CT volumetry with three-dimensional modelling in the preoperative management of patients with alveolar echinococcosis of the liver
Abstract
Alveolar echinococcosis of the liver is a chronic parasitic disease with an infiltrative growth pattern, leading to progressive destruction of the hepatic parenchyma and involvement of the vascular-biliary structures. The prolonged course of the disease is often accompanied by a compensatory increase in the total volume of the liver, which is important when assessing resectability and determining surgical tactics. One of the key parameters of preoperative planning is the Future liver remnant, an indicator that characterises the morphological reserve and allows predicting the likelihood of postoperative liver failure. The aim of the study was to evaluate the diagnostic value of computed tomography volumetry and virtual resection in planning surgical treatment for patients with alveolar echinococcosis of the liver. The study included 59 patients with a confirmed diagnosis who were examined at medical centres in Bishkek in 2023-2025. All patients underwent multispiral computed tomography with intravenous contrast, and post-processing was performed using the
LiverAnalysis+ software package. The total liver volume, the volume of affected tissue, the estimated resection volume, and the Future liver remnant were assessed. The average total liver volume in patients without previous surgery was 2,008 cm³, reflecting compensatory hypertrophy in the long-term course of the disease. In patients after surgery, this indicator was lower – 1,635 cm³. The average Future liver remnant was 1,162 cm³ (57.9%) in patients without surgery and 774 cm³ (49.7%) in patients after resection. In one-third of the operated patients, the Future liver remnant was below the critical level (<30–40%), indicating an increased risk of developing liver failure. The results confirmed that computed tomography volumetry with virtual resection is an essential tool
for assessing surgical risks and should be included in the standard preoperative planning for the treatment of patients with alveolar echinococcosis of the liver
Keywords:
alveolar echinococcosis of the liver; CT volumetry; Future liver remnant; preoperative planning; postoperative liver failureReferences
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