3D anatomical variations of hepatic vasculature and bile duct for right lateral sector of liver with special reference to transplantation.
To achieve a safer living related liver transplantation (LRLT) using the right lateral sector, anatomical variations of the portal vein, hepatic artery and bile duct for the right lateral sector and their three dimentional (3D) relationship were assessed by integrated 3D-CT images. 52 patients who underwent contrast enhanced multi-detector row CT (MD-CT) and MD-CT cholangiography were enrolled. Data from contrast enhanced MD-CT were used to reconstruct the 3D images of the hepatic artery and portal vein. 3D images reconstructed from MD-CT data of the hepatic artery, portal vein and bile duct were integrated into a single image. The dual branching of the right lateral portal vein was observed in 22 (42.3%) patients. Three (5.8%) had dual right lateral ducts and 14 (26.9%) had dual right lateral arteries. Among them, "south-turning" artery and "north-turning" bile duct was observed in 22 (42.3%). "South-turning" artery and "south-turning" bile duct were 3 (5.8%). "North-turning" artery and "north-turning" bile duct were 2 (7.4%). Only 27 (51.9%) had single portal vein, bile duct and artery for the right lateral sector, those were preferable as candidates for right lateral sector graft transplantation. 3D anatomical variations of portal vein, artery and bile duct for the right lateral sector were complexed, and only half of the donor candidates had preferable hepatic structures for right lateral sector graft transplantation. Understanding of the 3D hepatic structures by 3D-CT may contribute to a better definition of anatomical contraindications for LRLT which may further results in more safe and widely applied right lateral sector graft LRLT.
Yoshida
Atsushi
A
Department of Surgery, Kurume University School of Medicine, Kurume 830-0011, Japan.
Okuda
Koji
K
Sakai
Hisamune
H
Kinoshita
Hisafumi
H
Aoyagi
Shigeaki
S
D001652:Bile Ducts / Q000033:anatomy & histology*; D002758:Cholangiography; D006499:Hepatic Artery / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008099:Liver / Q000033:anatomy & histology / Q000098:blood supply* / Q000000981:diagnostic imaging; D016031:Liver Transplantation; D011169:Portal Vein / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed