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Published in: Abdominal Radiology 8/2018

01-08-2018

Liver vascular anatomy: a refresher

Authors: Rishi Philip Mathew, Sudhakar Kundapur Venkatesh

Published in: Abdominal Radiology | Issue 8/2018

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Abstract

To prevent and decrease procedural complications, it is important to identify variants of hepatic vascular anatomy before interventional radiologic procedures, surgery, and liver transplantation. Knowledge of the vascular variants helps in selecting patients and in exploring alternative management options. Non-invasive detailed demonstration of the hepatic vascular anatomy is possible with advanced multi-detector computed tomography (CT) and magnetic resonance (MR) imaging. The objective of this review is to provide a brief overview of clinically relevant hepatic vascular anatomy and important variants.
Literature
2.
go back to reference Saylisoy S, Atasoy C, Ersöz S, Karayalçin K, Akyar S (2005) Multislice CT angiography in the evaluation of hepatic vascular anatomy in potential right lobe donors. Diagn Interv Radiol 11:51–59PubMed Saylisoy S, Atasoy C, Ersöz S, Karayalçin K, Akyar S (2005) Multislice CT angiography in the evaluation of hepatic vascular anatomy in potential right lobe donors. Diagn Interv Radiol 11:51–59PubMed
3.
go back to reference Sahani D, D’souza R, Kadavigere R, et al. (2004) Evaluation of living liver transplant donors: method for precise anatomic definition by using a dedicated contrast-enhanced MR imaging protocol. Radiographics 24:957–967CrossRefPubMed Sahani D, D’souza R, Kadavigere R, et al. (2004) Evaluation of living liver transplant donors: method for precise anatomic definition by using a dedicated contrast-enhanced MR imaging protocol. Radiographics 24:957–967CrossRefPubMed
4.
go back to reference Kamel IR, Kruskal JB, Pomfret EA, et al. (2001) Impact of multidetector CT on donor selection and surgical planning before living adult right lobe liver transplantation. AJR Am J Roentgenol 176:193–200CrossRefPubMed Kamel IR, Kruskal JB, Pomfret EA, et al. (2001) Impact of multidetector CT on donor selection and surgical planning before living adult right lobe liver transplantation. AJR Am J Roentgenol 176:193–200CrossRefPubMed
5.
go back to reference Guiney MJ, Kruskal JB, Sosna J, et al. (2003) Multi-detector row CT of relevant vascular anatomy of the surgical plane in split-liver transplantation. Radiology 229:401–407CrossRefPubMed Guiney MJ, Kruskal JB, Sosna J, et al. (2003) Multi-detector row CT of relevant vascular anatomy of the surgical plane in split-liver transplantation. Radiology 229:401–407CrossRefPubMed
6.
go back to reference Wang S, He X, Li Z, et al. (2010) Characterization of the middle hepatic artery and its relevance to living donor liver transplantation. Liver Transpl 16:736–741PubMed Wang S, He X, Li Z, et al. (2010) Characterization of the middle hepatic artery and its relevance to living donor liver transplantation. Liver Transpl 16:736–741PubMed
7.
go back to reference Favelier S, Germain T, Genson PY, et al. (2015) Anatomy of liver arteries for interventional radiology. Diagn Interv Imaging 96:537–546CrossRefPubMed Favelier S, Germain T, Genson PY, et al. (2015) Anatomy of liver arteries for interventional radiology. Diagn Interv Imaging 96:537–546CrossRefPubMed
8.
go back to reference Michels NA (1966) Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg 112:337–347CrossRefPubMed Michels NA (1966) Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg 112:337–347CrossRefPubMed
10.
go back to reference Covey AM, Brody LA, Maluccio MA, Getrajdman GI, Brown KT (2002) Variant hepatic arterial anatomy revisited: digital subtraction angiography performed in 600 patients. Radiology 224:542–547CrossRefPubMed Covey AM, Brody LA, Maluccio MA, Getrajdman GI, Brown KT (2002) Variant hepatic arterial anatomy revisited: digital subtraction angiography performed in 600 patients. Radiology 224:542–547CrossRefPubMed
11.
