Boundaries Between Subsegments Iva And Ivb In The Human Liver

The posterior segment consists of subsegment VII cranially and subsegment VI caudally.

Liver Ultrasound Anatomy

The right lobe of the liver is highly variable in its caudal extent.

Segment Liver
► 71 Left lobe of liver, lateral segment, heart
Human Hearet Segments

► 72 Left lobe of liver, lateral segment, heart

Liver Anatomy Ultrasound

The left lobe of the liver is in close proximity to the heart, separated from it only by the diaphragm.

Iva And Ivb

The anatomical left lobe of the liver corresponds to the lateral hepatic segment.

Heptic Lobe Laterial Segment
► 73 Left lobe of liver, lateral segment, hepatic veins
Boundaries The Caudate Lobe
► 74 Left lobe of liver, lateral segment, caudate lobe

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28 VIII

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The left hepatic vein marks the boundary between the lateral and medial hepatic segments.

Liver Segments Ultrasound

The cranial part of the lateral hepatic segment is designated as subsegment II.

Boundaries The Caudate Lobe
► 75 Left lobe of liver, lateral segment, caudate lobe
Boundaries The Caudate Lobe
► 76 Left lobe of liver, lateral segment, left portal vein branch
Liver Segments Ultrasound

In scanning down the left lobe of the liver, the left branch of the portal vein marks the boundary between the cranial and caudal subsegments of the lobe.

Segments Left Lobe Liveer
► 77 Left lobe of liver, lateral segment, ligamentum teres
Ligamentum Teres Liver
► 78 Left lobe of liver, subsegment III, ligamentum teres
Ultrasound Liver Anatomy

Ligamentum teres presents a triangular or polygonal shape in cross section. It marks the boundary between subsegment III and the quadrate lobe, which is designated as subsegment IVb.

Quadrate Lobe Ultrasound

► 79 Medial and anterior hepatic segments, opening of hepatic veins

Ligamentum Teres Ultrasound

► 80 Medial and anterior hepatic segments, opening of hepatic veins

Ultrasound Transverse Ligamentum Teres
96

The hepatic veins converge and enter the vena cava just below the diaphragm.

Ultrasound Transverse Ligamentum Teres

The opening of the hepatic veins at the vena cava forms a typical stellate pattern in transverse section.

Caudate Lobe Inferior Vena Cava
► 81 Medial and anterior hepatic segments, hepatic veins, caudate lobe
Haepatic Segments
► 82 Medial and anterior hepatic segments, hepatic veins, caudate lobe
Boundaries The Caudate Lobe

The upper pole of the caudate lobe extends to a point just below the opening of the hepatic veins into the vena cava.

Boundaries The Caudate Lobe

The three hepatic veins define the boundaries between the lateral, medial, anterior, and posterior segments of the liver.

Boundaries The Caudate Lobe

► 83 Medial and anterior hepatic segments, caudate lobe

Caudate Lobe Portal Vein Ultrasound

► 84 Medial and anterior hepatic segments, left portal vein branch, caudate lobe

Caudate Lobe Liver
The caudate lobe of the liver is designated as subsegment I.
Venae Porta Ultrasound Anatomy

► 85 Medial and anterior hepatic segments, left portal vein branch, caudate lobe

Caudate Lobe Portal Vein Ultrasound

► 86 Medial and anterior hepatic segments, left portal vein branch, caudate lobe

Liver Segments Ultrasound Picture

The upper subsegments of the lateral and medial hepatic segments are designated as subsegment II and subsegment IVa, respectively.

Hepatic Segments

► 87 Medial and anterior hepatic segments, bifurcation of portal vein

Hepatic Segments

► 88 Medial and anterior hepatic segments, bifurcation of portal vein

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The upper subsegments of the anterior and posterior hepatic segments are designated as subsegments VIII and VII.

Portal Vein Ultrasound Exclamation Mark

The bifurcation of the portal vein is located just anterior to the vena cava.

Right Portal Vein Anterior Ultrasound

► 89 Medial and anterior hepatic segments, right portal vein branch

Right Portal Vein Anterior Ultrasound

► 90 Medial and anterior hepatic segments, right and left portal vein branches

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Right Portal Vein Anterior Ultrasound

The division of the portal vein into right and left branches marks the approximate boundary between the upper and lower subsegments.

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The division of the portal vein into right and left branches shows an antler-like configuration on ultrasound.

