To evaluate the clinical application of three-dimensional visualization in the treatment of severe liver trauma.

Clinical data of 12 patients with severe liver trauma admitted to the 900^th Hospital of the Joint Logistics Support Force of PLA from January 2014 to January 2017 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 10 patients were male and 2 female, aged 19-56 years with a median age of 40 years. 9 patients were diagnosed with the right lobe injury, 1 case of middle lobe injury and 2 cases of left lobe injury. According to American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS), 2 cases were classified as grade Ⅲ,8 were grade Ⅳ and 2 were grade Ⅴ. Three-dimensional visualization reconstruction was performed with 64-slice spiral CT scan to evaluate the injury and vascular involvement. The amount of abdominal hemorrhage was evaluated initially. The therapeutic regime was determined. The application of three-dimensional visualization and the curative effect were evaluated.

The three-dimensional reconstruction model could clearly display the hepatic vascular system including the courses of portal vein, hepatic artery and vein, the branches, spatial conformation as well as the injury-involved liver segments. It could observe the spatial anatomical relationship between the injured region and its surrounding vascular structure at any angle, and accurately locate and classify the injured site. Preoperative three-dimensional reconstruction results were consistent with the intraoperative findings. All 12 patients were successfully treated according to the preoperative therapeutic regime. 4 patients underwent open exploration, and the findings were consistent with the preoperative evaluation. 6 cases underwent interventional therapy by digital subtraction angiography (DSA). 2 patients received conservative therapy and were monitored closely. 1 patient suffered from rupture of a giant hematoma in the right lobe and renal failure after operation, and was treated with long-term intermittent blood purification. The remaining 11 cases were discharged without postoperative complications.

For patients with severe liver trauma, three-dimensional visualization can accurately evaluate the injured site and vascular involvement, contribute to design the optimal therapeutic regime and guide the implementation of individualized treatments.