go back to reference Saba L, Mallarini G (2008) Multidetector row CT angiography in the evaluation of the hepatic artery and its anatomical variants. Clin Radiol 63:312–321CrossRefPubMed Saba L, Mallarini G (2008) Multidetector row CT angiography in the evaluation of the hepatic artery and its anatomical variants. Clin Radiol 63:312–321CrossRefPubMed
12.
go back to reference Coşkun M, Kayahan EM, Ozbek O, et al. (2005) Imaging of hepatic arterial anatomy for depicting vascular variations in living related liver transplant donor candidates with multidetector computed tomography: comparison with conventional angiography. Transplant Proc 37:1070–1073CrossRefPubMed Coşkun M, Kayahan EM, Ozbek O, et al. (2005) Imaging of hepatic arterial anatomy for depicting vascular variations in living related liver transplant donor candidates with multidetector computed tomography: comparison with conventional angiography. Transplant Proc 37:1070–1073CrossRefPubMed
13.
go back to reference Catalano OA, Singh AH, Uppot RN, et al. (2008) Vascular and biliary variants in the liver: implications for liver surgery. Radiographics 28:359–378CrossRefPubMed Catalano OA, Singh AH, Uppot RN, et al. (2008) Vascular and biliary variants in the liver: implications for liver surgery. Radiographics 28:359–378CrossRefPubMed
14.
15.
go back to reference Covey AM, Brody LA, Getrajdman GI, Sofocleous CT, Brown KT (2004) Incidence, patterns, and clinical relevance of variant portal vein anatomy. AJR Am J Roentgenol 183:1055–1064CrossRefPubMed Covey AM, Brody LA, Getrajdman GI, Sofocleous CT, Brown KT (2004) Incidence, patterns, and clinical relevance of variant portal vein anatomy. AJR Am J Roentgenol 183:1055–1064CrossRefPubMed
16.
go back to reference Koç Z, Oğuzkurt L, Ulusan S (2007) Portal vein variations: clinical implications and frequencies in routine abdominal multidetector CT. Diagn Interv Radiol 13:75–80PubMed Koç Z, Oğuzkurt L, Ulusan S (2007) Portal vein variations: clinical implications and frequencies in routine abdominal multidetector CT. Diagn Interv Radiol 13:75–80PubMed
17.
18.
go back to reference Gallego C, Velasco M, Marcuello P, et al. (2002) Congenital and acquired anomalies of the portal venous system. Radiographics 22:141–159CrossRefPubMed Gallego C, Velasco M, Marcuello P, et al. (2002) Congenital and acquired anomalies of the portal venous system. Radiographics 22:141–159CrossRefPubMed
19.
go back to reference Kitami M, Takase K, Murakami G, et al. (2006) Types and frequencies of biliary tract variations associated with a major portal venous anomaly: analysis with multi-detector row CT cholangiography. Radiology 238:156–166CrossRefPubMed Kitami M, Takase K, Murakami G, et al. (2006) Types and frequencies of biliary tract variations associated with a major portal venous anomaly: analysis with multi-detector row CT cholangiography. Radiology 238:156–166CrossRefPubMed
20.
go back to reference Radin DR, Colletti PM, Ralls PW, Boswell WD, Halls JM (1987) Agenesis of the right lobe of the liver. Radiology 164:639–642CrossRefPubMed Radin DR, Colletti PM, Ralls PW, Boswell WD, Halls JM (1987) Agenesis of the right lobe of the liver. Radiology 164:639–642CrossRefPubMed
21.
go back to reference Ozgun B, Warshauer DM (1992) Absent medial segment of the left hepatic lobe: CT appearance. J Comput Assist Tomogr 16:666–668PubMed Ozgun B, Warshauer DM (1992) Absent medial segment of the left hepatic lobe: CT appearance. J Comput Assist Tomogr 16:666–668PubMed
22.
