Hepatic vascular variations and visual three-dimensional reconstruction technique in pediatric patients with choledochal
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ORIGINAL ARTICLE
Hepatic vascular variations and visual three‑dimensional reconstruction technique in pediatric patients with choledochal cyst Wei Chen1 · Lian Zhao1 · Jian Wang2 · Wan‑liang Guo1 Received: 4 June 2020 / Accepted: 29 September 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Purpose The aim of the present study was to identify the hepatic vascular variations with visual three-dimensional (3D) reconstruction of vessels in pediatric patients with choledochal cyst (CDC). Methods We retrospectively analyzed the data of 84 children with pathologically confirmed CDCs treated in the Children’s Hospital of Soochow University. 180 patients without CDCs as a control to analysis the hepatic artery and portal vein anatomy. All patients were examined by multi-slice spiral CT (MSCT) and the images of children with CDC were reconstructed by Hisense computer-assisted surgery system (Hisense CAS) to obtain visual 3D images. Results There were 71 females and 13 males diagnosed with CDC. According to Todani classification of CDC, there were 42 cases of type Ia, 10 cases of type Ic and 32 cases of type IVa. There were 10 (11.9%) patients with hepatic artery variations, 14 (16.7%) patients with right hepatic artery located on the ventral side of the CDC, and 16 (19.0%) patients with portal vein variations. Sex, age and types of the cyst were not associated with the presence of vascular variations. There was no significant difference in hepatic vascular variation between CDCs and control groups. Visual 3D images clearly displayed the hepatic vascular variations and the spatial structure of the CDC in pediatric patients with CDC. Conclusions Hepatic artery and portal vein variations can be detected in pediatric patients with CDC. Visual 3D technique can visually and stereoscopically display the anatomical variations of the hepatic artery and portal vein. Keywords Choledochal cyst · Pediatric · Hepatic vascular variation · Visual three-dimensional reconstruction Abbreviations CDC Choledochal cyst 3D Three-dimensional MSCT Multi-slice spiral CT Hisense CAS Hisense computer-assisted surgery MPR Multiplanar reformation MIP Maximum intensity projection LHA Left hepatic artery RHA Right hepatic artery LGA Left gastric artery
SMA Superior mesenteric artery MPV Main portal vein MPV Main portal vein RPV Right portal vein LPV Left portal vein RAPV Right anterior portal vein RPPV Right posterior portal vein CHD Common hepatic duct CBD Common bile duct
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00276-020-02590-9) contains supplementary material, which is available to authorized users. * Wan‑liang Guo [email protected] 1
Department of Radiology, Children’s Hospital of Soochow University, Suzhou 215025, China
Pediatric Surgery, Children’s Hospital of Soochow University, Suzhou, China
2
Pediatric choledochal cyst (CDC) often accompanied by acute cholangitis, acute pancreatitis, bile duct stones and biliary c
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