Third inflow
Citation, DOI, disclosures and article data
At the time the article was created Bruno Di Muzio had no recorded disclosures.
View Bruno Di Muzio's current disclosuresAt the time the article was last revised Arlene Campos had no financial relationships to ineligible companies to disclose.
View Arlene Campos's current disclosuresThird inflow refers to anatomical variants leading to an additional venous inflow to the liver apart from the usual dual blood supply (portal vein and hepatic artery). They tend to be associated with parenchymal pseudolesions (focal hyperenhancement on post-contrast imaging, focal fat infiltration, or focal fat sparing) and, therefore, the recognition of these variant liver hemodynamics is crucial. Potential anatomic variations include:
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aberrant right gastric venous drainage
reported prevalence is up to 49% of the population 1
can lead to hepatic pseudolesions in the inferior segment 4 posteriorly
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epigastric-paraumbilical veins
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venous blood flow from the abdominal wall to the liver 1,3
superior and inferior veins of Sappey
-
-
can lead to hepatic pseudolesions in the inferior segment 4B and 5 posteriorly
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aberrant left gastric venous drainage
around 4% of the population 1
can lead to hepatic pseudolesions in the lateral segment 2 and 3 posteriorly
NB: the hepatic segments were originally numbered by Roman numerals I to VIII, but the Arabic numerals 1 to 8 are now preferred 4.
References
- 1. Khaled M. Elsayes, Akram M. Shaaban, Sarah M. Rothan, Sanaz Javadi, Beatrice L. Madrazo, Rosa P. Castillo, Victor J. Casillas, Christine O. Menias. A Comprehensive Approach to Hepatic Vascular Disease. (2017) RadioGraphics. 37 (3): 813-836. doi:10.1148/rg.2017160161 - Pubmed
- 2. Unal E, Ozmen MN, Akata D, Karcaaltincaba M. Imaging of aberrant left gastric vein and associated pseudolesions of segments II and III of the liver and mimickers. (2015) Diagnostic and interventional radiology (Ankara, Turkey). 21 (2): 105-10. doi:10.5152/dir.2014.14360 - Pubmed
- 3. Kengo Yoshimitsu, Hiroshi Honda, Toshiro Kuroiwa, Hiroyuki Irie, Hitoshi Aibe, Kenji Shinozaki, Kouji Masuda. Unusual Hemodynamics and Pseudolesions of the Noncirrhotic Liver at CT1. (2001) RadioGraphics. 21 Spec No: S81-96. doi:10.1148/radiographics.21.suppl_1.g01oc06s81 - Pubmed
- 4. Strasberg S & Phillips C. Use and Dissemination of the Brisbane 2000 Nomenclature of Liver Anatomy and Resections. Ann Surg. 2013;257(3):377-82. doi:10.1097/sla.0b013e31825a01f6 - Pubmed
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