go back to reference Parisato FO (1965) Pataro EF [Anomalous portal vein]. Angiologia 17:119–123PubMed Parisato FO (1965) Pataro EF [Anomalous portal vein]. Angiologia 17:119–123PubMed
23.
go back to reference Altavilla G, Cusatelli P (1998) Ultrastructural analysis of the liver with portal vein agenesis: a case report. Ultrastruct Pathol 22:477–483CrossRefPubMed Altavilla G, Cusatelli P (1998) Ultrastructural analysis of the liver with portal vein agenesis: a case report. Ultrastruct Pathol 22:477–483CrossRefPubMed
24.
go back to reference Chou CK, Mak CW, Lin MB, Tzeng WS, Chang JM (1998) CT of agenesis and atrophy of the right hepatic lobe. Abdom Imaging 23:603–607CrossRefPubMed Chou CK, Mak CW, Lin MB, Tzeng WS, Chang JM (1998) CT of agenesis and atrophy of the right hepatic lobe. Abdom Imaging 23:603–607CrossRefPubMed
25.
go back to reference Cheng YF, Huang TL, Chen CL, et al. (1997) Variations of the middle and inferior right hepatic vein: application in hepatectomy. J Clin Ultrasound 25:175–182CrossRefPubMed Cheng YF, Huang TL, Chen CL, et al. (1997) Variations of the middle and inferior right hepatic vein: application in hepatectomy. J Clin Ultrasound 25:175–182CrossRefPubMed
26.
go back to reference Burk KS, Singh AK, Vagefi PA, Sahani D (2016) Pretransplantation Imaging Workup of the Liver Donor and Recipient. Radiol Clin North Am 54:185–197CrossRefPubMed Burk KS, Singh AK, Vagefi PA, Sahani D (2016) Pretransplantation Imaging Workup of the Liver Donor and Recipient. Radiol Clin North Am 54:185–197CrossRefPubMed
27.
go back to reference Sahani D, Mehta A, Blake M, et al. (2004) Preoperative hepatic vascular evaluation with CT and MR angiography: implications for surgery. Radiographics 24:1367–1380CrossRefPubMed Sahani D, Mehta A, Blake M, et al. (2004) Preoperative hepatic vascular evaluation with CT and MR angiography: implications for surgery. Radiographics 24:1367–1380CrossRefPubMed
28.
go back to reference Barbaro B, Soglia G, Alvaro G, et al. (2013) Hepatic veins in presurgical planning of hepatic resection: what a radiologist should know. Abdom Imaging 38:442–460CrossRefPubMed Barbaro B, Soglia G, Alvaro G, et al. (2013) Hepatic veins in presurgical planning of hepatic resection: what a radiologist should know. Abdom Imaging 38:442–460CrossRefPubMed
29.
go back to reference De Cecchis L, Hribernik M, Ravnik D, Gadzijev EM (2000) Anatomical variations in the pattern of the right hepatic veins: possibilities for type classification. J Anat 197(Pt 3):487–493CrossRefPubMed De Cecchis L, Hribernik M, Ravnik D, Gadzijev EM (2000) Anatomical variations in the pattern of the right hepatic veins: possibilities for type classification. J Anat 197(Pt 3):487–493CrossRefPubMed
30.
go back to reference Masselot R, Leborgne J (1978) Anatomical study of the hepatic veins. Anatomia Clinica 1:109–125CrossRef Masselot R, Leborgne J (1978) Anatomical study of the hepatic veins. Anatomia Clinica 1:109–125CrossRef
31.
go back to reference Makuuchi M, Hasegawa H, Yamazaki S, Takayasu K (1987) New hepatectomy procedures for resection of the right hepatic vein and preservation of the inferior right hepatic vein. Surg Gynecol Obstetr 164:69–72 Makuuchi M, Hasegawa H, Yamazaki S, Takayasu K (1987) New hepatectomy procedures for resection of the right hepatic vein and preservation of the inferior right hepatic vein. Surg Gynecol Obstetr 164:69–72
32.
