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Evaluation of hepatic vascular anatomy by multidetector computed tomography angiography in living liver right lobe donors

Year 2014, Volume: 13 Issue: 1, 1 - 6, 01.04.2014

Abstract

Background and Aims: The purpose of this study was to demonstrate the hepatic vascular anatomy and the variations in living right lobe donors by multidetector computed tomography angiography before the transplantation surgery and to detect the prevalence of these variations. Materials and Methods:Fifty-one potential liver donors (20 females, 31 males) underwent hepatic vascular computed tomography angiography in the arterial, portal and venous phases with a 16-row computed tomography scanner in our clinic. Two- and three-dimensional images were obtained using multiplanar reformat, maximum intensity projection and volume rendering techniques. Results:Thirty-five of the 51 patients (68,6%) had conventional arterial anatomic pattern (type I) and 16 patients (31,4%) had hepatic arterial variations. In 30 patients (58,8%), the portal vein had normal intrahepatic anatomy, while 21 patients (41,2%) had portal vein variations. Eight patients (15,7%) had normal hepatic venous anatomy and 43 patients (84,3%) had hepatic venous variations. Conclusions:Due to the high-speed volumetric scanning and high-quality two- and three-dimensional imaging with the use of thin slices, multidetector computed tomography angiography is a useful method for evaluating hepatic arterial, hepatic and portal venous systems in living liver right lobe donors.

References

  • Kamel IR, Kruskal JB, Pomfret EA, et al. Impact of multidetector CT on donor selection and surgical planning before living adult right lobe liver transplantation. AJR Am J Roentgenol 2001; 176: 193- 200.
  • Şaylısoy S, Atasoy Ç, Ersöz S, et al. Multislice CT angiography in the evaluation of hepatic vascular anatomy in potential right lobe donors. Diagn Interv Radiol 2005; 11: 51-9.
  • Brown RS Jr. Live donors in liver transplantation. Gastroenterology 2008; 134: 1802-13.
  • Horton KM. CT evaluation of living related liver donors. Crit Rev Comput Tomogr 2004; 45: 225-33.
  • Chan JK, Tso WK, Lo CM, et al. Preoperative evaluation of potential living donors for liver transplantation: the role of helical computed tomography-angiography. Transplant Proc 1998; 30: 3197-8.
  • Michels NA. Newer anatomy of the liver and its variant blood sup- ply and collateral circulation. Am J Surg 1966; 112: 337-47.
  • Bogetti D, Herts BR, Sands MJ, et al. Accuracy and utility of 3-di- mensional computed tomography in evaluating donors for adult living related liver transplants. Liver Transpl 2001; 7: 687-92.
  • Türkvatan A, Akgül A, Ökten S, et al. Multidetector computed to- mographic angiography in the assessment of the hepatic artery variations. Türk Klin J Cardiovasc Sci 2009; 21:127-34.
  • Koops A, Wojciechowski B, Broering DC, et al. Anatomic variations of the hepatic arteries in 604 selective celiac and superior mesen- teric angiographies. Surg Radiol Anat 2004; 26: 239-44.
  • Winston CB, Lee NA, Jarnagin WR, et al. CT angiography for delin- eation of celiac and superior mesenteric artery variants in patients undergoing hepatobiliary and pancreatic surgery. AJR Am J Roent- genol 2007; 189: W13-9.
  • Chen CY, Lee RC, Tseng HS, et al. Normal and variant anatomy of hepatic arteries: angiographic experience. Zhonghua Yi Xue Za Zhi (Taipei) 1998; 61: 17-23.
  • Mortele KJ, Cantisani V, Troisi R, et al. Preoperative liver donor evaluation: imaging and pitfalls. Liver Transpl 2003; 9: 6-14.
  • Kruskal JB, Raptopaulos V. How I do it: preoperative CT scanning for adult living right lobe liver transplantation. Eur Radiol 2002; 12: 1423-31.
  • Guiney MJ, Kruskal JB, Sosna J, et al. Multi-detector row CT of relevant vascular anatomy of the surgical plane in split-liver trans- plantation. Radiology 2003; 229: 401-7.
  • Kamel IR, Kruskal JB, Keogan MT, et al. Multidetector CT of po- tential right-lobe liver donors. AJR Am J Roentgenol 2001; 177: 645-51.
  • Kamel IR, Raptopoulos V, Pomfret EA, et al. Living adult right lobe liver transplantation: imaging before surgery with multidetector multiphase CT. AJR Am J Roentgenol 2000; 175: 1141-3.
  • Koc Z, Oğuzkurt L, Ulusan Ş. Portal vein variations: clinical implica- tions and frequencies in routine abdominal multidetector CT. Diagn Interv Radiol 2007; 13: 75-80.
  • Baba Y, Hokotate H, Nishi H, et al. Intrahepatic portal venous varia- tions: demonstration by helical CT during arterial portography. J Comput Assist Tomogr 2000; 24: 802-8.
  • Atasoy C, Ozyurek E. Prevalence and types of main and right portal vein branching variations on MDCT. AJR Am J Roentgenol 2006; 187: 676-81.
  • Varotti G, Gondolesi GE, Goldman J, et al. Anatomic variations in right liver living donors. J Am Coll Surg 2004; 198: 577-82.
  • Marcos A, Orloff M, Mieles L, et al. Reconstruction of double he- patic arterial and portal venous branches for right-lobe living donor liver transplantation. Liver Transpl 2001; 7: 673-9.
  • Hata F, Hirata K, Murakami G, et al. Identification of segments VI and VII of the liver based on the ramification patterns of the intra- hepatic portal and hepatic veins. Clin Anat 1999; 12: 229-44.

