Dilatation of left portal vein after right portal vein embolization: a simple estimation for growth of future liver remnant.

Abstract

To evaluate correlation between growth rate of left portal vein (LPV) and future liver remnant (FLR) after right portal vein embolization (PVE), and to design models predicting FLR growth rate and volume using LPV area measurements on computed tomography (CT). A total of 134 patients (59.6±10.2years; 103 men) who underwent right PVE with contrast-enhanced CT before and 3-5weeks after PVE were retrospectively identified. Kinetic hypertrophy ratio (KHR) and kinetic degree of hypertrophy (KDH) served as growth rate parameters. Correlations between LPV growth rate and FLR growth rate and volume change were evaluated by linear regression analysis. The agreements between actual volumetrically determined growth rates and volume of FLR and those estimated from regression equation using LPV measurements were assessed by Bland-Altman plots. Growth rates of LPV and FLR correlated significantly (P<0.001). The mean difference between actual and estimated value was 0.1% for KHR-FLR (actual, 9.5±6.0%; estimated, 9.4±3.8%), 0.0% for KDH-FLR (actual, 3.3±1.4%; estimated, 3.3±0.7%), -3.8cm3 for FLR volume (actual, 642.5±167.8cm3 ; estimated, 646.4±156.5cm3 ), and -0.1% for proportion of FLR volume (actual, 48.7±7.8%; estimated, 48.9±7.8%). After right PVE, FLR growth rate and volume can be simply estimated from the change in LPV area.