Background

Preoperative portal vein embolization (PVE) stimulates liver hypertrophy and improves the safety of major hepatectomy. It is essential to predict the future remnant liver volume (FRLV) and resection limit following PVE. Previously, we reported that evaluating functional FRLV (fFRLV) using EOB-MRI could predict post-hepatectomy liver failure. In this study, we investigated the usefulness of fFRLV in predicting the achieving of adequate resection limit for safe hepatectomy following PVE.

Methods

We included 55 patients who underwent PVE and were scheduled for major hepatectomy. We calculated the liver-to-muscle ratio in the remnant liver and fFRLV using EOB-MRI. We investigated the pre-PVE variables in determining the nonachievement of the resection limit.

Results

The median observation period between PVE and the first evaluation was 21 days, and the median growth rate of FRLV was 26.4%. In 54.5% of patients, the resection limit of fFRLV (615 mL/m²) was achieved. In logistic regression and receiver-operating characteristic analyses, pre-PVE fFRLV (p < 0.001, area under the curve: 0.852) was the reliable predictor of achieving the resection limit; the cutoff value of pre-PVE fFRLV was 446 mL/m².

Conclusion

Pre-PVE fFRLV can be useful in predicting the achievement of adequate resection limit following PVE.

中文翻译：

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通过功能性肝体积评估预测肝大切除患者门静脉栓塞后达到切除限度

背景

术前门静脉栓塞术 (PVE) 可刺激肝脏肥大并提高大肝切除术的安全性。预测 PVE 后的未来残肝体积 (FRLV) 和切除限度至关重要。以前，我们报道使用 EOB-MRI 评估功能性 FRLV (fFRLV) 可以预测肝切除术后肝功能衰竭。在这项研究中，我们调查了 fFRLV 在预测 PVE 后安全肝切除术达到足够切除限度方面的有用性。

方法

我们纳入了 55 名接受 PVE 并计划进行大肝切除术的患者。我们使用 EOB-MRI 计算了残肝和 fFRLV 中的肝肌比。我们调查了 PVE 之前的变量，以确定未达到切除限制。

结果

PVE与第一次评估之间的中位观察期为21天，FRLV中位增长率为26.4%。在 54.5% 的患者中，达到了 fFRLV 的切除极限（615 mL/m ²）。在逻辑回归和受试者操作特征分析中，PVE 前 fFRLV（p < 0.001，曲线下面积：0.852）是达到切除限度的可靠预测指标；pre-PVE fFRLV 的临界值为 446 mL/m ²。

结论

PVE 前 fFRLV 可用于预测 PVE 后达到足够切除限度。