Clinical application of preoperative volumetric measurement for interventional precise embolization in the treatment of hypersplenism caused by liver cirrhosis.

Abstract

Objective: Volume measurement software is not routinely utilized in clinical practice before splenic artery embolization. To explore the function of such software measurement in this context, we conducted a retrospective study.

Methods: We divided patients into two groups: 38 patients in Group A underwent three-dimensional reconstruction using Revolution CT, and 37 patients in Group B underwent imaging with normal CT technology. We compared the changes in liver function test results and haematological parameters between these two groups.

Results: A total of 75 patients who underwent splenic artery embolization from January 2018 to January 2023 were included. The preoperative baseline data were not significantly different (all P values > 0.05). Both groups showed improvements in liver function and hypersplenism-related parameters. Within 2 weeks after surgery, Group A had significantly greater WBC (5.54 ± 1.92 × 10^9/L) and PLT (65.80 ± 20.12 × 10^9/L) counts than Group B (WBC: 4.14 ± 1.96 × 10^9/L; PLT: 52.70 ± 14.78 × 10^9/L; P < 0.05), indicating better control of hypersplenism. At 2 months postintervention, Group A demonstrated more favourable improvements in postintervention splenic volume (reduced from 1045 ± 122.9 cm³ to 489.5 ± 84.93 cm³), portal vein diameter (from 1.51 ± 0.19 cm to 1.28 ± 0.13 cm), and portal vein flow velocity (increased from 17.70 ± 5.25 cm/s to 23.56 ± 6.40 cm/s) than Group B. Moreover, a 53.2% splenic volume reduction was noted in Group A, which was significantly greater than the 31.4% reduction in Group B. Additionally, Group A had fewer adverse reactions, with lower liver/gastrointestinal toxicity (χ²=4.242, P = 0.039) and fever severity (χ²= 4.805, P = 0.028).

Conclusions: This study suggests that using Revolution CT prior to splenic artery embolization provides an effective method for managing hypersplenism, enhancing liver function, and reducing the risk of complications.