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Hepatic vascular variations and visual three-dimensional reconstruction technique in pediatric patients with choledochal cyst

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Abstract

Purpose

The aim of the present study was to identify the hepatic vascular variations with visual three-dimensional (3D) reconstruction of vessels in pediatric patients with choledochal cyst (CDC).

Methods

We retrospectively analyzed the data of 84 children with pathologically confirmed CDCs treated in the Children's Hospital of Soochow University. 180 patients without CDCs as a control to analysis the hepatic artery and portal vein anatomy. All patients were examined by multi-slice spiral CT (MSCT) and the images of children with CDC were reconstructed by Hisense computer-assisted surgery system (Hisense CAS) to obtain visual 3D images.

Results

There were 71 females and 13 males diagnosed with CDC. According to Todani classification of CDC, there were 42 cases of type Ia, 10 cases of type Ic and 32 cases of type IVa. There were 10 (11.9%) patients with hepatic artery variations, 14 (16.7%) patients with right hepatic artery located on the ventral side of the CDC, and 16 (19.0%) patients with portal vein variations. Sex, age and types of the cyst were not associated with the presence of vascular variations. There was no significant difference in hepatic vascular variation between CDCs and control groups. Visual 3D images clearly displayed the hepatic vascular variations and the spatial structure of the CDC in pediatric patients with CDC.

Conclusions

Hepatic artery and portal vein variations can be detected in pediatric patients with CDC. Visual 3D technique can visually and stereoscopically display the anatomical variations of the hepatic artery and portal vein.

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Abbreviations

CDC:

Choledochal cyst

3D:

Three-dimensional

MSCT:

Multi-slice spiral CT

Hisense CAS:

Hisense computer-assisted surgery

MPR:

Multiplanar reformation

MIP:

Maximum intensity projection

LHA:

Left hepatic artery

RHA:

Right hepatic artery

LGA:

Left gastric artery

SMA:

Superior mesenteric artery

MPV:

Main portal vein

MPV:

Main portal vein

RPV:

Right portal vein

LPV:

Left portal vein

RAPV:

Right anterior portal vein

RPPV:

Right posterior portal vein

CHD:

Common hepatic duct

CBD:

Common bile duct

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Funding

This work was supported by the National Natural Science Foundation of China [Grant no. 81971685].

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Authors and Affiliations

  1. Department of Radiology, Children’s Hospital of Soochow University, Suzhou, 215025, China

    Wei Chen, Lian Zhao & Wan-liang Guo

  2. Pediatric Surgery, Children’s Hospital of Soochow University, Suzhou, China

    Jian Wang

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  1. Wei Chen
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  2. Lian Zhao
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  3. Jian Wang
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  4. Wan-liang Guo
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Contributions

JW: protocol/project development; WC, LZ, WG: data collection or management; LZ, WC: data analysis; WC, WG: manuscript writing/editing.

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Correspondence to Wan-liang Guo.

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Chen, W., Zhao, L., Wang, J. et al. Hepatic vascular variations and visual three-dimensional reconstruction technique in pediatric patients with choledochal cyst. Surg Radiol Anat 42, 1489–1499 (2020). https://doi.org/10.1007/s00276-020-02590-9

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