Right Portal Vein Anterior Ultrasound

► 91 Medial and anterior hepatic segments, right and left portal vein branches

Right Portal Vein Anterior Ultrasound

► 92 Medial and anterior hepatic segments, quadrate lobe, ligamentum teres, portal vein

Transverse Liver Segments Ultrasound

The right portal vein branch initially runs slightly caudally from the bifurcation.

Liver Segmental Anatomy Ultrasound

Ligamentum teres marks the boundary plane between the right and left lobes of the liver.

Ligamentum Teres Liver

► 93 Medial and anterior hepatic segments, quadrate lobe, ligamentum teres, portal vein

Ligamentum Teres Ultrasound

► 94 Medial and anterior hepatic segments, quadrate lobe, ligamentum teres, gallbladder

Ligamentum Teres Ultrasound

The lower subsegments of the lateral, medial, anterior, and posterior hepatic segments are designated, respectively, subsegments III, IVb, V, and VI.

Ligamentum Teres Ultrasound

The gallbladder and ligamentum teres form the boundary structures of the quadrate lobe in transverse section.

Ligamentum Teres Hepatis Ultrasound

► 95 Medial and anterior hepatic segments, quadrate lobe, ligamentum teres, gallbladder

Ultrasound Ligament Teres

► 96 Inferior border of liver, kidney, gallbladder, ligamentum teres

Ultrasound Anatomy Kidneys

The shape of the inferior hepatic border is influenced by the kidney, the gallbladder, and the groove for ligamentum teres.

Ultrasound Ligmentum Teres
► 97 Posterior segment, upper subsegment
Couinads Liver Portal Vein Segments
► 98 Posterior segment, portal vein
Shaped Neck Veins

The upper subsegment of the posterior hepatic segment is designated as subsegment VII.

Portal Vein Ultrasound Exclamation Mark

The right portal vein branch marks the approximate boundary between subsegment VII cranially and subsegment Vcaudally.

Portal Vein Ultrasound Exclamation Mark
► 99 Posterior segment, lower subsegment, kidney
Portal Vein Ultrasound Exclamation Mark
► 100 Posterior segment, inferior border

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The lower subsegment of the posterior hepatic segment is designated as subsegment VI.

Segment Liver

The right lobe of the liver is highly variable in its inferior extent.

Gallbladder in Upper Abdominal Transverse Sections

101 Right portal vein branch, ligamentum venosum

102 Gallbladder neck

103 Junction of neck and body of gallbladder

104 Body of gallbladder

105 Gallbladder fundus

106 Gallbladder fundus, inferior border

Gallbladder in Longitudinal Sections

107 Vena cava, duodenum, bifurcation of portal vein

108 Right portal vein branch, duodenum, gallbladder body

109 Right portal vein branch, body and neck of gallbladder

110 Body and fundus of gallbladder, kidney

111 Gallbladder fundus, kidney

112 Gallbladder fundus, kidney

Details of the Gallbladder

113 Regions of the gallbladder, spiral folds

114 Layers of the gallbladder wall

Ligamentum Venosum
► 101 Right portal vein branch, ligamentum venosum
Ultrasound Ligament Teres
► 102 Gallbladder neck
Ligamentum Venosum

The interlobar fissure (*), located anterior to the right portal vein branch, is the landmark for identifying the gallbladder.

Gallbladder Fold

The neck of the gallbladder is located just caudal to the right portal vein branch and the interlobar fissure.

Spiral Folds The Gallbladder
► 103 Junction of neck and body of gallbladder
Ultrasound Quadratus Lomborum
► 104 Body of gallbladder
Neck Anatomy Ultrasound

In a transverse scan through the body of the gallbladder, the duodenum is located between the gallbladder and the vena cava.

Human Gallbladder Location

The duodenal bulb can consistently be identified on the free peritoneal side of the body or neck of the gallbladder.

Ultrasound Abdomen Anatomy Pic
► 106 Gallbladder fundus, inferior border
Ultrasound Abdomen Anatomy Pic

The gallbladder fundus may extend almost to the anterior abdominal wall, but it may also be placed very deeply behind the liver.

Ultrasound Abdomen Anatomy Pic

The right colic flexure often impresses on the caudal surface of the gallbladder fundus.

Left Colic Flexure
► 107 Vena cava, duodenum, bifurcation of portal vein
Anatomy Duodenum Landmarks
► 108 Right portal vein branch, duodenum, gallbladder body
Bifurcation Vena Cava

The vena cava, the portal bifurcation, and the echodense band of the interlobar fissure provide conspicuous landmarks for locating the gallbladder in longitudinal section.

