Morphology and morphometry of the caudate lobe of the liver in two populations

Sagoo, Mandeep Gill; Aland, R. C.; Gosden, Edward

doi:10.1007/s12565-016-0365-7

Cited by 12 publications

(9 citation statements)

References 15 publications

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“…It is said to be complete when it covers posterior aspect of retrohepatic segment of inferior vena cava. 23 No pons hepaticus was encountered in our study.…”

Section: Discussionmentioning

confidence: 52%

Morphology of Caudate Lobe of Liver

Sadanandan¹,

Varghese²

2017

jemds

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BACKGROUNDCaudate lobe morphology has significance in diagnostic imaging and in minimally invasive surgery. The present study aims to assess the morphology of caudate lobe and its anatomical independence from rest of the liver, as it may be differentially affected in liver pathologies and may be beneficial for radiologists and surgeons. MATERIALS AND METHODSParameters like vertical and transverse diameters of caudate lobe and right lobe were measured with vernier callipers and surface area calculated using butter paper. Biliary drainage, venous supply and arterial supply of 36 adult human cadaveric livers were noted by gross dissection. RESULTSPapillary processes, caudate processes and notches were found in majority of caudate lobes studied. Caudate lobes varied in their shapes and measurements. An accessory fissure and lobe were seen. Ratio of surface area of caudate lobe to right lobe varied from 0.061 to 0.410. Portal vein and hepatic artery supplied the caudate lobes by their left branches and biliary drainage was also through left hepatic duct in majority of caudate lobes. CONCLUSIONThe anatomical independence of caudate lobe was assessed and confirmed by its mode of blood supply and biliary drainage. All the caudate lobes had independent vessels and ducts. The papillary process of caudate lobe can cause pitfalls in interpretation of C T images at the porta hepatis. Caudate lobe variations are important for surgeons and radiologists alike for avoiding misinterpretation and for better surgical outcome. Caudate lobe is so named, not because it is caudal in position, but because it often gives rise to a tail in the form of an elongated papillary process. The caudate lobe, also called spigelian lobe seems to be different from the rest of the liver in that it behaves in a paradoxical manner, particularly in cases of cirrhosis. It is anatomically independent from rest of the liver. KEYWORDSIt is bounded on the left by fissure for ligamentum venosum, inferiorly by porta hepatis, and on the right by inferior vena cava. It is continuous superiorly with the superior surface. It is subdivided into caudate lobe proper, and the papillary process, the caudate process and the paracaval portion which is anterior to inferior vena cava. The caudate lobe is connected to the right lobe of liver by the caudate process which passes laterally between portal vein and inferior vena cava at the porta hepatis. Sometimes, the 'Financial or Other Competing Interest': None.

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“…It is said to be complete when it covers posterior aspect of retrohepatic segment of inferior vena cava. 23 No pons hepaticus was encountered in our study.…”

Section: Discussionmentioning

confidence: 52%

Morphology of Caudate Lobe of Liver

Sadanandan¹,

Varghese²

2017

jemds

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“…The caudate notch was the second most common variant IHF we encountered. Sagoo et al defined this as a fissure on the visceral surface of the liver that separates the normally cuboid bridge of the caudate parenchyma into the caudate lobe proper and a caudate process [18]. We only found this in 8.3% of our population, but the worldwide prevalence varies from 9% in Northern India to 100% at Karnataka in Southwest India [19][20].…”

