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Stepwise evaluation of liver sectors and liver segments by endoscopic ultrasound

World Journal of Gastrointestinal Endoscopy 2018年第11期10卷 326-339页

作者： Malay Sharma Piyush Somani Chittapuram Srinivasan Rameshbabu Tagore Sunkara Praveer Rai Department of Gastroenterology Jaswant Rai Speciality HospitalMeerut 25001Uttar PradeshIndia Department of Gastroenterology Thumbay HospitalDubai 415555United Arab Emirates Department of Anatomy Muzaffarnagar Medical CollegeMuzaffarnagar 251001Uttar PradeshIndia Department of Gastroenterology and Hepatology the Brooklyn Hospital CenterClinical Affliate of The Mount Sinai HospitalBrooklynNY 11201United States

The liver has eight segments, which are referred to by numbers or by names. The numbering of the segments is done in a counterclockwise manner with the liver being viewed from the inferior surface, starting from Segment Ⅰ(the caudate lobe). Standard anatomical description of the liver segments is available by computed tomographic scan and ultrasonography. Endoscopic ultrasound(EUS) has been used for a detailed imaging of many intra-abdominal organs and for the assessment of intra-abdominal vasculature. A stepwise evaluation of the liver segments by EUS has not been described. In this article, we have described a stepwise evaluation of the liver segments by EUS. This information can be useful for planning successful radical surgeries, preparing for biopsy, portal vein embolization, transjugular intrahepatic portosystemic shunt, tumour resection or partial hepatectomy, and for planning EUS guided diagnostic and therapeutic procedures.

关键词： Endoscopic ultrasound Hepatic vein Liver sectors Portal vein Liver segments Caudate lobe Cantlie’s line falciform ligament Gallbladder

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Linear endoscopic ultrasound evaluation of hepatic veins

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World Journal of Gastrointestinal Endoscopy 2018年第10期10卷 283-293页

作者： Malay Sharma Piyush Somani Chittapuram Srinivasan Rameshbabu Department of Gastroenterology Jaswant Rai Speciality Hospital Department of Gastroenterology Thumbay Hospital Department of Anatomy Muzaffarnagar Medical College

Liver resection surgery can be associated with significant perioperative mortality and morbidity. Extensive knowledge of the vascular anatomy is essential for successful, uncomplicated liver surgeries. Various imaging techniques like multidetector computed tomographic and magnetic resonance angiography are used to provide information about hepatic vasculature. Linear endoscopic ultrasound(EUS) can offer a detailed evaluation of hepatic veins, help in assessment of liver segments and can offer a possible route for EUS guided vascular endotherapy involving hepatic veins. A standard technique for visualization of hepatic veins by linear EUS has not been described. This review paper describes the normal EUS anatomy of hepatic veins and a standard technique for visualization of hepatic veins from four stations. With practice an imaging of all the hepatic veins is possible from four stations. The imaging from fundus of stomach is the easiest and most convenient method of imaging of hepatic veins. EUS of hepatic vein and the tributaries is an operator dependent technique and in expert hands may give a mapping comparable to computed tomographic and magnetic resonance imaging. EUS of hepatic veins can help in identification of individual sectors and segments of liver. EUS guided interventions involving hepatic veins may require approach from different stations.

关键词： Endoscopic ultrasound Hepatic vein Portal vein Liver segments Caudate lobe Inferior vena cava Liver Cantlie line falciform ligament Gall bladder

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