Gallbladder Interlobar Fissure

The duodenum is adjacent to the gallbladder posteriorly and to the right colic flexure caudally.

Colic Flexure Ultrasound
► 109 Right portal vein branch, body and neck of gallbladder
Gallbladder With Portal Vein
► 110 Body and fundus of gallbladder, kidney
Size Gallbladder Wall Ultrasound

The shape and position of the gallbladder are highly variable. However, the neck of the gallbladder is always located in the porta hepatis, caudal to the right portal vein branch.

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The healthy gallbladder is typically a pear-shaped, fluid-filled organ that contains no internal echoes.

Anatomical Landmarks The Kidneys
► 111 Gallbladder fundus, kidney
Gallbladder Fold
► 112 Gallbladder fundus, kidney

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A wedge of liver tissue, variable in size, is interposed between the gallbladder and kidney in longitudinal section.

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In a more lateral scan, the gallbladder may be in direct contact with the kidney.

Right Renal Artery Ultrasound Location
► 113 Regions of gallbladder, spiral folds
Porta Hepatis Measurements Ultrasound

► 114 Layers of gallbladder wall

Gallbladder Wall Layers

The anterior wall of the gallbladder consists of three identifiable layers. Usually the posterior wall of the gallbladder is poorly demarcated from the duodenum.

115 Duodenum lateral to head of pancreas

116 Head of pancreas, bile duct

117 Head of pancreas, bile duct

118 Head of pancreas, hilar vessels, vena cava ] 119 Head of pancreas, superior mesenteric vein, uncinate process 120 Head of pancreas, superior mesenteric vein, uncinate process H 121 Body of pancreas, splenic vein

-| 122 Body of pancreas, splenic vein, superior mesenteric artery, aorta iqJ 123 Body of pancreas, splenic vein

124 Tail of pancreas, splenic artery and vein, renal artery and vein

I_t 125 Tail of pancreas, splenic artery and vein, renal artery and vein

126 Tail of pancreas

Head of the Pancreas in Transverse Sections

127 Section cranial to head of pancreas, vena cava, splenic vein

128 Head of pancreas, vena cava, superior mesenteric vein

129 Head of pancreas, vena cava, superior mesenteric vein, uncinate process, common bile duct

130 Head of pancreas, vena cava, superior mesenteric vein, uncinate process, gallbladder

Body of the Pancreas in Transverse Sections

131 Scan cranial to body of pancreas, celiac trunk

132 Body of pancreas, splenic vein

133 Body of pancreas, splenic vein, superior mesenteric artery, aorta

134 Left renal artery and vein, superior mesenteric artery and vein, aorta

Tail of the Pancreas in Transverse Sections

135 Tail of pancreas, splenic artery

136 Tail of pancreas, splenic vein

137 Tail of pancreas, gas in stomach

138 Tail of pancreas

Transsplenic View of the Tail of the Pancreas in Longitudinal Sections

139 Scan posterior to tail of pancreas, spleen, kidney

140 Spleen, tail of pancreas, kidney

141 Spleen, tail of pancreas, kidney

142 Scan anterior to tail of pancreas, spleen, stomach

Transsplenic View of the Tail of the Pancreas in Transverse Sections

143 Spleen, tail of pancreas, kidney

144 Spleen, tail of pancreas, kidney

Details of the Pancreas

145 Transverse scan of pancreatic duct

146 Longitudinal scan of pancreatic duct

Longitudinal Image Pancreas
► 115 Duodenum lateral to head of pancreas
Head Ultrasound Anatomy
► 116 Head of pancreas, bile duct

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The head of the pancreas lies in the duodenal loop of the duodenum and is bounded laterally by the duodenum.

Cranial Ultrasound Anatomy

The bile duct, hepatic artery, and portal vein are located cranial to the head of the pancreas.

Pancreatic Duct Anatomy Ultrasound
► 117 Head of pancreas, bile duct
Vena Cava Pancreas Anatomy
► 118 Head of pancreas, hilar vessels, vena cava
Vena Cava Pancreas Anatomy

The head of the pancreas lies against the anterior surface of the vena cava and is bordered cranially by the main trunk of the portal vein.