go back to reference Erbay N, Raptopoulos V, Pomfret EA, Kamel IR, Kruskal JB (2003) Living donor liver transplantation in adults: vascular variants important in surgical planning for donors and recipients. AJR Am J Roentgenol 181:109–114CrossRefPubMed Erbay N, Raptopoulos V, Pomfret EA, Kamel IR, Kruskal JB (2003) Living donor liver transplantation in adults: vascular variants important in surgical planning for donors and recipients. AJR Am J Roentgenol 181:109–114CrossRefPubMed
33.
go back to reference Reichert PR, Renz JF, D’Albuquerque LA, et al. (2000) Surgical anatomy of the left lateral segment as applied to living-donor and split-liver transplantation: a clinicopathologic study. Ann Surg 232:658–664CrossRefPubMedPubMedCentral Reichert PR, Renz JF, D’Albuquerque LA, et al. (2000) Surgical anatomy of the left lateral segment as applied to living-donor and split-liver transplantation: a clinicopathologic study. Ann Surg 232:658–664CrossRefPubMedPubMedCentral
34.
go back to reference Radtke A, Sotiropoulos G, Sgourakis G, et al. (2011) “Anatomical” versus “Territorial” belonging of the middle hepatic vein: virtual imaging and clinical repercussions. J Surg Res 166:146–155CrossRefPubMed Radtke A, Sotiropoulos G, Sgourakis G, et al. (2011) “Anatomical” versus “Territorial” belonging of the middle hepatic vein: virtual imaging and clinical repercussions. J Surg Res 166:146–155CrossRefPubMed
35.
go back to reference Matsui O, Kadoya M, Takahashi S, et al. (1995) Focal sparing of segment IV in fatty livers shown by sonography and CT: correlation with aberrant gastric venous drainage. AJR Am J Roentgenol 164:1137–1140CrossRefPubMed Matsui O, Kadoya M, Takahashi S, et al. (1995) Focal sparing of segment IV in fatty livers shown by sonography and CT: correlation with aberrant gastric venous drainage. AJR Am J Roentgenol 164:1137–1140CrossRefPubMed
36.
go back to reference Unal E, Ozmen MN, Akata D, Karcaaltincaba M (2015) Imaging of aberrant left gastric vein and associated pseudolesions of segments II and III of the liver and mimickers. Diagn Interv Radiol 21:105–110CrossRefPubMedPubMedCentral Unal E, Ozmen MN, Akata D, Karcaaltincaba M (2015) Imaging of aberrant left gastric vein and associated pseudolesions of segments II and III of the liver and mimickers. Diagn Interv Radiol 21:105–110CrossRefPubMedPubMedCentral
37.
go back to reference Seong NJ, Chung JW, Kim HC, et al. (2012) Right gastric venous drainage: angiographic analysis in 100 patients. Korean J Radiol 13:53–60CrossRefPubMed Seong NJ, Chung JW, Kim HC, et al. (2012) Right gastric venous drainage: angiographic analysis in 100 patients. Korean J Radiol 13:53–60CrossRefPubMed
38.
go back to reference Yoshimitsu K, Honda H, Kuroiwa T, et al. (2001) Unusual hemodynamics and pseudolesions of the noncirrhotic liver at CT. Radiographics 21:S81–S96CrossRefPubMed Yoshimitsu K, Honda H, Kuroiwa T, et al. (2001) Unusual hemodynamics and pseudolesions of the noncirrhotic liver at CT. Radiographics 21:S81–S96CrossRefPubMed
39.
go back to reference Saint JH (1961) The epicholedochal venous plexus and its importance as a means of identifying the common duct during operations on the extrahepatic biliary tract. Br J Surg 48:489–498CrossRefPubMed Saint JH (1961) The epicholedochal venous plexus and its importance as a means of identifying the common duct during operations on the extrahepatic biliary tract. Br J Surg 48:489–498CrossRefPubMed
40.
