Clinical application of three-dimensional visualization technology in assessing the spatial configuration of major hepatic vessels and liver lobar volume distribution

Abstract:

Background and Aims The hepatic vascular and biliary systems exhibit substantial anatomical variability and complex spatial relationships, posing challenges for precise surgical planning based on conventional two-dimensional imaging. This study aimed to evaluate the clinical value of three-dimensional visualization in characterizing the spatial architecture of hepatic vasculature and bile ducts and to explore its association with hepatic volumetric distribution.Methods A total of 610 living liver donors and 158 patients with bile duct dilatation were retrospectively analyzed. Three-dimensional models of the hepatic artery, portal vein, hepatic veins, and bile ducts were reconstructed from contrast-enhanced CT images. Vascular and biliary anatomical patterns, spatial relationships, and their correlations with hepatic lobe and segmental volumes were systematically assessed.Results Three-dimensional visualization enabled intuitive and comprehensive depiction of hepatic vascular and biliary anatomy. Distinct portal vein configurations were associated with significant differences in regional liver volume distribution, with an increased proportion of the right posterior lobe observed in patients with specific portal vein branching patterns. The presence of an inferior right hepatic vein with a diameter ≥5 mm was also associated with a larger right posterior lobe volume. Analyses of extrahepatic and intrahepatic spatial relationships revealed relatively consistent positional patterns between the right hepatic artery, portal vein, and bile ducts, and a significant correlation was observed between the spatial courses of the right hepatic artery and the right posterior bile duct.Conclusion Three-dimensional visualization provides accurate preoperative assessment of hepatic vascular and biliary anatomy and clarifies complex spatial relationships and their volumetric implications. This technique offers critical anatomical support for precision hepatobiliary surgery and liver transplantation.