Objective：To study the displaying features and clinical significance of multi-detector spiral CT angiography (MDCTA) for demonstrating the hepatic arterial and portal venous systems in patients with neoplastic hepatic lesions.
Methods：One hundred and nineteen patients with neoplastic liver disease whose clinical data were complete were selected to perform MDCTA. All patients underwent 64-detector spiral CT scanning of hepatic arterial and portal venous phase, and images were reconstructed by maximum intensity projection (MIP), shaded-surface display (SSD) and volume rendering (VR) technique, respectively. The imaging findings of hepatic arterial and portal venous system from MDCTA with different reconstruction methods were compared, and the risk of bleeding in surgery was also assessed.
Results：The display for the VI level of hepatic artery in MIP and VR showed no difference (P＞0.05) but both displayed better than SSD (P＜0.05). The 3 reconstruction methods all clearly displayed the I, II and III levels of portal vein and the display rates were all above 98.1% (P＞0.05). The coincidence rate of CTA estimation of low bleeding risk in surgery was 96.7%, high bleeding risk in surgery was 90.5%, and the results were statistically significant (P＜0.05).
Conclusions：MDCTA can satisfy the clinical requirements in liver surgery. The combined use of MIP and VR can  optimally displaly the hepatic artery and portal vein, and SSD also has helpful effects. CTA can be used for prelimmary estimation of the risk of intraoperative bleeding.