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Variant Vascular and Biliary Anatomy of Liver
Atif Zaheer, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Abbreviations

          • Celiac axis (CA), common hepatic artery (CHA), proper hepatic artery (PHA), gastroduodenal artery (GDA), superior mesenteric artery (SMA)
          • Right hepatic artery (RHA), replaced right hepatic artery (rRHA), accessory right hepatic artery (aRHA)
          • Left hepatic artery (LHA), replaced left hepatic artery (rLHA), accessory left hepatic artery (aLHA)
          • Main hepatic artery (MHA)
          • Main portal vein (MPV), right portal vein (RPV), left portal vein (LPV)
          • Right anterior portal vein (RAPV), right posterior portal vein (RPPV)
          • Superior mesenteric vein (SMV), inferior mesenteric vein (IMV), splenic vein (SV)
          • Right hepatic vein (RHV), middle hepatic vein (MHV), left hepatic vein (LHV), inferior RHV (IRHV), mid RHV (MRHV)
          • Inferior vena cava (IVC)
        • Definitions

          • Variant hepatic vascular and biliary anatomy

        IMAGING

        • Conventional Arterial Anatomy

          • Variant Arterial Anatomy

            • Conventional Venous Anatomy

              • Variant Venous Anatomy

                • Conventional Biliary Anatomy

                  • Variant Biliary Anatomy

                    • CT Findings

                      • MR Findings

                        • Imaging Recommendations

                          PATHOLOGY

                          • General Features

                            CLINICAL ISSUES

                            • Treatment

                              • Liver Transplant

                                • Liver Surgery

                                  Selected References

                                  1. Hecht EM et al: Living donor liver transplantation: overview, imaging technique, and diagnostic considerations. AJR Am J Roentgenol. 213(1):54-64, 2019
                                  2. Sureka B et al: Hepatic vein variations in 500 patients: surgical and radiological significance. Br J Radiol. 92(1102):20190487, 2019
                                  3. Mathew RP et al: Liver vascular anatomy: a refresher. Abdom Radiol (NY). 43(8):1886-95, 2018
                                  4. Tigga SR et al: Variant anatomy of the hepatic vasculature: importance in hepatobiliary resections. J Clin Diagn Res. 11(6):AD01-3, 2017
                                  5. Favelier S et al: Anatomy of liver arteries for interventional radiology. Diagn Interv Imaging. 96(6):537-46, 2015
                                  6. Singh AK et al: Imaging of preoperative liver transplantation in adults: what radiologists should know. Radiographics. 31(4):1017-30, 2011
                                  7. Artioli D et al: Detection of biliary and vascular anatomy in living liver donors: value of gadobenate dimeglumine enhanced MR and MDCT angiography. Eur J Radiol. 76(2):e1-5, 2010
                                  8. Catalano OA et al: Vascular and biliary variants in the liver: implications for liver surgery. Radiographics. 28(2):359-78, 2008
                                  9. Koc Z et al: Venous variants and anomalies on routine abdominal multi-detector row CT. Eur J Radiol. 61(2):267-78, 2007
                                  10. Sahani D et al: Preoperative hepatic vascular evaluation with CT and MR angiography: implications for surgery. Radiographics. 24(5):1367-80, 2004
                                  11. Covey AM et al: Variant hepatic arterial anatomy revisited: digital subtraction angiography performed in 600 patients. Radiology. 224(2):542-7, 2002
                                  12. Cheng YF et al: Single imaging modality evaluation of living donors in liver transplantation: magnetic resonance imaging. Transplantation. 72(9):1527-33, 2001
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Clinical Issues

                                        TERMINOLOGY

                                        • Abbreviations

                                          • Celiac axis (CA), common hepatic artery (CHA), proper hepatic artery (PHA), gastroduodenal artery (GDA), superior mesenteric artery (SMA)
                                          • Right hepatic artery (RHA), replaced right hepatic artery (rRHA), accessory right hepatic artery (aRHA)
                                          • Left hepatic artery (LHA), replaced left hepatic artery (rLHA), accessory left hepatic artery (aLHA)
                                          • Main hepatic artery (MHA)
                                          • Main portal vein (MPV), right portal vein (RPV), left portal vein (LPV)
                                          • Right anterior portal vein (RAPV), right posterior portal vein (RPPV)
                                          • Superior mesenteric vein (SMV), inferior mesenteric vein (IMV), splenic vein (SV)
                                          • Right hepatic vein (RHV), middle hepatic vein (MHV), left hepatic vein (LHV), inferior RHV (IRHV), mid RHV (MRHV)
                                          • Inferior vena cava (IVC)
                                        • Definitions

                                          • Variant hepatic vascular and biliary anatomy

                                        IMAGING

                                        • Conventional Arterial Anatomy

                                          • Variant Arterial Anatomy

                                            • Conventional Venous Anatomy

                                              • Variant Venous Anatomy

                                                • Conventional Biliary Anatomy

                                                  • Variant Biliary Anatomy

                                                    • CT Findings

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          PATHOLOGY

                                                          • General Features

                                                            CLINICAL ISSUES

                                                            • Treatment

                                                              • Liver Transplant

                                                                • Liver Surgery

                                                                  Selected References

                                                                  1. Hecht EM et al: Living donor liver transplantation: overview, imaging technique, and diagnostic considerations. AJR Am J Roentgenol. 213(1):54-64, 2019
                                                                  2. Sureka B et al: Hepatic vein variations in 500 patients: surgical and radiological significance. Br J Radiol. 92(1102):20190487, 2019
                                                                  3. Mathew RP et al: Liver vascular anatomy: a refresher. Abdom Radiol (NY). 43(8):1886-95, 2018
                                                                  4. Tigga SR et al: Variant anatomy of the hepatic vasculature: importance in hepatobiliary resections. J Clin Diagn Res. 11(6):AD01-3, 2017
                                                                  5. Favelier S et al: Anatomy of liver arteries for interventional radiology. Diagn Interv Imaging. 96(6):537-46, 2015
                                                                  6. Singh AK et al: Imaging of preoperative liver transplantation in adults: what radiologists should know. Radiographics. 31(4):1017-30, 2011
                                                                  7. Artioli D et al: Detection of biliary and vascular anatomy in living liver donors: value of gadobenate dimeglumine enhanced MR and MDCT angiography. Eur J Radiol. 76(2):e1-5, 2010
                                                                  8. Catalano OA et al: Vascular and biliary variants in the liver: implications for liver surgery. Radiographics. 28(2):359-78, 2008
                                                                  9. Koc Z et al: Venous variants and anomalies on routine abdominal multi-detector row CT. Eur J Radiol. 61(2):267-78, 2007
                                                                  10. Sahani D et al: Preoperative hepatic vascular evaluation with CT and MR angiography: implications for surgery. Radiographics. 24(5):1367-80, 2004
                                                                  11. Covey AM et al: Variant hepatic arterial anatomy revisited: digital subtraction angiography performed in 600 patients. Radiology. 224(2):542-7, 2002
                                                                  12. Cheng YF et al: Single imaging modality evaluation of living donors in liver transplantation: magnetic resonance imaging. Transplantation. 72(9):1527-33, 2001