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Helping the Hepatic Surgeon |
1 From the Russell H. Morgan Department of Radiology and Radiological Science (H.K.P., E.K.F.) and Department of Surgery (W.R.M.), Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287. Recipient of a Certificate of Merit award for an education exhibit at the 2000 RSNA scientific assembly. Received January 19, 2001; revision requested March 2 and received April 16; accepted April 25. Address correspondence to H.K.P. (e-mail: hpannu@jhmi.edu).
Liver transplantation is a successful therapeutic option for patients with chronic liver disease and liver failure in that 1-year survival is greater than 80%. Orthotopic transplantation is usually performed from a cadaveric or living adult donor. The necessary evaluation of recipients and donors prior to transplantation can be successfully performed with computed tomography (CT). CT is useful in determining clinically relevant information for recipients such as size of the caudate lobe, exclusion of advanced hepatocellular carcinoma and other malignancy, patency of the venous system, presence of perihepatic varices, patency of the celiac artery, exclusion of splenic artery aneurysm, and position of iatrogenic venous shunts. CT in living donors may help to determine clinically relevant information about variant hepatic arterial anatomy, source of the artery to segment IV, intraparenchymal anatomy of the hepatic veins and accessory hepatic veins, trifurcation of the portal vein or hepatic duct, liver volume, and fatty change of the parenchyma. Surgical approaches and the imaging findings that influence management are reviewed.
Index Terms: Hepatic arteries, CT, 952.12914 • Hepatic veins, CT, 957.12914 • Liver, CT, 761.12114 • Liver, transplantation, 761.459
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