Multislice CT angiography in the evaluation of hepatic vascular anatomy in potential right lobe donors.

PURPOSE

To assess the role of multislice CT angiography in the evaluation of arterial, hepatic and portal venous variations in potential right lobe donors.

MATERIALS AND METHODS

Fifty-two potential liver donors (28 females, 24 males), underwent CT angiography in the arterial and portal venous phases with an eight-row CT scanner. Two- and three-dimensional images were obtained from 1.25-mm-thick axial images with multiplanar reformatting, maximum intensity projection and volume rendering techniques. Both axial and two- and threedimensional images were evaluated for possible variants of hepatic vasculature. In twelve operated patients, CT angiography results were compared with the results of surgery.

RESULTS

Of 52 patients, 40 had type I, five type III, two type II, three type IX, and two type V hepatic arterial anatomy. In 13 patients (25%), segment IV artery originated from the right hepatic artery. In 26 patients (50%), veins that drained segment V and/or VIII to the middle hepatic vein were larger than 5 mm. Twenty-five patients (48%) had 28 accessory hepatic veins larger than 3 mm; 23 of these drained to the inferior vena cava more than 4 cm caudal to the right hepatic vein-vena cava junction. Three patients (6%) had trifurcation and one patient (2%) had quadrifurcation of the main portal vein. In two patients (4%), the right posterior portal vein arose directly from the main portal vein before its bifurcation. CT angiography findings showed one-to-one correlation with surgery in the 12 operated patients.

CONCLUSION

Multislice CT angiography can successfully show the relevant hepatic vascular variations in potential liver donors.