Section: Discussionmentioning

confidence: 64%

Inferior Hepatic Fissures: Anatomic Variants in Trinidad and Tobago

Cawich

Gardner

Barrow³

et al. 2020

Cureus

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Classic descriptions of the visceral surface of the human liver only define three fissures: transverse, sagittal and umbilical fissures. Any additional fissures that are present on the visceral surface of the liver are considered variant inferior hepatic fissures (IHFs). This study was carried out to document the prevalence of IHFs in the Eastern Caribbean. Knowledge of these variants is important to clinicians who treat liver disorders in persons of the Caribbean diaspora.In this study, two independent researchers observed all consecutive autopsies performed at the facility over a period of 10 weeks. They examined the visceral surface of the unfixed liver in situ. Any specimen with variant IHFs was selected for detailed study. We documented the relation of the variant IHFs to nearby viscera and then explanted the livers using a standardized technique. The following details were recorded for each liver: number, location, depth, length, and width of IHFs. All measurements were checked independently by two researchers and the average measurement was used as the final dimension. Each liver was then sectioned in 1 cm sagittal slices to document the relationship of intraparenchymal structures.We observed 60 consecutive autopsies in unselected cadavers. Variant IHFs were present in 21 (35%) cadavers at a mean age of 68.25 years (range: 61 -83; median 64.5; standard deviation (SD) ± 8.45). The variants included a deep fissure in the coronal plane between segments V and VI in 19 (31.7%) cadavers (related to the right branch of the portal vein in 63.2% of cases), a well-defined segment VI fissure running in a sagittal plane in four (6.7%) cadavers, a well-defined fissure incompletely separating the caudate process from the caudate lobe proper in five (8.3%) cadavers, a consistent fissure that arose from the left side of the transverse fissure and coursed between segments II and III in three (5%) cadavers, and a deep coronal fissure dividing the quadrate to form an accessory quadrate lobe in one (1.7%) cadaver.Almost one in three unselected persons in this population have anatomically variant fissures on the visceral surface of the liver. The variants include Rouvière's sulci (31.7%), caudate notches (8.3%), segment VI fissures (6.7%), left medial segment fissures (5%), and quadrate fissures (1.7%). The clinical relevance of these variants is discussed. Any clinician treating liver diseases in persons of Caribbean extract should be aware of their presence.

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“…Nonetheless, computer assisted extraction of caudate segment from nearby sections remained problematic, because of its morphological variants and ambiguous boundaries, especially on CT images. However, a radiologist could identify caudate segment by its general appearance, i.e., rectangle, piriform or irregular form [48]. From posterior perspective, it is positioned behind the hepatic helium and in front of LPV.…”

Section: Planementioning

confidence: 99%

“…Its upper end is bounded by HV. To its left is ligamentum venosum, whereas its right margin is unclear [47][48][49][50]. As a result, this structure had so far been disregarded by most CAD studies.…”

Section: Planementioning

confidence: 99%

Functional Segmentation for Preoperative Liver Resection Based on Hepatic Vascular Networks

Chansangrat

Keeratibharat

et al. 2021

IEEE Access

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Successful liver resection relies on accurate estimation of future liver remnant volume (FLRV). According to Couinaud's scheme, a liver is composed of eight functionally independent segments, each of which has its own vascular in-and out-flow tracks. Segmenting a liver by this scheme is vital to postoperative regeneration and hence prognosis outcome. Conventionally, estimation of liver segments was often done by hand on 3D computed tomography. The process is generally tedious, time consuming, and prone to observer variability. Alternatively, computerized methods had been proposed but impeded by anatomically irrelevant approximation and manually specified markers. To resolve the issues, this paper presents a novel method for functional liver segmentation. Its main contribution was performing analyses of differential geometry directly on a liver surface and interior venous system. Except for a few points being placed on major vessels, anatomical references required for defining all separating surfaces were automatically identified. To demonstrate its merits, virtual liver resection was implemented on the standard MICCAI SLIVER07 dataset, and the resultant segments were benchmarked against four most related works. Visual and numerical assessments reported herein indicated that our method could faithfully label all Couinaud's segments, especially the caudate, with lesser degree of user interaction. The preliminary findings suggested that it can be integrated into augmented surgical planning and intervention.

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Morphology and morphometry of the caudate lobe of the liver in two populations

Cited by 12 publications

References 15 publications

Morphology of Caudate Lobe of Liver

Morphology of Caudate Lobe of Liver

Inferior Hepatic Fissures: Anatomic Variants in Trinidad and Tobago

Functional Segmentation for Preoperative Liver Resection Based on Hepatic Vascular Networks

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