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Preoperative Hepatic Vascular Evaluation with CT and MR Angiography: Implications for Surgery¹

¹ From the Division of Abdominal Imaging and Intervention, Departments of Radiology (D.S., A.M., M.B., S.P., S.S.) and 3D Image Processing (G.H.), Massachusetts General Hospital, White 270, 55 Fruit St, Boston, MA 02114. Presented as an education exhibit at the 2001 RSNA scientific assembly. Received December 12, 2003; revision requested January 20, 2004; final revision received February 25; accepted March 9. All authors have no financial relationships to disclose. Address correspondence to D.S. (e-mail: dsahani@partners.org).

Partial liver resection for living donor transplantations and treatment of hepatic tumors is a major surgical undertaking, and detailed knowledge of the hepatic angioarchitecture is essential to ensure safe and successful liver surgery. Noninvasive imaging techniques such as computed tomographic (CT) and magnetic resonance (MR) angiography have begun to replace conventional catheter angiography for evaluation of the hepatic vascular anatomy. Multisection CT angiography and MR angiography are complementary modalities that permit comprehensive, accurate preoperative delineation of the hepatic vascular anatomy and evaluation of the parenchyma in patients undergoing liver surgery, thereby obviating multiple invasive studies including catheter angiography. Understanding a surgeon’s perspective on liver surgery is critical so that the required information can be provided accurately with imaging. Both CT angiography and MR angiography have had a significant impact on the selection of candidates for liver surgery as well as on surgical technique.

© RSNA, 2004

Index Terms: Liver, anatomy, 761.92 • Liver, angiography, 761.12116, 761.12142 • Liver, surgery • Liver, transplantation

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