Human dorsal liver: an analysis using CT images and autopsy sections

Abstract

Learning objectives: The aim of this study is to demonstrate and to describe the human dorsal liver (DL) anatomy on CT images and on a cadaver liver. Background: The DL is defined as an area sandwiched between the major vascular structures of the liver and containing the caudate lobe (CL). There is an anastomosis between the hepatic veins and the inferior vena cava (IVC). The DL can enlarge and compress the IVC in cases of cirrhosis and in the Budd–Chiari syndrome. The intraparenchymal border planes of the DL still cause great confusion. Imaging findings OR Procedure details: Couinaud’s, Kitagawa's, and Murakami's descriptions of DL border planes were used. Twenty normal CT images were analysed. The vascular structures of the DL were visualised and examined in 25 cadaver livers. Conclusion: The DL has five border planes: 1) the left surface facing the S2; 2) the dorsal surface composed of a) the dorsal surface of anatomical CL and b) the parenchymal surface of the groove for the IVC; 3) the right plane is marked by the bifurcation of the right portal vein, the end of the RHV and the notch in the gallbladder fossa; 4) the inferior surface crosses the portal bifurcation and reaches the main hepatic veins; 5) a ventral curved plane including the main hepatic veins. These planes can be shifted depending on the border branches. Clearly defined major vascular structures can be useful for assessing the borders and can help in planning liver surgery.