P.M. Zelter¹, A.V. Kolsanov², A.A. Manukyan³, Z.N. Zvonareva4, S.S. Chaplygin5

1–5 Institute of Innovative Development of FSBEI HE SamSMU MOH Russia (Samara, Russia)

The variability of the vascular anatomy of the liver, duodenum and pancreas determines the need to know it when planning surgical interventions. Establishing the type of arterial blood supply to the liver is an important stage in hepatectomy and pancreatoduodenal resection. Knowing the individual characteristics of blood supply allows you to choose the best option for vascular reconstruction, to avoid damage to aberrant arteries. Data on the prevalence of abnormalities in arterial and venous blood supply to the liver vary significantly depending on the study. With various surgical interventions, it is the anatomical features that determine the tactics of the surgeon One of the best methods for reflecting the features of anatomical structure of blood vessels is computed tomography. Currently, CT with bolus contrast enhancement is the main technique for excluding the surgical pathology of the abdominal organs. Tomograms allow to access  detailed study of the anatomical relationships of the abdominal organs at the level of a thin section. Moreover, for three-dimensional modeling on a standard workstation, only arterial trunks are available: the density of the contrasted portal and hepatic veins does not allow it to be displayed in Volume rendering mode. Moreover, for the surgeon, a separate threedimensional representation of the vessels is important, in which the parenchymal organs do not obscure the zone of interest.  Aim of study – to develop an algorithm for vascular segmentation, to assess the variability of the arteries of the hepatoduodenal pool, to compare the results of the analysis of standard studies and three-dimensional models

Vascular plugin was developed at Samara State Medical University. In addition to the classical Michels variant, the most frequent variant was type 5 - the presence of additional LHA from left gastric.

As a result, a plugin was developed to obtain polygonal models of arteries and veins of the abdomen. Using this plugin allowed us to carry out segmentation to separately obtain models of the arterial and venous vessels. Polygonal models clearly show the type of blood supply. Indication of the appropriate type is important for planning surgical interventions on the liver. Analysis of polygonal models reveals vascular aberrations and saves the doctor’s time.

Zelter P.M., Kolsanov A.V., Manukyan A.A., Zvonareva Z.N., Chaplygin S.S. Evaluation of variant anatomy of arteries of hepatoduodenal pool using computed tomography with polygonal models’ forming. Technologies of Living System. 2021. V. 18. № 2. Р. 47–53. DOI: https://doi.org/10.18127/j20700997-202102-06 (In Russian).

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