Karaciğer sağ lob canlı donör adaylarında hepatik vasküler anatominin multidedektör bilgisayarlı tomografik anjiyografi ile değerlendirilmesi

Year 2014, Volume: 13 Issue: 1, 1 - 6, 01.04.2014

Abstract

Giriş ve Amaç: Bu çalışmanın amacı karaciğer sağ lob canlı donör adaylarında hepatik vasküler anatomiyi ve varyasyonları multidedektör bilgisayarlı tomografik anjiyografi ile transplantasyon cerrahisi öncesinde görüntülemek ve bu varyasyonların prevalansını saptamaktır. Gereç ve Yöntem: Ellibir olgunun (20 kadın, 31 erkek) görüntüleri değerlendirilmiştir. Olguların tümünün incelenmesinde 16-dedektörlü multidedektör bilgisayarlı tomografi cihazı ve aynı inceleme protokolü (arteryel faz, portal faz ve venöz faz) kullanıldı. Alınan ham görüntülerden 'multiplanar reformat', 'maximum intensity projection' ve 'volum rendering' teknikleri kullanılarak iki ve üç boyutlu görüntüler oluşturuldu. Bulgular: Çalışma grubumuzdaki 51 hastanın 35'inde (%68,6) konvansiyonel arteryel anatomik patern (tip I) ve 16'sında (%31,4) hepatik arteryel varyasyon mevcuttu. Çalışmamıza dahil olan 51 hastanın 21'inde (%41,2) portal ven varyasyonlarına rastlanmış olup 30 hastada (%58,8) normal intrahepatik anatomi izlendi. Ellibir hastanın 43'ünde (%84,3) hepatik venöz varyasyon mevcutken 8 hastada (%15,7) normal hepatik venöz anatomi saptandı. Sonuç: Hızlı bir şekilde volumetrik tarama yapabilme ve ince aksiyel kesitleri kullanarak yüksek kalitede iki ve üç boyutlu görüntüler oluşturulabilme özelliği sayesinde multidedektör bilgisayarlı tomografik anjiyografi, karaciğer sağ lob canlı donörlerinin hepatik arteriyel, hepatik ve portal venöz sistemlerinin değerlendirilmesinde oldukça faydalı bir metoddur.