Uncinate Process The Pancreas
► 119 Head of pancreas, superior mesenteric vein, uncinate process
Superior Mesenteric Vein Ultrasound
► 120 Head of pancreas, superior mesenteric vein, uncinate process
Pancreas Anatomy Ultrasound
The superior mesenteric vein marks the boundary between the head and body of the pancreas.
Ultrasound Images Spleen
► 121 Body of pancreas, splenic vein
Splenic Artery Ultrasound Longitudinal

► 122 Body of pancreas, splenic vein, superior mesenteric artery, aorta

► 122 Body of pancreas, splenic vein, superior mesenteric artery, aorta

Splenic Vein Ultrasound

The celiac trunk is cranially adjacent to the body of the pancreas. The splenic vein and body of the pancreas cross over the superior mesenteric artery.

Imaging The Splenic Artery And Vein
► 123 Body of pancreas, splenic vein
Splenic Artery Ultrasound Longitudinal
► 124 Tail of pancreas, splenic artery and vein, renal artery and vein
Imaging The Splenic Artery And Vein

A longitudinal scan at the junction of the body and tail of the pancreas displays four vessels in cross section: the splenic artery, splenic vein, renal artery, and renal vein.

Splenic Artery Ultrasound Longitudinal
► 125 Tail of pancreas, splenic artery and vein, renal artery and vein
Anatomy Tail Vein
► 126 Tail of pancreas
Cross Sectional Celiac Artery

The tail of the pancreas often has a plump appearance in cross section.

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The tail of the pancreas can be completely visualized in an anterior scan only if acoustic conditions are good.

Vena Cava Pancreas Anatomy
► 127 Section cranial to head of pancreas, vena cava, splenic vein
Vena Cava Pancreas Anatomy
► 128 Head of pancreas, vena cava, superior mesenteric vein
Echo Images Superior Vena Cava

The body of the pancreas overlies the superior mesenteric vein. All parts of the gland that lie to the right of the superior mesenteric vein are designated as the head of the pancreas.

Uncinate Process Ultrasound

The uncinate process extends between the vena cava and superior mesenteric vein.

Common Bile Duct Ultrasound Transverse

► 129 Head of pancreas, vena cava, superior mesenteric vein, uncinate process, common bile duct

Vena Cava Pancreas Anatomy

► 130 Head of pancreas, vena cava, superior mesenteric vein, uncinate process, gallbladder

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The common bile duct is visible at the right border of the pancreatic head in transverse section.

The head of the pancreas lies between the liver, gallbladder, vena cava, and superior mesenteric vein.

► 131 Scan cranial to body of pancreas, celiac trunk
► 132 Body of pancreas, splenic vein

The borders of the healthy pancreas form a continuous outline from head to body to tail.

► 133 Body of pancreas, splenic vein, superior mesenteric artery, aorta

► 134 Left renal artery and vein, superior mesenteric artery and vein, aorta

The splen ic vein is the landmark for locating the pancreas. The superior mesenteric artery lies between the splenic vein and the aorta, appearing as an echo-free spot surrounded by bright echoes.

When the renal vessels are displayed in a transverse scan, usually the pancreas is no longer visualized.

► 135 Tail of pancreas, splenic artery
► 136 Tail of pancreas, splenic vein

The tail of the pancreas is angled sharply posterior from the body and extends a variable distance between the stomach and the upper renal pole toward the splenic hilum.

► 137 Tail of pancreas, gas in stomach
► 138 Tail of pancreas

The junction between the body and tail of the pancreas is located at the level of the left aortic margin.

The tail of the pancreas is the most difficult part of the gland to evaluate with ultrasound.

► 139 Scan posterior to tail of pancreas, spleen, kidney
► 140 Spleen, tail of pancreas, kidney

The tail of the pancreas is scanned intercostally through the spleen. Kidney and spleen serve as landmarks.

The tail of the pancreas is located in the splenic hilum between the spleen and the kidney.

► 141 Spleen, tail of pancreas, kidney
► 142 Scan anterior to tail of pancreas, spleen, stomach

Interference from bowel gas is often encountered caudal to the tail of the pancreas.

The stomach is a source of numerous artifacts anterior to the tail of the pancreas.

► 143 Spleen, tail of pancreas, kidney
► 144 Spleen, tail of pancreas, kidney

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In transverse sections as well, the spleen is used as an acoustic window for scanning the tail of the pancreas.

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The tail of the pancreas lies in an angle between the spleen and the kidney.

► 145 Transverse scan of pancreatic duct
► 146 Longitudinal scan of pancreatic duct

The pancreatic duct has a variable course. It usually runs in the ventrocranial part of the parenchyma, appearing sonographically as two parallel echogenic lines.

