Classification of variant portal vein anatomy based on three-dimensional CT: surgical implications.

IF 1.4 4区医学 Q2 Medicine Surgical and Radiologic Anatomy Pub Date : 2024-08-01 Epub Date: 2024-07-04 DOI:10.1007/s00276-024-03427-5

Zheyu Liu, Tianni Shen, Kexin Xia, Junye He, Tianhao Rui, Wei Chen

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Abstract

Purposes: The purpose of this study was to develop a new and more comprehensive classification system for portal vein (PV) variations using three-dimensional visualization and evaluation (3DVE) and to discuss the prevalence rates and clinical implications of the variants.

Methods: The anatomies of PVs were tracked and analyzed by using three-dimensional visualization of CT images acquired between 2013 and 2022. Scans from 200 adults were evaluated and a total of 178 patients (N = 178) were included in the study. The new classification system, named BLB classification, was developed based on the level of the absent PV branch in each variant anatomy.

Results: Using the BLB classification system, PVs were divided into thirteen subtypes. Only 82.6-84.8% of the portal veins of the 178 patients were depicted in Atri's, Cheng's or Covey's classification, compared with 100% identified by the BLB classification. The BLB classification was validated against external data sets from previous studies, with 97.0-98.9% of patients classified by the BLB system.

Conclusion: Variant PV anatomies are more commonly seen based on 3DVE than in previous reports. The BLB classification covers almost all portal vein variants and may be used for planning liver surgery.

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基于三维 CT 的变异门静脉解剖学分类：手术意义。

目的：本研究的目的是利用三维可视化评估（3DVE）为门静脉（PV）变异建立一个新的、更全面的分类系统，并讨论变异的患病率和临床意义：方法：通过对2013年至2022年间获得的CT图像进行三维可视化，跟踪和分析门静脉的解剖结构。研究评估了 200 名成人的扫描结果，共纳入 178 名患者（N = 178）。新的分类系统被命名为BLB分类，是根据每个变异解剖中缺失的PV分支的水平而制定的：结果：使用 BLB 分类系统，PV 被分为 13 个亚型。在 178 名患者中，只有 82.6%-84.8%的门静脉符合 Atri、Cheng 或 Covey 的分类，而 BLB 分类法可识别出 100%的门静脉。BLB分类法与之前研究的外部数据集进行了验证，97.0%-98.9%的患者按照BLB系统进行了分类：结论：与之前的报告相比，基于 3DVE 的变异门静脉解剖更常见。BLB分类几乎涵盖了所有门静脉变异，可用于规划肝脏手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine

CiteScore

2.40

自引率

14.30%

发文量

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.