Summary
Liver segmentation is a matter of increasing importance for radiologists, in particular with respect to accurate preoperative localisation of focal hepatic lesions. Procedures for delineating the segmental anatomy from CT or MR images are therefore much in demand. In this context, a convenient technique for generating the intersegmental scissurae by computer has recently been proposed [9]. The procedure, however, seemed questionable from an anatomical point of view. We therefore checked its relevance using anatomical vascular casts of post mortem livers and comparing the computergenerated scissurae with the actual course of the intrahepatic vessels. The results presented in this paper confirm that a rigid application of flat scissural planes is not able to render the real intrahepatic compartmentation. Only techniques considering the effective individual vascular anatomy can provide a correct determination of the hepatic segments.
Résumé
L’anatomie segmentaire du foie est un sujet d’intérêt croissant pour les radiologistes, en particulier en raison du besoin d’une localisation préopératoire précise de pathologies hépatiques focales. Des procédés simples et efficaces pour déterminer cette anatomie segmentaire à partir d’images TDM ou IRM sont donc très recherchés. C’est dans ce contexte qu’une méthode élégante a été proposée récemment, consistant à générer par ordinateur les scissures intersegmentaires [9]. Le procédé nous semblait toutefois contestable d’un point de vue anatomique. Nous avons testé notre hypothèse sur des préparations de corrosion vasculaire en comparant les scissures générées par ordinateur au cheminement effectif des vaisseaux intrahépatiques. Les résultats obtenus confirment que toute application de plans scissuraux rigides ne peut réellement rendre compte de la compartimentation intrahépatique. Seules des techniques prenant en considération l’anatomie vasculaire individuelle authentique et dans sa totalité permettent une détermination correcte de la segmentation hépatique.
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Fasel, J.H.D., Gailloud, P., Grossholz, M. et al. Relationship between intrahepatic vessels and computer-generated hepatic scissurae: anin vitro assay. Surg Radiol Anat 18, 43–46 (1996). https://doi.org/10.1007/BF03207761
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DOI: https://doi.org/10.1007/BF03207761