Branching patterns of the main portal vein: effect on estimated remnant liver volume in preoperative evaluation of donors for liver transplantation.

OBJECTIVES: To compare estimated remnant liver volume (ERLV) ratios among the major main portal vein (MPV) variants. METHODS: Eighty-five potential donors underwent multidetector CT examination. Arterial, portal and hepatic venous phase images were obtained. CT volumetric measurements were performed by using summation-of-area method. MPV variants were classified into three groups. In type 1 (group 1), the MPV branches into the right portal vein (RPV) and the left portal vein (LPV). In type 2 (group 2), the MPV trifurcates into the right anterior portal vein (RAPV), right posterior portal vein (RPPV) and LPV. In type 3 (group 3), the RPPV arises from the MPV as a first branch, and the RAPV emerges directly from the LPV. RESULTS: No differences were observed between groups 1 and 2 with respect to ERLV ratios. However, significant differences were discovered between groups 1 and 3 and between groups 2 and 3 (p<0.001 and p<0.05, respectively). CONCLUSIONS: The ERLV proportions in the donors with a type 3 MPV variation were significantly lower than those in the donors with type 1 and type 2 MPV variations and six (31.6%) donors in group 3 presented an ERLV percentage below 30% of the total liver volume.

Evaluation of the effect of visceral fat area on the distance and angle between the superior mesenteric artery and the aorta.

PURPOSE: To investigate the effect of visceral fat area on the distance and angle between the superior mesenteric artery (SMA) and the aorta. METHODS: On axial and sagittal images from abdomen CT scan, the distance and the angle between the SMA and the aorta were measured at the location where the third part of the duodenum crosses. The visceral fat area was calculated at the level of the umbilicus on the abdominal CT section. Body mass index was calculated. RESULTS: For both genders, the correlation between the distance and visceral fat area was substantial (p < 0.001). For males, there was no statistically significant relationship between the angle and the visceral fat area. For females, the correlation between the angle and the visceral fat area was low but significant and positive (r = 0.25, p < 0.048). In addition, it was found that males have a greater proportion of visceral fat than females. In both females and males, the subcutaneous fat area correlated with BMI (r = 0.65, r = 0.69, respectively, p < 0.001), more strongly than the visceral fat area did (r = 0.51, r = 0.63, respectively, p < 0.001). CONCLUSIONS: The distance between the aorta and the SMA significantly correlates with visceral fat area than with BMI. The size of visceral fat area of females and males vary; therefore, the amount of visceral fat area should be considered in the establishing diagnosis of SMA syndrome.