[Liver evaluation with multidetector CT. Angiotomography, volume determination and virtual hepatectomy].
OBJECTIVE
to show a new technique of presurgical liver tumor evaluation using multidetector computed tomography (MDCT), determining the usefulness of an-giographic reconstructions, presurgical virtual hepatectomy and 3D liver volume determination, in correlation with surgery findings.


METHODS
twenty patients with primary or secondary liver tumors were evaluated with MDCT and then operated on. Dual-phase CT was performed in all patients on a 4-row multidetector CT scanner (Mx8000; Philips Medical Systems) after mechanical injection of 120 ml of iodinated contrast medium. Scanning was performed using a detector configuration of 4 x 2.5 mm. Images were sent to a workstation and they were analysed with the surgeons. The 3D volumes of each lesion, of the total liver and of the segments to be resected were calculated. Vascular reconstructions and virtual hepatectomy were also performed. Correlation of the liver volume between MDCT and surgery was calculated using the Bland and Altman method.


RESULTS
virtual liver segmentation allowed to perform the surgery in 100% of the patients in one time and there were no complications. The correlation coefficient was 0.83 (CI 95%: -132.08, 159.78).


CONCLUSIONS
presurgical liver hepatectomy is a new application tool of MDCT The angiographic findings and the volume determination are useful to determine the surgical techniquefor each patient and this information allows the surgeons to know if the remnant liver will be enough for the patients to avoid a post-surgical liver insufficiency.
Carrascosa
Patricia M
PM
Diagnóstico Maipú, San Isidro, Buenos Aires, Argentina. investigacion@diagnosticomaipu.com.ar
Capuñay
Carlos M
CM
Sisco
Pablo
P
Perrone
Nora
N
Ulla
Marina
M
Martin López
Elba
E
Pagliarino
Gustavo
G
Carrascosa
Jorge
J
D000328:Adult; D000368:Aged; D000792:Angiography / Q000295:instrumentation / Q000379:methods*; D003287:Contrast Media; D005260:Female; D006498:Hepatectomy / Q000295:instrumentation / Q000379:methods*; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006503:Hepatic Veins / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media