title: Fusion of the midplane with the left intersectional plane: a liver anatomical variation revisited with multidetector-row CT.
abstract: This article updates the description of an anatomical variation of the liver, in which the gallbladder is adjacent to the ligamentum teres, that was described until now as "right-sided ligamentum teres and right umbilical portion of the portal vein". A study of eight patients showing this anatomical variation has led to a new archetypal anatomical description of the hepatic and portal veins, using multidetector-row computed tomography (MDCT) with three-dimensional (3D) volume-rendering (VR) reconstructions. While 2D axial imaging gave the same information, MDCT imaging with VR reconstructions provided a clear 3D visualization of this anatomical variation. Typical features can be described as follows: (1) juxtaposition of the ligamentum teres and the gallbladder; (2) typical portal vein branching with a right posterior branch, a left posterior branch and a main medial branch that terminates in the ligamentum teres; (3) two main hepatic veins and a hypotrophied medial hepatic vein. We think, based on the direct comparison of anatomical findings and knowledge of chronological embryological development, that this abnormality results from the defective development of the central part of the liver and not from the persistence of the right rather than the left umbilical vein. Because of the presence of only one medial plane, containing both the gallbladder and the ligamentum teres, we propose renaming it "fusion of hepatic planes".
authors.affiliation: Department of Radiology, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) and Pierre-et-Marie-Curie University (UPMC), 47-83, boulevard de l'Hôpital, 75651 Paris, Cedex 13, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lucidarme
authors.forename: Jacques
authors.initials: J
authors.lastname: Taboury
authors.forename: Eric
authors.initials: E
authors.lastname: Savier
authors.forename: Mehdi
authors.initials: M
authors.lastname: Cadi
authors.forename: Laurent
authors.initials: L
authors.lastname: Hannoun
authors.forename: Philippe A
authors.initials: PA
authors.lastname: Grenier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D005704:Gallbladder / Q000033:anatomy & histology; D006503:Hepatic Veins / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007472:Iohexol / Q000031:analogs & derivatives; D008099:Liver / Q000033:anatomy & histology* / Q000098:blood supply / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; C093233:iobitridol; D007472:Iohexol