Morphological changes of liver in patients with postoperative intestinal adhesion under artificial pneumoperitoneum CT
10.3969/j.issn.1002-1671.2023.12.013
- VernacularTitle:基于CT影像人工气腹对肝脏形态及腹部血流影响的研究
- Author:
Muqing LIU
1
,
2
;
Xiaoxia CHEN
;
Rongrong HUA
;
Sihan DU
;
Xucheng HE
;
Guisheng WANG
Author Information
1. 锦州医科大学研究生院,辽宁 锦州 121001
2. 中国人民解放军总医院第三医学中心放射诊断科,北京 100039
- Keywords:
artificial pneumoperitoneum;
liver morphology;
abdominal vessels;
postoperative intestinal adhesion
- From:
Journal of Practical Radiology
2023;39(12):1967-1970,1979
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the characteristics of liver deformation and changes in abdominal vascular diameter under artificial pneumoperitoneum based on CT images,and also to reveal the impact of intestinal adhesion on these characteristics.Methods A retrospective study was conducted on 61 patients who underwent abdominal CT scan and artificial pneumoperitoneum CT.Eight cases did not meet the inclusion criteria.The sample included 41 patients with postoperative intestinal adhesion(POIA)and 12 patients without POIA.A three-dimensional post-processing software was used to quantify the gas volume,liver volume,liver surface area,and lumen of the abdominal aorta,inferior vena cava,and portal vein on CT images of patients who underwent abdominal CT scan and artificial pneumoperitoneum CT.The measured indices were compared before and after artificial pneumoperitoneum in all patients,and the impact of intestinal adhesion on the aforementioned indices was evaluated.Results At equivalent levels of pneumoperitoneum pressure,no statistically significant difference was observed in the quantity of gas in the abdominal cavity between patients with and without POIA(P=0.753).In the absence of pneumoperitoneum,POIA patients exhibited a significantly higher liver volume than non-adhesion patients(P＜0.01).Following the application of artificial pneumoperitoneum pressure,both liver volume and liver surface area were reduced in all patients,with a more pronounced decrease in POIA group(P=0.003,P=0.002).In addition,the reductions in the internal diameters of the inferior vena cava at three locations and the portal vein position 1 were also observed in all patients(P＜0.05).Notably,the POIA group exhibited more significant decrease in the internal diameters of inferior vena cava position 1 and the portal vein position 1(P=0.022,P=0.038).No significant differences were observed in the changes of internal diameter of other blood vessels or in the intergroup comparison.Conclusion Artificial pneumoperitoneum can reduce the volum,the surface area of liver,and the inner diameter of some abdominal vessels,which provides a scientific basis for navigation and real-time correction in laparoscopic abdominal surgery for patients,especially for patients with POIA.
