Preliminary application of three-dimensional visualization in interventional treatment of Budd-Chiari syndrome

Objective To analyze the application of three-dimensional visualization in interventional treatment of Budd-Chiari syndrome (BCS) with the hepatic vein occlusion type. Methods A retrospective study was conducted on 15 patients with BCS of the hepatic vein occlusion type who were admitted to the Affiliated Hospital of Xuzhou Medical University from January 2017 to June 2018. The study included 8 males and 7 females with a mean age of (36.7±14.4) years. All patients were examined with MRI enhanced scanning and the original MRI data of the DICOM format were extracted. The digital data were then extracted and reconstructed by the Mimics software to obtain a three-dimensional visualization model. The hepatic vein was recanalized under the guidance of the three-dimensional visualization model. Results The three-dimensional visualization model was successfully constructed. Of all the 15 three-dimensional visualization models, right hepatic vein ostial stenosis occurred in 4 patients and occlusion in 11 patients. The middle hepatic vein and the left hepatic vein formed a common trunk in 15 patients, and ostial stenosis and occlusion of the common trunk occurred in 3 and 12 patients, respectively. Communicating branches between the right and middle hepatic veins occurred in 6 patients. Accessory hepatic veins occurred in 3 of 15 patients, and the accessory hepatic vein ostium was stenosed in 3 patients. Communicating branches between the accessory hepatic vein and the right hepatic vein occurred in 2 patients, and communicating branches between the accessory hepatic vein and the middle hepatic vein occurred in 1 patient. All patients were treated successfully with interventional treatment without any complications. One, 2, and 3 hepatic veins were recanalized in 7, 5 and 3 patients, respectively. Conclusion The three-dimensional visualization was valuable in displaying the location, pattern and collateral vessels of the hepatic veins in BCS patients with the hepatic vein occlusion type. It was helpful for accurate preoperative assessment and to make individualized interventional treatment plans. Key words: Budd-Chiari syndrome; Hepatic vein; Imaging, three-dimensional; Interventional treatment