Three-dimensional helical CT of intrahepatic venous structures: Comparison of three rendering techniques

Objective: To define the advantages and disadvantages of various rendering techniques to obtain three-dimensional (3D) displays of intrahepatic venous structures with helical CT data. Materials and Methods: After rapid preprocessing segmentation of the liver, helical CT data (8 mm slice thickness overlapped every 4 mm) from 10 patients were reconstructed using maximum intensity projection (MIP), volume rendering, and surface rendering algorithms. Three-dimensional imaging was evaluated blindly and independently by three observers for presence of artifacts and overall quality. Results: Three-dimensional displays showed the hepatic veins and fifth order portal branches with the volume and MIP rendering techniques. Best overall quality in the 3D representation of the liver was achieved with the MIP technique (p < 0.05). Small details in venous anatomy and portal involvement by tumor were better imaged with the MIP technique. ''Stair-step'' artifacts markedly degraded the 3D displays obtained with the surface rendering technique, making it inappropriate for imaging the intrahepatic venous structures. Conclusion: Maximum intensity projection appears to be an adequate technique to perform 3D imaging of intrahepatic venous structures with helical CT data when 8 mm slice thicknesses overlapping every 4 mm are used. However, optimization of imaging protocols needs to be done and compared in a larger series.