morphoМорфологические ведомостиMorphological newsletter1812-31712686-8741Private Medical University REAVIZ10.20340/mv-mn.2025.33(2).944morpho-944Research ArticleНАУЧНЫЕ ОБЗОРЫSCIENTIFIC REVIEWSНЕРЕШЕННЫЕ ВОПРОСЫ И КЛИНИЧЕСКОЕ ЗНАЧЕНИЕ СЕГМЕНТАЦИИ И ВОЛЮМЕТРИИ ПЕЧЕНИTHE LIVER SEGMENTATION AND VOLUMETRY UNRESOLVED ISSUES AND CLINICAL SIGNIFICANCEhttps://orcid.org/0009-0006-8830-0076СубочевСергей ВладимировичSubochevSergey V.

аспирант кафедры морфологии и патологии

Aspirant of the Morphology and Pathology Department

subochevs@yandex.ruhttps://orcid.org/0000-0002-1350-0704СупильниковАлексей АлександровичSupil'nikovAleksey A.

кандидат медицинских наук, доцент, первый проректор по научной деятельности, заведующий кафедрой морфологии и патологии

Candidate of Medical Sciences, Associate Professor, First Vice-Rector for Scientific Activities

supilnikov@reaviz.ruМедицинский университет РЕАВИЗ, СамараРоссияREAVIZ Private Medical University, SamaraRussian Federation202505072025332id-944 Cтатья опубликована / The Article is publishedCopyright © Субочев С.В., Супильников А.А., 20252025Субочев С.В., Супильников А.А.Subochev S.V., Supil'nikov A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.morpholetter.com/jour/article/view/944

Современные методы медицинской визуализации способствовали появлению новых технологий и направлений в медицине печени – сегментации печени, представляющей собой процесс разделения органа на функционально независимые сегменты с индивидуальной системой кровоснабжения, венозного оттока и выведения желчи и ее волюметрии (волюмометрии – измерений и оценки функциональных объемов органа). Учитывая значительную вариабельность формы, размеров, объема, особенностей кровоснабжения не только печени в целом, но и каждого из ее сегментов, выполнение точной сегментации этого органа остается сложной задачей. Цель обзора - анализ классических и альтернативных системы сегментации печени, представляющих собой анатомо-функциональные модели органа. Выделены их преимущества и недостатки. Особое внимание уделено лучевым методам визуализации печени с рассмотрением спектра их возможностей и ограничений при сегментации и волюметрии. Материалом для исследования послужили источники зарубежной и отечественной литературы за последние годы. Источники отбирались по следующим ключевым словам: печень, анатомия, сегменты печени, волюметрия печени, трансплантация, liver, anatomy, liver segments, liver volumetry, transplantation и некоторым другим. Всего было отобрано 50 источников. Использован описательный метод анализа. Сегментация и волюмометрия печени уже сейчас позволяют решать широкий перечень клинических задач, включая предоперационное планирование резекций и трансплантаций, оценку динамики и эффективности лечения, а также построения прогностических моделей и обучения. В обзоре приведены результаты исследований волюметрической оценки функционального резерва органа при планировании операций и способов его увеличения, обсуждаются ручные, полуавтоматические и автоматические методы сегментации с их преимуществами и недостатками. Особенно подчеркивается роль развития технологий сегментации и волюметрии в трансплантологии. В заключении отмечаются нерешенные проблемы, что требует совершенствования алгоритмов визуализации, учета анатомических вариантов при сегментации и волюметрии печени со скорейшей интеграцией искусственного интеллекта для повышения точности и скорости проводимого анализа. Своевременное решение широкого перечня обозначенных задач продолжат способствовать трансформации подходов в хирургической гепатологии, обеспечивая приоритет безопасным и персонифицированным.

Modern methods of medical imaging have contributed to the emergence of new technologies and trends in liver medicine – liver segmentation, which is the process of dividing the organ into functionally independent segments with an individual system of blood supply, venous outflow and excretion of bile and its volumetry (volume-metry – measurements and assessment of the functional volumes of the organ). Given the significant variability of the shape, size, volume, features of the blood supply not only of the liver as a whole, but also of each of its segments, performing accurate segmentation of this organ remains a complex task. The objective of the review is to analyze classical and alternative systems of liver segmentation, which are anatomical and functional models of the organ. Their advantages and disadvantages are highlighted. Particular attention is paid to radiation methods of liver visualization with consideration of the range of their capabilities and limitations in segmentation and volumetry. The material for the study was foreign and domestic literature sources of recent years. The sources were selected using the following keywords: liver, anatomy, liver segments, liver volumetry, transplantation and some others. A total of 50 sources were selected. The descriptive method of analysis was used. Liver segmentation and volumetry already allow solving a wide range of clinical problems, including preoperative planning of resections and transplants, assessment of the dynamics and effectiveness of treatment, as well as building prognostic models and training. The review presents the results of studies of the volumetric assessment of the functional reserve of an organ when planning operations and ways to increase it, discusses manual, semi-automatic and automatic methods of segmentation with their advantages and disadvantages. Particular emphasis is placed on the role of the development of segmentation and volumetry technologies in transplantology. In conclusion, unresolved problems are noted, which require improvement of visualization algorithms, consideration of anatomical variants in segmentation and liver volumetry with the fastest integration of artificial intelligence to improve the accuracy and speed of the analysis. Timely solution of a wide range of designated tasks will continue to contribute to the transformation of approaches in surgical hepatology, providing priority to safe and personalized.

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The authors declare that there are no conflicts of interest present.