Abstract: Objective The purpose of this study was to investigate the application of three-dimensional (3D) computed tomography (CT) reconstruction in the evaluation of resectability of giant intrahepatic tumors in patients with primary liver cancer (PLC). Methods 68 PLC patients with giant intrahepatic tumors were encountered in our hospital between January 2018 and January 2020, and all patients underwent CT scan and 3D reconstruction with 3d visualization software -MI-3DVS before hepatectomy. The tumor size, morphology, blood supply and its relationship with surrounding tissues, the hepatic artery and portal vein involvement, as well as lymph node metastasis were observed, and the resectability of tumors was determined. Results The reconstruction was finished in all the patients, which could clearly show the tumor size, morphology, blood supply and its relationship with surrounding tissues, demonstrating hepatic artery involvement in 18 cases, portal vein involvement in 20 cases, and the lymph node metastasis in 12 cases; the resectability was made in 42 cases (61.8%) based on the 3D reconstruction of CT scan, while the hepatectomy was successfully carried out in 45 cases(66.2%); the consistency analysis showed that the sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Kappa value of CT scan 3d reconstruction in the evaluation of hepatic artery involvement were 84.2%, 95.9%, 92.6%, 88.9%, 94.0% and 0.814, those of in the evaluation of portal vain involvement were 86.4%, 97.8%, 94.1%, 95.0%, 93.8% and 0.862, in the evaluation of lymph node metastasis were 84.6%, 98.2%, 95.6%, 91.7%, 96.4% and 0.853, and in the evaluation of resectability of tumors were 91.1%, 95.7%, 92.6%, 97.6%, 86.4% and 0.841. Conclusion The CT scan 3D reconstruction technology could demonstrate the intrahepatic tumor involvement of blood vessels and lymph node metastasis in PLC patients with massive tumor mass, which could tell the surgeons what tumor resectable and guide the hepatectomy in clinical practice.

Key words: Hepatoma, Giant tumors, Computed tomography, Three-dimensional reconstruction