Abstract
To determine whether 2-dimensional or 3-dimensional hepatic visualization is better for the medical students to be used while studying the clinical hepatic anatomy. Twenty-nine patients who underwent surgical intervention due to focal hepatic pathology at the Department of General Surgery, University of Heidelberg, and at Clinics of Santariskes, Vilnius University Hospital were included in the retrospective cohort study. Before the surgical intervention, the computed tomography (CT) liver scan and 3-dimensional (3D) hepatic visualization were performed. A total of 58 2-dimensional and 3-dimensional digital liver images, mixed up in random sequence not to follow each other with a specially designed questionnaire, were presented to the students of Faculty of Medicine, Vilnius University. Their aim was to determine tumor-affected liver segments, to plan which liver segments should be resected, and to predict anatomical difficulties for liver resection. Results were compared with the data of real operation. The students achieved better results for tumor localization analyzing 3D liver images vs. CT scans. This was especially evident determining the localization of tumor in segments 5, 6, 7, and 8 (P<0.05). Furthermore, the results of proposed extent of liver resection have been found to be better with 3D visualization (mean+/-SD - 0.794+/-0.175) in comparison with CT scans (mean+/-SD - 0.670+/-0.200), (P<0.001). Computer-generated 3D visualizations of the liver images helped the medical students to determine the tumor localization and to plan the prospective liver resection operations more precisely comparing with 2D visualizations. Computer-generated 3D visualization should be used as a means of studying liver anatomy.
Highlights
Learning and identification of anatomy is known to be a fundamental component in any clinical specialty, in surgical education, and especially, it plays a very important role in studying liver anatomy
Computer-generated 3D visualizations of the liver images helped the medical students to determine the tumor localization and to plan the prospective liver resection operations more precisely comparing with 2D visualizations
Computer-generated 3D visualization should be used as a means of studying liver anatomy
Summary
Learning and identification of anatomy is known to be a fundamental component in any clinical specialty, in surgical education, and especially, it plays a very important role in studying liver anatomy. The first introduction to anatomical hepatic nomenclature begins in the first year of the medical studies learning human anatomy [2]. Students will be acquainted with the nomenclature of the Couinaud hepatic segmental anatomy. This model proposed by Couinaud in the 1960s was widely accepted in clinical practice and especially in the hepatic surgery [3]. This is only an approximation of individually differentiated segment anatomy, and despite advantages in visualization technologies, this hepatic nomenclature remains difficult to be imagined in a nontransparent organ
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