HEPATIC AND PORTAL VEINS ANATOMICAL VARIANTS: PREVALENCE AND CLINICAL IMPLICATIONS ON ROUTINE ABDOMINAL MDCT

Abstract

ABSTRACT:

This study reviewed the types, prevalence rate and implications of anatomical variants of the hepatic and portal veins by using routine abdominal multidetactor computed tomography (MDCT). These aberrant increase the risk of catastrophic liver injury and must be diagnosed for intervention radiologists’ and vascular surgeons before complex hepatectomy, living donor transplantation or hepatic venous embolization. MATERIAL AND METHOD: This is a prospective study of 7 months from May ‘to November’2017, included 100 patients referred to radiology department. RESULTS: In total, 66 patients out of 100 had at least one abdominal vein variant and anomalies. The hepatic vein variants had high frequency 45% (n=45), while hepatic veins were identified in 41% (n=41). And 20% (n=20) had both variations. Inferior right hepatic IRHV was more common in 46.6% (n=21). The surgically significant mean diameter of hepatic vein was >5mm in 13.3% (n=06). The Variations of the PV system were observed in 41% (n=41) while 59% (n=59) had the normal or classic pattern of the PVs anatomy. The commonest was trifurcation PV (Type 2) in 58.5% followed by right posterior PV as a first branch of main PV (Type 3) in 19.5% (n=08) patients. The branch of segment VII and VI was identifies as a separate branch of RPV in 4.2% (n=02) and 14.6% (n=06) respectively. CONCLUSION: The aberrant portal veins in 66% patients indicate vulnerability to inadvertent complications during surgery and radiological interventions. This emphasizes for diligence CT reporting by radiologists to reduce injury and complications in liver procedures and transplant.