References

  • Kamel IR, Kruskal JB, Pomfret EA, et al. Impact of multidetector CT on donor selection and surgical planning before living adult right lobe liver transplantation. AJR Am J Roentgenol 2001; 176: 193- 200.
  • Şaylısoy S, Atasoy Ç, Ersöz S, et al. Multislice CT angiography in the evaluation of hepatic vascular anatomy in potential right lobe donors. Diagn Interv Radiol 2005; 11: 51-9.
  • Brown RS Jr. Live donors in liver transplantation. Gastroenterology 2008; 134: 1802-13.
  • Horton KM. CT evaluation of living related liver donors. Crit Rev Comput Tomogr 2004; 45: 225-33.
  • Chan JK, Tso WK, Lo CM, et al. Preoperative evaluation of potential living donors for liver transplantation: the role of helical computed tomography-angiography. Transplant Proc 1998; 30: 3197-8.
  • Michels NA. Newer anatomy of the liver and its variant blood sup- ply and collateral circulation. Am J Surg 1966; 112: 337-47.
  • Bogetti D, Herts BR, Sands MJ, et al. Accuracy and utility of 3-di- mensional computed tomography in evaluating donors for adult living related liver transplants. Liver Transpl 2001; 7: 687-92.
  • Türkvatan A, Akgül A, Ökten S, et al. Multidetector computed to- mographic angiography in the assessment of the hepatic artery variations. Türk Klin J Cardiovasc Sci 2009; 21:127-34.
  • Koops A, Wojciechowski B, Broering DC, et al. Anatomic variations of the hepatic arteries in 604 selective celiac and superior mesen- teric angiographies. Surg Radiol Anat 2004; 26: 239-44.
  • Winston CB, Lee NA, Jarnagin WR, et al. CT angiography for delin- eation of celiac and superior mesenteric artery variants in patients undergoing hepatobiliary and pancreatic surgery. AJR Am J Roent- genol 2007; 189: W13-9.
  • Chen CY, Lee RC, Tseng HS, et al. Normal and variant anatomy of hepatic arteries: angiographic experience. Zhonghua Yi Xue Za Zhi (Taipei) 1998; 61: 17-23.
  • Mortele KJ, Cantisani V, Troisi R, et al. Preoperative liver donor evaluation: imaging and pitfalls. Liver Transpl 2003; 9: 6-14.
  • Kruskal JB, Raptopaulos V. How I do it: preoperative CT scanning for adult living right lobe liver transplantation. Eur Radiol 2002; 12: 1423-31.
  • Guiney MJ, Kruskal JB, Sosna J, et al. Multi-detector row CT of relevant vascular anatomy of the surgical plane in split-liver trans- plantation. Radiology 2003; 229: 401-7.
  • Kamel IR, Kruskal JB, Keogan MT, et al. Multidetector CT of po- tential right-lobe liver donors. AJR Am J Roentgenol 2001; 177: 645-51.
  • Kamel IR, Raptopoulos V, Pomfret EA, et al. Living adult right lobe liver transplantation: imaging before surgery with multidetector multiphase CT. AJR Am J Roentgenol 2000; 175: 1141-3.
  • Koc Z, Oğuzkurt L, Ulusan Ş. Portal vein variations: clinical implica- tions and frequencies in routine abdominal multidetector CT. Diagn Interv Radiol 2007; 13: 75-80.
  • Baba Y, Hokotate H, Nishi H, et al. Intrahepatic portal venous varia- tions: demonstration by helical CT during arterial portography. J Comput Assist Tomogr 2000; 24: 802-8.
  • Atasoy C, Ozyurek E. Prevalence and types of main and right portal vein branching variations on MDCT. AJR Am J Roentgenol 2006; 187: 676-81.
  • Varotti G, Gondolesi GE, Goldman J, et al. Anatomic variations in right liver living donors. J Am Coll Surg 2004; 198: 577-82.
  • Marcos A, Orloff M, Mieles L, et al. Reconstruction of double he- patic arterial and portal venous branches for right-lobe living donor liver transplantation. Liver Transpl 2001; 7: 673-9.
  • Hata F, Hirata K, Murakami G, et al. Identification of segments VI and VII of the liver based on the ramification patterns of the intra- hepatic portal and hepatic veins. Clin Anat 1999; 12: 229-44.
There are 22 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Fatma Ayça Edis Özdemir This is me

Rıza Sarper Ökten This is me

Mustafa Özdemir - This is me

Melih Ereren - This is me

Fahrettin Küçükay This is me

Muharrem Tola - This is me

Eyüp Şenol - This is me

Publication Date April 1, 2014
Published in Issue Year 2014 Volume: 13 Issue: 1

Cite

APA Özdemir, F. A. E., Ökten, R. S., -, M. Ö., -, M. E., et al. (2014). Karaciğer sağ lob canlı donör adaylarında hepatik vasküler anatominin multidedektör bilgisayarlı tomografik anjiyografi ile değerlendirilmesi. Akademik Gastroenteroloji Dergisi, 13(1), 1-6. https://doi.org/10.17941/agd.96064

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