Abstract
The segmental anatomy of the human liver has become a field of increasing interest to radiologists during the past the past few years. The number of different terminologies which have been used since the topic has been systematically investigated is, however, a source of serious confusion. The present paper describes the reasons why the authors plead for an international working nomenclature which distinguishes a right hemiliver consisting of a right posterior and a right anterior segment, formed by subsegments 6 and 7, and 5 and 8, respectively, and a left hemiliver consisting of a left medial and a left lateral segment, the former corresponding to segment 4, and the latter to subsegments 2 and 3. This basic concept, however, must be carefully tailored to the highly variable individual anatomy of each patient. Furthermore, some aspects of hepatic segmentation are not yet understood and require additional anatomical investigation.
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References
Glisson F (1654) Anatomia hepatis. Pullein, London.
Rex H (1888) Beiträge zur Morphologie der Säugerleber. Morphol Jahrb 14: 517–616.
Cantlie J (1898) On a new arrangement of the right and left lobes of the liver. J Anat Physiol (Proc Natl Soc GB Jr) 32: IV-IX.
Segall HN (1923) An experimental anatomical investigation of the blood and bile channels of the liver. Surg Gynecol Obstet 37: 152–178.
Melnokoff A (1924) Architektur der intrahepatischen Gefässe und der Gallenwege des Menschen. Z Anat Entw-Gesch 70: 411–465.
Fainsinger MH (1950) The radiology of the intrahepatic biliary trans. A Afr J Med Sci 15: 51–66.
Hjortsjö CH (1951) The topography of the intrahepatic duct systems. Acta Anat 11: 599–615.
Ellias H, Petty D (1952) Gross anatomy of the blood vessels and ducts within the human liver. Am J Anat 90: 59–111.
Healey JE, Schroy P (1953) Anatomy of the biliary ducts within the human liver. Arch Surg 6: 599–616.
Nettelblad CS (1954) Die Lobierung und innere Topographie der Säugerleber. Acta Anat (Suppl 20 ad vol. 21).
Schmidt H von, Guttman E (1954) Röntgenuntersuchungen über die Verzweigung der grossen intrahepatischen Gallenwege. Anat Anz 100: 277–289.
Gans H (1955) Introduction to hepatic surgery. Elsevier, Amsterdam.
Couinaud C (1975) Le foie. Etudes anatomiques et chirurgicales. Masson, Paris.
Goldsmith NA, Woodburne RT (1957) The surgical anatomy pertaining to liver resection. Surg Gynecol Obstet 105: 310–318.
Mukai JK, Stack CM, Turner DA, Gould RJ, Petasnick JP, Matalon TAS, Doolas AM, Murakami M (1987) Imaging of surgically relevant hepatic vascular and segmental anatomy. Part 1: normal anatomy. AJR 149: 287–292.
Nelson RC, Chezmar JL, Sugarbaker PH, Murray DR, Bernardino ME (1990) Preoperative localisation of focal liver lesions to specific liver segments: utility of CT during arterial portography. Radiology 176: 89–94.
Sugarbaker PH (1990) En bloc resection of heaptic segments 4 b, 5 and 6 by transverse hepatectomy. Surg Gynecol Obstet 170: 250–252.
LaFortune M, Madore F, Patriquin H, Breton G (1991) Segmental anatomy of the liver: a sonographic approach to the Couinaud nomenclature. Radiology 181: 443–448.
Soyer P, Roche P, Levesque M (1991) Preoperative segmental localisation of hepatic metastases: utility of three-dimensional CT during arterial portography. Radiology 180: 653–658.
Gazelle GS, Haaga JR (1991) Hepatic neoplasms: surgically relevant segmental anatomy and imaging techniques. AJR 158: 1015–1018.
Leeuwen MS van, Fernadez MA, Ens HW van, Stokking R, Drillon EH, Feldberg MAM (1994) Variations in venous and segmental anatomy of the liver: two-and three-dimensional MR imaging in healthy volunteers. AJR 162: 1337–1345.
Leeuwen MS van, Noordzij J, Fernandez MA, Hennipman A, Feldberg MAM, Dillon EH (1994) Portal venous and segmental anatomy of the right hemiliver: observations based on three-dimensional spiral CT renderings. AJR 163: 1395–1404.
Soyer P, Bluemke DA, Bliss DF, Woodhouse CE, Fishman EK (1994) Surgical segmental anatomy of the liver: demostration with spiral CT during arterial portography and multiplanar reconstruction. AJR 163: 99–103.
Soyer P, Bluemke DA, Choti MA, Fishman EK (1995) Variations in the intrahepatic portions of the hepatic and portal veins: findings on helical CT scans during arterial portography. AJR 164: 103–108.
Soyer P (1993) Segmental anatomy of the liver: utility of a nomenclature accepted worldwide. AJR 161: 572–573.
Bismuth H (1982) Surgical anatomy and anatomical surgery of the liver. World J Surg 6: 3–9.
IANC (International Anatomical Nomenclature Committee); (1983): Nomina anatomica, 5th edn. Williams and Wilkins, Baltimore, p. A37.
IANC (International Anatomical Nomenclature Committee); (1989) Nomina anatomica, 6th edn. Churchill Livingstone, Edinburg, p. A41.
Coui C, Houssin D (1991) Controlled partition of the liver for transplantation. Couinaud, Paris.
Downey PR (1994) Radiologic identification of liver segments (letter). AJR 163: 1267.
Gore RM, Levine MS, Laufer I (1994) Textbook of gastrointestinal radiology. Saunders, Philadelphia, pp 1788–1795.
Makuuchi M, Hasegawa H, Yamazaki S (1987) Four new hepatectomy procedures for resection of the right hepatic vein and preservation of the inferior right hepatic vein. Surg Gynecol Obstet 0164: 68–72.
Scheele J (1990) Die gefässorientierte Segmentresektion der Leber. Langenbecks Arch Chir 375: 308–317.
Sugarbaker PH, Nelson RC, Murray DR, Chezmar JL, Bernardino ME (1990) A segmental approach to computerized tomographic portography for hepatic resection. Surg Gynecol Obstet 171: 189–195.
Dodd GD III (1993) An American guide to Couinaud's numbering system. AJR 161: 574–575.
Platzer W, Maurer H (1966) Zur Segmenteinteilung der Leber. Acta Anat 63: 8–31.
Couinaud C (1986) Anatomie chirurgicale du foie. Quelques aspects nouveaux. Chirurgie 112: 337–342.
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Correspondence to: J. H. D. Fasel
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Fasel, J.H.D., Gaillound, P., Terrier, F. et al. Segmental anatomy of the liver: a review and a proposal for an international working nemenclature. Eur. Radiol. 6, 834–837 (1996). https://doi.org/10.1007/BF00240684
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DOI: https://doi.org/10.1007/BF00240684