3D CT reconstruction in the surgical management of hepatic injuries

We employed 3D reconstruction of CT images for evaluation of hepatic injuries in a series of eight trauma patients. One had additional reconstruction of a renal injury. 3D imaging provided precise anatomical delineation of damaged areas, particularly in relation to major vessels. Moreover, the imaging agreed with operative findings in every case. The 3D reconstruction facilitated decisions regarding intraoperative, reoperative and non-operative management. The improved imaging provided by 3D reconstruction may allow hepatic CT scans to be interpreted with greater ease and accuracy than conventional CT. We believe this is the first report of its use in liver trauma. Current indications may include postoperative confirmation of the extent of hepatic injuries, assessment before reoperation, and contribution to decisions regarding non-operative management. A limitation at present is the time taken for image production, but we suggest that in the future 3D imaging might contribute to evaluation before emergency surgery in patients with abdominal injuries.