Bernd B Frericks MD, Presenter: Nothing to Disclose

Timm D Kirchhoff MD, Abstract Co-Author: Nothing to Disclose

Georg Stamm PhD, Abstract Co-Author: Nothing to Disclose

Andrea Schenk, Abstract Co-Author: Nothing to Disclose

Bjoern Nashan MD, Abstract Co-Author: Nothing to Disclose

Michael Galanski MD, Abstract Co-Author: Nothing to Disclose

A semi-automatic four-detector row CT based non-invasive preoperative protocol to asses the volumes of the hepatic venous draining areas in the right paramedian sector drained via the MHV and its tributaries was evaluated.

Biphasic helical computed tomography was performed in 34 potential donors for adult-to-adult LDLT. Data sets were post-processed using a non-commercial software tool. Semi-automatic definition of liver margins allowed the segmentation of parenchyma. Hepatic vessels were delineated using a region-growing algorithm with automatically determined thresholds. Volumes and shapes of liver parts were calculated automatically based either on individual portal venous branches (portal venous perfusion areas) or the hepatic veins with special regard on the MHV-tributaries from the right paramedian sector (hepatic venous draining areas). Results were visualized three-dimensionally and compared to the intraoperative findings in 23 transplanted cases.

Image processing was performed within 23 minutes. In the 23 transplanted cases, preoperatively visualized vessels were confirmed. Calculated volumes were: A) Portal venous perfusion areas: Total liver 1600 ± 280 ml, right lobe 1050 ± 190 ml, left lobe 550 ± 130 ml, and segments II + III 270 ± 90 ml. B) Hepatic venous draining areas: Right hepatic vein (RHV) 720 ± 190 ml, MHV 330 ± 100 ml, left hepatic vein (LHV) 330 ± 90 ml, Segment 5-tributary (14 cases) 110 ± 70 ml, Segment 8-tributary (15 cases) 110 ± 40 ml, inferior right hepatic vein (IRHV) (5 cases) 140 ± 100 ml. Calculated volumes of the portal venous perfusion areas and intraoperatively measured graft weights correlated significantly (p < 0.001).

A novel image processing technique was evaluated which allows semiautomatic volume calculation and 3D visualization of the different portal venous perfusion areas and the hepatic venous draining areas.

Frericks, B, Kirchhoff, T, Stamm, G, Schenk, A, Nashan, B, Galanski, M, Preoperative Evaluation of Hepatic Vein Anatomy and Volume Calculation of the Hepatic Venous Drainage Areas with Multi-Detector Row CT in Living Donor Liver Transplantation.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4412676.html