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Anatomy of the Right Anterosuperior Area (Segment 8) of the Liver: Evaluation with Helical CT during Arterial Portography¹

¹ From the Second Department of Surgery, Chiba University School of Medicine, Japan (A.C., S.O., W.T., A.T., K.I., S.S., T.N., T.K., S.K., T.O.), and the Department of Surgery, National Cancer Center Hospital East, Chiba, Japan (M.R.). Received February 24, 1999; revision requested April 27; revision received June 4; accepted August 16. Address reprint requests to A.C., Department of Surgery, Sawara Prefectural Hospital, 2285 I Sawara, Chiba, 287-0003, Japan. (e-mail: cho@maple.ocn .ne.jp).

PURPOSE: To evaluate the segmental anatomy of the right anterosuperior area (segment 8) of the liver by using helical computed tomography during arterial portography (CTAP).

MATERIALS AND METHODS: Twenty-seven patients without lesions at segment 8 underwent helical CTAP. Three-dimensional portograms were reconstructed to verify the course of the portal veins. The number of subsegmental branches, in addition to the branching point and the distribution in segment 8, was assessed.

RESULTS: In 25 (93%) patients, the dorsal branch of segment 8 gave rise to dorsally directed branches posterior to the right hepatic vein. In only four (25%) of 16 patients in whom the medial branch of segment 8 arose near the porta hepatis, the long paracaval portal branch of the caudate lobe extended upward above the interval between the middle and right hepatic veins.

CONCLUSION: In most of the patients, the dorsal branches of segment 8 supplied the dorsocranial area of the right lobe posterior to the right hepatic vein. The paracaval portion of the caudate lobe was limited to below the interval between the middle and right hepatic veins in the majority of patients who showed medial branches of segment 8 arising near the porta hepatis. Recognition of this vascular anatomy is clinically important for preoperative evaluation of hepatic tumors in segment 8 because it may contribute to a safer surgical approach.

Index terms: Computed tomography (CT), helical, 957.12915 • Computed tomography (CT), three-dimensional, 957.12917 • Liver, blood supply, 761.92 • Portal vein, anatomy, 957.92 • Portal vein, CT, 957.12915, 957.12916, 957.12917 • Portography, 761.1242, 957.1242

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