Detection of intrahepatic veno-venous shunts by three-dimensional venography using multidetector-row computed tomography during angiography

作者：Sakaguchi Takanori^*; Suzuki Shohachi; Hiraide Takanori; Shibasaki Yasushi; Morita Yoshifumi; Suzuki Atsushi; Fukumoto Kazuhiko; Inaba Keisuke; Takehara Yasuo; Nasu Hatsuko; Kamiya Mika; Yamashita Shuhei; Ushio Takasuke; Konno Hiroyuki

来源：Surgery Today, 2014, 44(4): 662-667.

DOI：10.1007/s00595-013-0710-6

• Hepatic vein
• Hepatectomy
• Liver transplantation
• Reconstruction
• Congestion

The hepatic vein (HV) can be removed during hepatectomy if there is an effective intrahepatic veno-venous shunt (vv-shunt). We evaluated the efficacy of vv-shunt detection by three-dimensional (3D) venography reconstructed from multidetector-row computed tomography (MDCT) during angiography. %26lt;br%26gt;3D venography was reconstructed using computer software in 88 patients with intrahepatic tumors. %26lt;br%26gt;We found that 12 patients had one shunt [4 right hepatic vein (RHV)-middle hepatic vein (MHV) and 12 RHV- inferior right hepatic vein (IRHV)] and 1 patient had 2 shunts (RHV-MHV and -IRHV), confirming a clinically efficient vv-shunt in 14.8 % of the patients. In one patient with an RHV-IRHV shunt, the preserved RHV-IRHV shunt worked well and prevented congestion of the postero-caudal subsegment after central bisegmentectomy with partial resection of the RHV ventral trunk for huge hepatocellular carcinoma (HCC). %26lt;br%26gt;Although the vv-shunt detection rate by 3D venography is low, a visualized vv-shunt proved to be efficient. Thus, invasive occlusion venography is avoidable if a vv-shunt is seen on 3D venography.

• 出版日期2014-4