Portal vein variations in 1000 patients: surgical and radiological importance.
OBJECTIVE
The purpose of the study was to evaluate the spectrum and incidence of intrahepatic portal vein (PV) variations on triphasic abdomen multidetector CT (MDCT) and to discuss the surgical and radiological implications.


METHODS
A retrospective review of 1000 triphasic MDCT abdomen scans was performed in patients sent for various liver and other abdominal pathologies between January 2014 and August 2014. A total of 967 patients (N = 967) were included in the study. The variations in branching pattern of PV were classified according to classification used by Covey et al (Covey AM, Brody LA, Getrajdman GI, Sofocleous CT, Brown KT. Incidence, patterns, and clinical relevance of variant portal vein anatomy. AJR Am J Roentgenol 2004; 183: 1055-64) and Koç et al (Koç Z, Oğuzkurt L, Ulusan S. Portal vein variations: clinical implications and frequencies in routine abdominal CT. Diagn Interv Radiol 2007; 13: 75-80).


RESULTS
Normal anatomy (Type I) was seen in 773 patients (79.94%) out of 967 patients in our study. Trifurcation (Type II) anomaly was seen in 66 (6.83%) of cases. Right posterior vein as first branch of main PV (Type III) anomaly was seen in 48 (4.96%) of cases. Type IV anomaly and Type V anomaly was seen in 26 (2.69%) and 13 (1.34%) cases, respectively. 19 cases showed other types of variations.


CONCLUSIONS
Variations in the hepatic PV branching patterns are commonly seen that are similar to variations in hepatic artery and biliary anatomy. Knowledge of these variations is extremely important for transplant surgeons and intervention radiologists.


CONCLUSIONS
Awareness of the variations in PV branching patterns is essential for intervention radiologists and vascular surgeons and avoids major catastrophic events.
Department of Radiology/Interventional Radiology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi.
Binit
B
Sureka
Department of Radiology/Interventional Radiology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi.
Yashwant
Y
Patidar
Department of Radiology/Interventional Radiology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi.
Kalpana
K
Bansal
Department of Radiology/Interventional Radiology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi.
S
S
Rajesh
Department of Radiology/Interventional Radiology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi.
Nitesh
N
Agrawal
Department of Radiology/Interventional Radiology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi.
Ankur
A
Arora
D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011169:Portal Vein / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies
D003287:Contrast Media