Vascular liver anatomy and main variants: what the radiologist must know

Advances in surgical techniques are extremely demanding regarding the accuracy and level of detail expected for display of the vascular anatomy of the liver. Precise knowledge of the arterial, portal and hepatic vein territories are mandatory whenever a liver intervention is planned. Sectional anatomy can now be routinely performed on multidetector computed tomography (MDCT) with volumetric data and isotropic voxel display, by means of sub-millimetric slice thickness acquisition. The relevant vascular information can thus be gathered, reviewed and post-processed with unprecedented clarity, obviating the need for digital subtraction angiography. The scope of the present paper is to review the normal vascular liver anatomy, its most relevant variants including additional sources of vascular inflow. Apart from providing the surgeon with a detailed vascular and parenchymal roadmap knowledge of imaging findings may avoid potential confusion with pathologic processes.