Portal vein branching order helps in the recognition of anomalous right-sided round ligament: common features and variations in portal vein anatomy.

Rikiya Yamashita, Toshihide Yamaoka, Ryuta Nishitai, Hiroyoshi Isoda, Kojiro Taura, Shigeki Arizono, Akihiro Furuta, Tsuyoshi Ohno, Ayako Ono, Kaori Togashi

Abdominal radiology (New York) 2017 Jul

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This study aimed to evaluate the common features and variations of portal vein anatomy in right-sided round ligament (RSRL), which can help propose a method to detect and diagnose this anomaly. In this retrospective study of 14 patients with RSRL, the branching order of the portal tree was analyzed, with special focus on the relationship between the dorsal branch of the right anterior segmental portal vein (PA-D) and the lateral segmental portal vein (PLL), to determine the common features. The configuration of the portal vein from the main portal trunk to the right umbilical portion (RUP), the inclination of the RUP, and the number and thickness of the ramifications branching from the right anterior segmental portal vein (PA) were evaluated for variations. In all subjects, the diverging point of the PA-D was constantly distal to that of the PLL. The portal vein configuration was I- and Z-shaped in nine and five subjects, respectively. The RUP was tilted to the right in all subjects. In Z-shaped subjects, the portal trunk between the branching point of the right posterior segmental portal vein and that of the PLL was tilted to the left in one subject and was almost parallel to the vertical plane in four subjects. Multiple ramifications were radially distributed from the PA in eight subjects, whereas one predominant PA-D branched from the PA in six subjects. Based on the diverging points of the PA-D and PLL, we proposed a three-step method for the detection and diagnosis of RSRL.

Citation

Rikiya Yamashita, Toshihide Yamaoka, Ryuta Nishitai, Hiroyoshi Isoda, Kojiro Taura, Shigeki Arizono, Akihiro Furuta, Tsuyoshi Ohno, Ayako Ono, Kaori Togashi. Portal vein branching order helps in the recognition of anomalous right-sided round ligament: common features and variations in portal vein anatomy. Abdominal radiology (New York). 2017 Jul;42(7):1832-1838