To investigate the type and incidence of anatomical variation of hepatic vessels by using three-dimensional (3D) CT reconstruction.

160 adult patients undergoing abdominal 64-slice enhanced multi-slice spiral CT (MSCT) three-dimensional reconstruction in the First Affiliated Hospital of Harbin Medical University from September, 2017 to July, 2020 were enrolled in this study. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 80 patients were male and 80 female, aged from 27 to 78 years, with a median age of 54 years. MSCT imaging data were imported into IQQA system to perform 3D reconstruction of hepatic arteries and veins, to simulate the target segment and record the type and quantity of hepatic vascular variation in each patient.

According to Hiatt classification of hepatic arterial variations, 130 cases were classified as HiattⅠ, 11 cases of HiattⅡ, 10 cases of Hiatt Ⅲ, 1 case of Hiatt Ⅳ, 1 case of Hiatt Ⅴ, 4 cases of Hiatt Ⅵ, 1 case of Hiatt Ⅶ, 2 cases of Hiatt Ⅷ and 0 case of Hiatt Ⅸ, respectively. The proportion of left hepatic vein with primary-trunk type was 56.9%(91/160), 30.0%(48/160) for dual-trunk type and 13.1%(21/160) for radial type. The main types of the middle hepatic vein included 61.9%(99/160) of segment 4 (S4) hepatic vein converging to the left hepatic vein, 36.9%(59/160) of S4 hepatic vein converging to the middle hepatic vein and 1.2%(2/160) of S4 hepatic vein independently converging to the inferior vena cava. The main types of the right hepatic vein consisted of 74.4%(119/160) of primary-trunk type S6 hepatic vein, 22.5%(36/160) of dual-trunk type and 3.1%(5/160) of triple-trunk type. The proportion of umbilical fissure vein was 78.8%(126/160), of which 53.2%(67/126) converging to the root of left hepatic vein, 23.8%(30/126) converging to the distal end of left hepatic vein, 13.5%(17/126) converging to the root of middle hepatic vein, and 9.5% (12/126) converging to the space between middle and left hepatic veins. Anterior fissure vein accounted for 74.4%(119/160), of which 94.1%(112/119) converging to the middle hepatic vein and 5.9%(7/119) converging to the right hepatic vein.

Anatomical variations of hepatic vessels are extremely complicated and accidental. 3D reconstruction technology can assist surgeons to choose the optimal surgical method and technique to improve the safety of surgery.