In this plane the pancreatic duct appears as a fine, tubular structure with a luminal diameter up to 3 mm. It is located slightly anterior to the center of the gland.

Longitudinal Flank Scans of the Spleen

147 Spleen, kidney

148 Splenic hilum, splenic vein

149 Spleen, stomach

150 Spleen, stomach

Transverse Flank Scans of the Spleen

151 Spleen, kidney, stomach

152 Spleen, kidney, pancreas

153 Spleen, stomach

154 Spleen, small bowel

Details of the Spleen

155 Accessory spleen

156 Accessory spleen

► 148 Splenic hilum, splenic vein

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The spleen is identified in the longitudinal flank scan as a rounded triangle between the upper renal pole and the diaphragm.

A flank scan at the level of the hilum displays the spleen in its greatest longitudinal dimension.

► 149 Spleen, stomach
► 150 Spleen, stomach

The spleen lies against the stomach anteriorly and medially.

The spleen exhibits a typical crescent shape in an anterior flank scan.

► 151 Spleen, kidney, pancreas, stomach
► 152 Spleen, kidney, pancreas

A high transverse flank scan demonstrates the typical triad of the spleen, kidney, and stomach.

The tail of the pancreas can usually be identified in the splenic hilum next to the splenic vessels.

► 153 Spleen, stomach
► 154 Spleen, small bowel

The spleen may be deeply lobulated by septa.

Loops of small bowel are located medial to the lower pole of the spleen.

► 155 Accessory spleen
► 156 Accessory spleen

Accessory spleens are most commonly found in the hilar region.

An accessory spleen is occasionally found at the lower pole.

Longitudinal Flank Scans of the Right Kidney from Posterior to Anterior

157 Kidney, liver

158 Kidney, liver, colic flexure

159 Kidney, renal vein, liver

160 Kidney, renal vein, liver

Transverse Flank Scans of the Right Kidney from Above Downward

161 Kidney, liver, psoas muscle, quadratus lumborum muscle

162 Kidney, liver, psoas muscle, quadratus lumborum muscle

Upper Abdominal Longitudinal Scans of the Right Kidney from Right to Left

163 Kidney, liver

164 Kidney, liver, colic flexure

165 Kidney, renal vein, colon

166 Kidney, renal vein, colon

Upper Abdominal Transverse Scans of the Right Kidney from Above Downward

167 Kidney, renal vein, vena cava, liver

168 Kidney, renal vein, renal artery, vena cava, liver

Longitudinal Flank Scans of the Left Kidney from Posterior to Anterior

169 Kidney, spleen, psoas muscle

170 Kidney, spleen, psoas muscle

171 Kidney, spleen, psoas muscle

172 Kidney, renal vein, spleen, aorta

Transverse Flank Scans of the Left Kidney from Above Downward

173 Kidney, spleen, bowel

174 Kidney, spleen, psoas muscle

Details of the Kidneys

175 Medullary pyramids

176 Collecting system

► 158 Kidney, liver, colic flexure

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The central echo complex of the kidney is a summation effect produced by the pyelocaliceal system, blood vessels, lymphatics, fatty tissue, and the renal sinus.

► 159 Kidney, renal vein, liver
► 160 Kidney, renal vein, liver

The fibrous renal capsule cannot be visualized with ultrasound.

► 161 Kidney, liver, psoas muscle, quadratus lumborum muscle
► 162 Kidney, liver, psoas muscle, quadratus lumborum muscle

The posterior aspect of the right kidney lies in an angle between the spinal column, musculature, and right lobe of the liver.

*quadratus / lumborum / muscle /

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The kidney is located anterior to the quadratus lumborum muscle and lateral to the psoas major muscle.

► 164 Kidney, liver, colic flexure

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Unlike the left kidney, the right kidney is readily scanned from the anterior aspect by using the liver as an acoustic window.

"quadratus lumborum muscle

"quadratus lumborum muscle

The right lobe of the liver covers the kidney anteriorly. The right colic flexure and duodenum also overlie the kidney, especially its caudal half.

► 165 Kidney, renal vein, colon
► 166 Kidney, renal vein, colon
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Responses

  • taziana
    What is posterior to gallbladder on ultrasound?
    5 years ago
  • alberic hogpen
    Where is the fundus and neck of a transverse image of the gallbladder?
    5 years ago
  • kristian
    Where is liver kidneys?
    4 years ago
  • chilimanzar
    Where is the anterior and posterior portal vein ultrasound?
    2 years ago

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