Preoperative hepatic vascular evaluation with CT and MR angiography: implications for surgery.
Partial liver resection for living donor transplantations and treatment of hepatic tumors is a major surgical undertaking, and detailed knowledge of the hepatic angioarchitecture is essential to ensure safe and successful liver surgery. Noninvasive imaging techniques such as computed tomographic (CT) and magnetic resonance (MR) angiography have begun to replace conventional catheter angiography for evaluation of the hepatic vascular anatomy. Multisection CT angiography and MR angiography are complementary modalities that permit comprehensive, accurate preoperative delineation of the hepatic vascular anatomy and evaluation of the parenchyma in patients undergoing liver surgery, thereby obviating multiple invasive studies including catheter angiography. Understanding a surgeon's perspective on liver surgery is critical so that the required information can be provided accurately with imaging. Both CT angiography and MR angiography have had a significant impact on the selection of candidates for liver surgery as well as on surgical technique.
Sahani
Dushyant
D
Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, White 270, 55 Fruit St, Boston, MA 02114, USA. dsahani@partners.org
Mehta
Aparna
A
Blake
Michael
M
Prasad
Srinivasa
S
Harris
Gordan
G
Saini
Sanjay
S
D000792:Angiography / Q000295:instrumentation / Q000379:methods*; D003287:Contrast Media; D005682:Gadolinium; D014644:Genetic Variation; D006498:Hepatectomy; D006499:Hepatic Artery / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000473:pathology; D006503:Hepatic Veins / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D015918:Infusion Pumps, Implantable; D007261:Infusions, Intra-Arterial; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D008113:Liver Neoplasms / Q000098:blood supply / Q000601:surgery; D016031:Liver Transplantation; D019520:Living Donors; D018810:Magnetic Resonance Angiography / Q000379:methods*; D011169:Portal Vein / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000473:pathology; D011300:Preoperative Care / Q000379:methods*; D011856:Radiographic Image Enhancement; D020858:Tissue and Organ Harvesting; D036542:Tomography, Spiral Computed / Q000379:methods*
D003287:Contrast Media; D005682:Gadolinium