Radiological Anatomy of the Liver

Pp. 17-37 (21)

Lee Grant, Albert Loh and Dow-Mu Koh

Abstract

• Perioperative imaging is fundamental in modern hepatic surgery. Accurate knowledge of the regular anatomy of the liver and its variations is essential for planninghepatectomy or transplantation.

• A minority of patients has the classical vascular and/or biliary anatomy and somenormal radiological findings can be misinterpreted as disease.

• The liver is divided in two hemi-livers by a sagittal plane from the gallbladder fossa to the inferior vena cava. The Cantlie line is better delimited by radiology andincludes the middle hepatic vein.

• Modern multislice computed tomography can scan the whole liver in 5-10s andprovides precise parenchymal and vascular anatomy using three phases (arterial,portal, and venous).

• Magnetic Resonance Imaging (MRI) is free of ionizing radiation and especially usefulto evaluate focal and diffuse parenchymal diseases. Cholangio MRI plays a majorrole in the assessment of the biliary tree.

Affiliation:

Department of Radiology, Royal Marsden NHS Foundation Trust, Sutton, UNITED KINGDOM.