Intraoperative three-dimensional visualization of liver vasculature by ultrasonography.
OBJECTIVE
To understand the three-dimensional relationship between the liver vasculature and tumor by intraoperative sonography, some training is inevitable. Three-dimensional ultrasound has been evaluated in various fields, but not yet in intraoperative sonography.


METHODS
Extracorporeal 3-D ultrasonography was performed in 32 patients. Of these, 20 underwent intraoperative 3-D ultrasonography. Using these images, we evaluated whether or not the portal vein, hepatic vein and its branches were discernible.


RESULTS
Satisfactory images were obtained in all 32 patients by extracorporeal methods and in 15 by intraoperative 3-D ultrasonography. The number of visualized veins, including the right portal vein, its anterior branch, posterior branch, anterior superior branch, anterior inferior branch and right hepatic vein, was 32, 32, 23, 28, 22, and 30 by extracorporeal 3-D ultrasonography, and 15, 14, 10, 8, 5, and 12 by intraoperative 3-D ultrasonography. The relationships between the intrahepatic artery, portal vein, and hepatic vein were more clearly visualized by intraoperative 3-D sonography.


CONCLUSIONS
Intraoperative 3-D ultrasonography clearly showed small branches of the liver vasculature and their 3-D relation, which may be helpful for liver surgery. However, this method requires further improvement.
Minagawa
Masami
M
Department of Hepato-Biliary-Pancreatic Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. minagawa-tky@umin.ac.jp
Makuuchi
Masatoshi
M
Kubota
Keiichi
K
Kondo
Yuji
Y
D001650:Bile Duct Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D006498:Hepatectomy; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006503:Hepatic Veins / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007432:Intraoperative Period; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D011169:Portal Vein / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D018608:Ultrasonography, Doppler