Caudate lobe

Fig. 2.5 Segmentation of the liver. a ie/t/oZie (1,1-4) 4 segments centre of the liver (II) quadrate lobe (II, 3) caudate lobe (II, 1,2) and caudate process (II, 2) right lobe (HI, 1 -4) 4 segments. Rex-Cantlie s line (= = = ) as functional division between both liver lobes runs between II 2,4 and II 1,3. Topographically, the liver lobes are...

Internai structure fine homogeneous reflexes somewhat more echogenic than the kidney parenchyma, slightly less echogenic than the pancreas rather dark and sharply contrasted the area of the caudate lobe is usually more hypoechoic... 

As a rule, liver cirrhosis exhibits absorption values which are no different from those of a normal liver. Advanced stages show an enlargement of the caudate lobe and possibly also of the left lobe as well as alterations in form or shrinkage of the right lobe (or both lobes) with fine to coarse nodular irregularities on the surface. In some cases, an increase in density of up to 60-70 HU is verifiable. Usually, splenomegaly and further signs of portal hypertension are present. Hypodense foci may indicate HCC and should be examined with the aid of contrast medium or MRI. (7,29,46,49)... 

In the Budd-Chiari syndrome, the central area of the liver shows a normal or even increased concentration of radioactivity, whereas the peripheral regions of both lobes of liver exhibit reduced or even no uptake ( hot spots and multiple focal storage defects). Only the caudate lobe shows increased activity due to its separate venous flow, it is not functionally affected by hepatic vein thrombosis. (26)... 

Watanabe, S., Kimura, Y., Nishioka, M., Ohkawa, M., Kozeki, M., Yano, M., Hashimoto, N. Assessment of hepatic functional reserve in cirrhotic patients by computer tomography of the caudate lobe. Dig. Dis. Sci. 1999 44 2554-2563... 

The fiver is divided into left and right anatomical lobes by the falciform ligament, an anterior extension of the peritoneal folds that connects the fiver to the diaphragm and anterior abdominal wall (Figure 47-1). Two smaller lobes are found on the posterior surface (caudate lobe) and the infe-... 

Cirrhotic changes within the liver in patients who are candidates for OLT or interventional treatment for HCC can be demonstrated by means of 3D-CT and MR angiography liver atrophy, nodularity, reduced size of right hepatic lobe and enlargement of the left hepatic lobe or caudate lobe (Smith et al. 1998). 

Selective right hepatic arteriogram-injection of 3 cc/sec for 12 cc. Normally, the right hepatic artery provides flow to segments 1 (caudate lobe may have other blood supply), 5,6,7, and 8. Particular attention should be paid to the supraduodenal, retro-duodenal, retroportal and cystic arteries. 

Fig. 1.1. In a sagittal section through the left liver, the caudate lobe (segment 1) can be seen posterior to segments 2 and 3. Note the fine stippled texture of the hver s parenchyma. IVC, inferior vena cava RAT, right atrium...

The left pedicle runs almost horizontal and separates a quadrate lobe anteriorly and a caudate lobe... 

Fig. 4.2. Inferior aspect of the liver the round ligament continues into the umhilical portion of the left portal vein (at an anatomical landmark called Rex s recessus). The hepatic pedicle spreads out, near the liver, as a virtual space called the porta hepatis or hepatic hilum (defined by the bifurcation of the portal vein) and divides into a shorter right pedicle and a longer left pedicle. The left pedicle separates a quadrate lobe anteriorly and a round caudate lobe posteriorly and arches up as an umbilical portion to join the round ligament. Arantius ligament runs from the angle between the transverse portion and the umbilical portion of the left portal vein to the confluence of the left and middle hepatic veins. The right hepatic pedicle is in contact with the gallbladder that defines the right border of the quadrate lobe. Posteriorly the right hepatic pedicle is separated from the vena cava by a rim of liver tissue that corresponds to the right portion of the caudate lobe...

The right hepatic pedicle is in contact with the gallbladder that defines the right border of the quadrate lobe. Posteriorly the right hepatic pedicle is separated from the vena cava by a rim of liver tissue that corresponds to the right portion of the caudate lobe. 

A last segment is constituted by the liver tissue that lies between the posterior aspect of the portal bifurcation and the vena cava. This segment extends from the left (where it has a recognizable external identity in the form of the caudate lobe) to the right, around the vena cava, up to the confluence of the hepatic veins. This segment is fed by a series of smaller portal branches originating from the portal bifurcation before the takeoff of the right and left portal branches, and its parenchyma is drained by a variable number of separate hepatic veins directly into the vena cava. 

Kogure K, Kuwano H, Fujimaki N, et al. (2000) Relation among portal segmentation, proper hepatic vein, and external notch of the caudate lobe in the human liver. Ann Surg 231 223-228... 

The left portal vein initially courses anterior to the caudate lobe and describes a smooth arch from the main bifurcation to the round ligament. All liver tissue consisting of the concavity of the arch and the middle hepatic vein will be segment 4. On the convexity of the arch, on the left side (the left lobe of the descriptive anatomy) the distal part of the left hepatic vein will separate segment 2 (posteriorly and superiorly) from segment 3 (more anteriorly and in-feriorly). 

Left lobe Median lobe Right lobe Caudate lobe... 

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