Application of Multi-slice Spiral CT on Donor Selection and Surgical Planning before Living Adult Right Lobe Liver Transplantation

Objective To evaluate the application of multi-slice spiral CT on donor selection and surgical planning before living adult right lobe liver transplantation.Methods Sixty consecutive potential donors were included in this study.Sixty cases were classified into 2 groups which were performed enhanced scanning at 70s,75s after the initiation of injection at the rate of 3.5ml/s with 100ml contrast material.Postprocessing was performed by a radiologist using postprocessing software of surface shaded display(SSD),volume rendering(VR)and maximum intensity projection(MIP)were performed in some donor.CT data included hepatic vein anatomy traversing the anticipated surgical hepatectomy plane to the right of the middle hepatic vein(MHV),the presence and size of the accessory inferior hepatic vein,and the coronal distance from caval insertion of the accessory inferior hepatic vein to the RHV-caval confluence.CT number of the MHV trunks and the subtraction of the MHV trunks and the hepatic parenchyma were analyzed comparatively between two groups.Results The segment VIII and Ⅴdraining into the MHV in 30(50%)patients(the major draining vein was 5 mm in diameter)which traversed the hepatectomy plane.25 accessory hepatic veins were identified in 22(36.7%)patients,and in these 22 donors,two accessory hepatic veins were seen in 3(5%)patients.The diameter were larger than 5 mm in 14 accessory hepatic veins.The average distance to the RHV-inferior vena cava confluence more than 40 mm were seen in 18.The image quality of the hepatic veins in the 75s and 70 s group was of not significant difference.Conclusion Multi-slice spiral CT examination can provide most of the necessary preoperative hepatic vein data which are required for surgical planning and donors selection by showing a virtual hepatectomy plane and the hepatic vein anatomic variations that traverse the hepatectomy plane.