Abstract

EVALUATION OF VARIATIONS OF PORTAL VEIN BRANCHING BY MULTIDETECTOR COMPUTED TOMOGRAPHY

Author(s): Vijay Kumar K. R, Jagruthi Sundar

BACKGROUND Variations of the main portal vein (MPV) and right portal vein (RPV) branching at the hepatic hilum are quite frequent. Identification and reporting of such variations are necessary prior to interventions such as liver transplantation, as some are relative contraindications to living donor lobectomy or they at least require different techniques of anastomosis. MATERIALS AND METHODS This was a prospective study conducted on 100 patients at Department of Radiodiagnosis, Victoria Hospital, Bangalore Medical College and Research Institute. The study was conducted from May 2018 to November 2018. Multidetector Computed Tomography (MDCT) scan was performed with Philips Ingenuity 128 Slice CT machine. Portal venous phase images were acquired in an axial plane. Images were transferred to a Philips workstation; maximum intensity projection (MIP) and 3D volumerendering images were reconstructed and the branching patterns of MPV and RPV were analysed. RESULTS Type 1 anatomy was the most common type, seen in 68 patients, that is, conventional portal venous anatomy. Type 3 anatomy was the most common type of variation in our study. Three patients had miscellaneous variations. Most patients had conventional MPV branching had conventional RPV branching. Ten out of 68 patients with conventional main portal vein branching had variant right portal vein branching. Most patients with conventional MPV branching had conventional RPV branching. Other variations observed were RPV quadrification and proximal origin of segment VII vein from RPV. CONCLUSION Main portal vein branching variations are quite frequent. Common RAPV-LPV trunk is more common than trifurcation of MPV. Variations in right portal vein branching are less frequent. MDCT plays an important role in accurate assessment of variations.