Using Multidetector CT for Preoperative Vascular Evaluation of Liver Neoplasms: Technique and Results

Abstract

Multidetector CT provides valuable preoperative information about hepatic vascular architecture and can be used as a noninvasive alternative to catheter angiography before oncologic liver surgery.

Accessory hepatic artery: incidence and distribution

“…Pre-operative arterial imaging is of paramount importance to plan open and endovascular procedures involving the upper abdominal organs. [2][3][4] Volpe et al 5 reported that injuries to hepatic arterial supply are more likely to be involved in pancreaticoduodenectomy, especially in the region of porta hepatis. The hepatic artery originates from the celiac axis in 52 to 76% of individuals, and the presence of variations of the normal hepatic artery anatomy is found in 32 to 48% of patients.…”

Three-dimensional images of liver tumours reconstructed by Gd-EOB-DTPA-enhanced MRI

“…Reconstructed 3D images have been adopted to increase understanding of major blood vessels and other important structures related to the lesion, and have been very useful in hepatic resection and hepatic transplantation [1][2][3][4]. Until recently, 3D images of the liver have been mainly reconstructed by CT data, and these images have been widely utilised in surgical planning [1][2][3][4]. Segmental anatomy of the liver is mainly defined by hepatic veins and portal branches, so sliced MR provide all the information on the major vessels and the tumour.…”

“…Better understanding of 3D appearances of liver structure may improve the outcome of curative surgery, and make more aggressive resection possible. Most 3D images of the liver have been reconstructed using volume data from multidetector row helical CT (MDCT) with multiphasic contrast-enhanced studies [1][2][3][4]. Although MDCT images are widely utilised, there may be some cases when a liver tumour can only be determined by MRI, or when a patient cannot undergo contrast-enhanced CT owing to risk of allergic reaction to the contrast medium.…”

Prospective intraindividual comparison between respiratory-triggered balanced steady-state free precession and breath-hold gradient-echo and time-of-flight magnetic resonance imaging for assessment of portal and hepatic veins

“…Due to the fast imaging capabilities of MDCT scanners, a resolution of the intravenous contrast bolus passage into separate phases, including the hepatic arterial and portal venous phases, became possible. Several studies have demonstrated excellent correlation between MDCT imaging and catheter DSA or intraoperative sonography in assessment of portal and hepatic veins, with accuracy of up to 100% for depiction of surgically important portal and hepatic venous anatomical variants [14][15][16][17]. However, MDCT with the use of iodinated contrast medium, is limited in patients with renal insufficiency.…”