MSCT evaluation of pre-operation of liver transplantation candidates

Objective: To study the value of three-phase ce-MSCT with 3D-MSCTA(P) for evaluation of pre-operation of orthotopic liver transplantation candidates. Methods: Sixty-three potential candidates for liver transplantation were evaluated with three-phase ce-MSCT scanning(intravenous contrast medium was administered at the rate of 3ml/s. Three-phase scanning acquisition at 22～25s, 60s and 120s respectively after initiation of contrast medium injection). Arterial phase and portal venous phase scan information was used for volume rendering CTA(P). All images were analyzed to define the parenchymal liver disease and the size of hepatocellular carcinoma, as well as the diameter of common hepatic artery and celiac axis. The hepatic arterial blood supply was categorized according to Michel's classification. Portal vein thrombosis was defined. Hepatic volume was measured by CT as well as collateralization stage of the hepatic venous system and splenic artery aneurysms. Results: Masses were pathologically proven as hepatocellular carcinoma in 15 cases(small hepatocellular carcinoma in 3 cases), cholangiocellular carcinoma in 2 cases, cholecystic carcinoma in 1 case in all of the 63 patients. Michels IX anatomy in 2 cases, celiac axis stenosis in 3 cases, small-caliber hepatic arterial vessels in 2 cases, SA aneurysms in 2 cases. Portal vein thrombosis in 12 cases(long segment in 7 cases), the mean hepatic volume was 1114.41cm3. Conclusions: Three-phase ce-MSCT with CTA(P) can define parenchymal liver disease, show the anatomy of hepatic artery and hepatic vein as well as vascular diseases, hepatic volume can be measured. MSCT can provide comprehensive preoperative liver evaluation for transplantation candidates.