go back to reference Vellar ID (2001) Preliminary study of the anatomy of the venous drainage of the intrahepatic and extrahepatic bile ducts and its relevance to the practice of hepatobiliary surgery. ANZ J Surg 71:418–422CrossRefPubMed Vellar ID (2001) Preliminary study of the anatomy of the venous drainage of the intrahepatic and extrahepatic bile ducts and its relevance to the practice of hepatobiliary surgery. ANZ J Surg 71:418–422CrossRefPubMed
41.
go back to reference Ramesh Babu CS, Sharma M (2014) Biliary tract anatomy and its relationship with venous drainage. J Clin Exp Hepatol 4:S18–26CrossRefPubMed Ramesh Babu CS, Sharma M (2014) Biliary tract anatomy and its relationship with venous drainage. J Clin Exp Hepatol 4:S18–26CrossRefPubMed
42.
go back to reference Stringer MD (2008) The clinical anatomy of congenital portosystemic venous shunts. Clin Anat 21:147–157CrossRefPubMed Stringer MD (2008) The clinical anatomy of congenital portosystemic venous shunts. Clin Anat 21:147–157CrossRefPubMed
43.
go back to reference Alonso-Gamarra E, Parrón M, Pérez A, et al. (2011) Clinical and radiologic manifestations of congenital extrahepatic portosystemic shunts: a comprehensive review. Radiographics 31:707–722CrossRefPubMed Alonso-Gamarra E, Parrón M, Pérez A, et al. (2011) Clinical and radiologic manifestations of congenital extrahepatic portosystemic shunts: a comprehensive review. Radiographics 31:707–722CrossRefPubMed
44.
go back to reference Morgan G, Superina R (1994) Congenital absence of the portal-vein—2 cases and a proposed classification-system for portasystemic vascular anomalies. J Pediatr Surg 29:1239–1241CrossRefPubMed Morgan G, Superina R (1994) Congenital absence of the portal-vein—2 cases and a proposed classification-system for portasystemic vascular anomalies. J Pediatr Surg 29:1239–1241CrossRefPubMed
45.
go back to reference Park JH, Cha SH, Han JK, Han MC (1990) Intrahepatic portosystemic venous shunt. AJR Am J Roentgenol 155:527–528CrossRefPubMed Park JH, Cha SH, Han JK, Han MC (1990) Intrahepatic portosystemic venous shunt. AJR Am J Roentgenol 155:527–528CrossRefPubMed
46.
go back to reference De Gaetano AM, Rinaldi P, Barbaro B, et al. (2007) Intrahepatic portosystemic venous shunts: Color Doppler sonography. Abdom Imaging 32:463–469CrossRefPubMed De Gaetano AM, Rinaldi P, Barbaro B, et al. (2007) Intrahepatic portosystemic venous shunts: Color Doppler sonography. Abdom Imaging 32:463–469CrossRefPubMed
47.
go back to reference Tanoue S, Kiyosue H, Komatsu E, et al. (2003) Symptomatic intrahepatic portosystemic venous shunt: embolization with an alternative approach. AJR Am J Roentgenol 181:71–78CrossRefPubMed Tanoue S, Kiyosue H, Komatsu E, et al. (2003) Symptomatic intrahepatic portosystemic venous shunt: embolization with an alternative approach. AJR Am J Roentgenol 181:71–78CrossRefPubMed
48.
go back to reference Timpanaro T, Passanisi S, Sauna A, et al. (2015) Congenital portosystemic shunt: our experience. Case Rep Pediatr 2015:691618PubMedPubMedCentral Timpanaro T, Passanisi S, Sauna A, et al. (2015) Congenital portosystemic shunt: our experience. Case Rep Pediatr 2015:691618PubMedPubMedCentral
Metadata
Title
Liver vascular anatomy: a refresher
Authors
Rishi Philip Mathew
Sudhakar Kundapur Venkatesh
Publication date
01-08-2018
Publisher
Springer US
Published in
Abdominal Radiology / Issue 8/2018
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-018-1623-z

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