To investigate the three-dimensional classification of splenic artery (SA) in splenic hilum based on three-dimensional visualization (3DVT).

CT scan data of 100 patients admitted to the First Affiliated Hospital of Anhui Medical University and Yijishan Hospital Affiliated to Wannan Medical College from June, 2018 to June, 2021 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 61 patients were male and 39 female, aged from 49 to 88 years, with a median age of 63 years. All patients received thin-slice enhanced CT scan, and the data were extracted and imported into the 3D visualization system for 3D reconstruction. The number, distribution range, three-dimensional direction of SA branches, and the spatial relationship with the end of pancreatic tail and splenic hilum were observed and 3D classification were performed.

The success rate of 3D model reconstruction of SA in the splenic hilum, spleen and pancreas in 100 patients was 100%(100/100). Regarding the number of primary SA branches, 4 patients (4%) had 1 branch, 2 branches in 76 cases (76%), 3 branches in 15 cases (15%) and multiple branches (≥4) in 5 cases (5%), respectively. The distance between the primary branching of SA and splenic hilum was 0-68 mm, with a median of 19 mm. The distance between the primary branching of SA and the end of pancreatic tail was 0-127 mm, with a median of 16 mm. The distance between splenic hilum and pancreatic tail was 0-138 mm, with a median of 21 mm. SA could be divided into 5 types: type A in 4 cases (4%), type B in 76 cases (76%), type C in 16 cases (16%), type D in 2 cases (2%) and type E in 2 cases (2%), respectively.

The anatomical structure of splenic hilum is complex and varied. Preoperatively, 3DVT can be applied to observe and classify the terminal branches of SA, which can provide guidance for precise and individualized splenic, pancreatic surgeries.