title: Endoscopic ultrasound description of liver segmentation and anatomy.
abstract: Endoscopic ultrasound (EUS) can demonstrate the detailed anatomy of the liver from the transgastric and transduodenal routes. Most of the liver segments can be imaged with EUS, except the right posterior segments. The intrahepatic vascular landmarks include the major hepatic veins, portal vein radicals, hepatic arterial branches, and the inferior vena cava, and the venosum and teres ligaments are other important intrahepatic landmarks. The liver hilum and gallbladder serve as useful surface landmarks. Deciphering liver segmentation and anatomy by EUS requires orienting the scan planes with these landmarkstructures, and is different from the static cross-sectional radiological images. Orientation during EUS requires appreciation of the numerous scan planes possible in real-time, and the direction of scanning from the stomach and duodenal bulb. We describe EUS imaging of the liver with a curved linear probe in a step-by-step approach, with the relevant anatomical details, potential applications, and pitfalls of this novel EUS application.
authors.affiliation: Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, India.
authors.forename: Vikram
authors.initials: V
authors.lastname: Bhatia
authors.forename: Susumu
authors.initials: S
authors.lastname: Hijioka
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hara
authors.forename: Nobumasa
authors.initials: N
authors.lastname: Mizuno
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imaoka
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamao
mesh_terms: D019160:Endosonography / Q000379:methods*; D006499:Hepatic Artery / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006801:Humans; D008099:Liver / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D011168:Portal System / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D011169:Portal Vein / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity
keywords: endoscopic ultrasound (EUS); hepatic vein; ligamentum teres; ligamentum venosum; liver; liver segment