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DOI: 10.1148/rg.271065050
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RadioGraphics 2007;27:129-143
© RSNA, 2007

EDUCATION EXHIBIT

The Perihepatic Space: Comprehensive Anatomy and CT Features of Pathologic Conditions1

Suk Kim, MD, Tae Un Kim, MD, Jun Woo Lee, MD, Tae Hong Lee, MD, Suck Hong Lee, MD, Tae Yong Jeon, MD and Ki Hyung Kim, MD

1 From the Departments of Diagnostic Radiology (S.K., T.U.K., J.W.L., T.H.L., S.H.L.), Surgery (T.Y.J.), and Obstetrics and Gynecology (K.H.K.), Pusan National University Hospital, 1-10 Ami-Dong, Seo-gu, Busan 602-739, Korea. Presented as an education exhibit at the 2005 RSNA Annual Meeting. Received March 30, 2006; revision requested May 24; final revision received August 9; accepted August 14. All authors have no financial relationships to disclose. Address correspondence to J.W.L. (e-mail: junwlee{at}pusan.ac.kr).

The liver is covered by visceral peritoneum except at the bare area, bed of the gallbladder, and porta hepatis. The investing peritoneum becomes contiguous with the adjacent structures such as the diaphragmatic peritoneum, lesser omentum, and ligamentum teres. An inflammatory process or tumors involving the perihepatic space are usually affected by intraperitoneal flow dynamics, which depend on the anatomy of the recess as well as gravity and negative subdiaphragmatic pressure. Pathologic conditions that occur in the perihepatic space include abnormal air, fatty masses, conditions producing fluid attenuation at computed tomography (CT), and soft-tissue masses. Enhancement of the hepatic capsule indicates inflammation, as is seen in Fitz-Hugh–Curtis syndrome. The perihepatic ligaments may be invaded by various conditions by means of direct invasion, subperitoneal extension, or extension along the lymphatic vessels. Knowledge of the normal anatomy of the perihepatic space together with the clinical history and characteristic features at CT can assist the radiologist in making the correct diagnosis.

© RSNA, 2007






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