery in 72 cases (100.0%) ), proper hepatic artery in 72 cases (100.0%), celiac trunk in 72 cases (100.0%), superior mesenteric in 67 cases (93.1%), splenic artery in 72 cases (100.0%), and common hepatic artery in 72 cases (100.0%), gastroduodenal artery in 72 cases (100.0%), proper hepatic artery in 72 cases (100.0%), DSA showed celiac trunk in 72 cases (100.0%), superior mesentery in 69 cases (95.8%), splenic artery in 72 cases (100.0%), common hepatic artery in 72 cases (100.0%), gastroduodenal artery in 72 cases (100.0%), and proper hepatic artery in 72 cases (100.0%), there was no significant difference in the number of cases among the three (χ²=24.376, P>0.05). MIP showed tumor feeding arteries in 70 cases (97.2%), VR showed tumor feeding arteries in 68 cases (94.4%), DSA showed tumor feeding arteries in 72 cases (100.0%), and there was no significant difference between the three cases (χ²=4.114, P>0.05); As the results of tumor blood vessel display, 63 cases (87.5%) displayed by MIP and 72 cases (100.0%) displayed by DSA, both were significantly higher than those of 26 cases (36.1%) displayed by VR(χ²=87.716, P<0.05). As for portal vein branches, MIP displayed 70 cases (97.2%) of grade 4 portal vein branches, 67 cases (93.1%) of grade 5 portal vein branches, 46 cases (63.9%) of grade 6 and above portal vein branches; VR displayed 66 cases (91.7%) of grade 4 portal vein branches, 63 cases (87.5%) of grade 5 portal vein branches, and 44 cases (61.1%) of grade 6 and above portal vein branches. There were no significant difference was found between the portal vein branches displayed by MIP and VR (χ²=0.004, P>0.05).Conclusion 3D reconstruction by MIP and VR in PLC patients before TACE treatment can intuitively and three-dimensionally display liver vascular system, which can provide basis for establishing optimised treatment regimes, as well as the follow-up plans post surgical treatment.

Key words: Primary liver cancer, Hepatic arterial chemoembolization, Maximum density projection, Volume reconstruction, Three-dimensional reconstruction, Angiography

ZHU Ye-chen, GENG Cheng-jun, YIN Hui-kang, LI Ya-nan, FENG Quan-ye. The application of three-dimensional reconstruction in the evaluation of vascular system of primary liver cancer before TACE intervention[J]. Chinese Hepatolgy, 2023, 28(5): 559-563.

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