title: Detection of intrahepatic veno-venous shunts by three-dimensional venography using multidetector-row computed tomography during angiography.
abstract: OBJECTIVE
  The hepatic vein (HV) can be removed during hepatectomy if there is an effective intrahepatic veno-venous shunt (vv-shunt). We evaluated the efficacy of vv-shunt detection by three-dimensional (3D) venography reconstructed from multidetector-row computed tomography (MDCT) during angiography.
  
  
  METHODS
  3D venography was reconstructed using computer software in 88 patients with intrahepatic tumors.
  
  
  RESULTS
  We found that 12 patients had one shunt [4 right hepatic vein (RHV)-middle hepatic vein (MHV) and 12 RHV- inferior right hepatic vein (IRHV)] and 1 patient had 2 shunts (RHV-MHV and -IRHV), confirming a clinically efficient vv-shunt in 14.8% of the patients. In one patient with an RHV-IRHV shunt, the preserved RHV-IRHV shunt worked well and prevented congestion of the postero-caudal subsegment after central bisegmentectomy with partial resection of the RHV ventral trunk for huge hepatocellular carcinoma (HCC).
  
  
  CONCLUSIONS
  Although the vv-shunt detection rate by 3D venography is low, a visualized vv-shunt proved to be efficient. Thus, invasive occlusion venography is avoidable if a vv-shunt is seen on 3D venography.
authors: Second Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan, saka1119@hama-med.ac.jp.
authors: Takanori
authors: T
authors: Sakaguchi
authors: Shohachi
authors: S
authors: Suzuki
authors: Takanori
authors: T
authors: Hiraide
authors: Yasushi
authors: Y
authors: Shibasaki
authors: Yoshifumi
authors: Y
authors: Morita
authors: Atsushi
authors: A
authors: Suzuki
authors: Kazuhiko
authors: K
authors: Fukumoto
authors: Keisuke
authors: K
authors: Inaba
authors: Yasuo
authors: Y
authors: Takehara
authors: Hatsuko
authors: H
authors: Nasu
authors: Mika
authors: M
authors: Kamiya
authors: Shuhei
authors: S
authors: Yamashita
authors: Takasuke
authors: T
authors: Ushio
authors: Hiroyuki
authors: H
authors: Konno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000556:secondary / Q000601:surgery; D018281:Cholangiocarcinoma / Q000098:blood supply* / Q000556:secondary / Q000601:surgery; D005260:Female; D006498:Hepatectomy; D006503:Hepatic Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008113:Liver Neoplasms / Q000098:blood supply* / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D010690:Phlebography / Q000379:methods*; D014656:Vascular Surgical Procedures
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