Anatomy and clinical importance of cholecystic venous drainage

Helical CT observations during injection of contrast medium into the cholecystic artery

Kengo Yoshimitsu, Hiroshi Honda, Kuniyuki Kaneko, Toshiro Kuroiwa, Hiroyuki Irie, Kazuo Chijiiwa, Kenji Takenaka, Kouji Masuda

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study was to use helical CT to elucidate the anatomy and clinical importance of cholecystic venous drainage. SUBJECTS AND METHODS. We performed helical CT of the upper abdomen during injection of contrast medium through a superselectively catheterized cholecystic artery (cholecystic artery CT) in 28 patients, all of whom were surgical candidates for suspected hepatobiliary abnormality. In nine of these patients, CT during arterial portography (CTAP) was also performed. RESULTS. Cholecystic venous blood most frequently entered peripheral portal branches of hepatic segment V (27 of 28 patients, 96%) and segment IV (26 of 28, 93%). In order of decreasing frequency, cholecystic venous blood also drained to segments I, VI, VIII, III, and VII. Cholecystic venous blood subsequently drained into the middle hepatic vein (21 of 28, 75%) or right hepatic vein (20 of 28, 71%). In two patients with adenocarcinoma involving the gallbladder associated with multiple liver metastases, cholecystic venous drainage was seen around each metastatic focus. In the nine patients in whom both cholecystic artery CT and CTAP were performed, nontumorous portal perfusion defects were attributable to cholecystic venous drainage. CONCLUSION. Recognition of cholecystic venous drainage as a possible pathway for spread of disease from the gallbladder to the liver and also as one of the causes of non-tumorous portal perfusion defects seen on CTAP is important.

Original languageEnglish
Pages (from-to)505-510
Number of pages6
JournalAmerican Journal of Roentgenology
Volume169
Issue number2
DOIs
Publication statusPublished - Jan 1 1997

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Spiral Computed Tomography
Gallbladder
Contrast Media
Drainage
Anatomy
Arteries
Injections
Portography
Hepatic Veins
Liver
Perfusion
Gallbladder Diseases
Abdomen
Adenocarcinoma
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Anatomy and clinical importance of cholecystic venous drainage : Helical CT observations during injection of contrast medium into the cholecystic artery. / Yoshimitsu, Kengo; Honda, Hiroshi; Kaneko, Kuniyuki; Kuroiwa, Toshiro; Irie, Hiroyuki; Chijiiwa, Kazuo; Takenaka, Kenji; Masuda, Kouji.

In: American Journal of Roentgenology, Vol. 169, No. 2, 01.01.1997, p. 505-510.

Research output: Contribution to journalArticle

Yoshimitsu, Kengo ; Honda, Hiroshi ; Kaneko, Kuniyuki ; Kuroiwa, Toshiro ; Irie, Hiroyuki ; Chijiiwa, Kazuo ; Takenaka, Kenji ; Masuda, Kouji. / Anatomy and clinical importance of cholecystic venous drainage : Helical CT observations during injection of contrast medium into the cholecystic artery. In: American Journal of Roentgenology. 1997 ; Vol. 169, No. 2. pp. 505-510.
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AB - OBJECTIVE. The purpose of this study was to use helical CT to elucidate the anatomy and clinical importance of cholecystic venous drainage. SUBJECTS AND METHODS. We performed helical CT of the upper abdomen during injection of contrast medium through a superselectively catheterized cholecystic artery (cholecystic artery CT) in 28 patients, all of whom were surgical candidates for suspected hepatobiliary abnormality. In nine of these patients, CT during arterial portography (CTAP) was also performed. RESULTS. Cholecystic venous blood most frequently entered peripheral portal branches of hepatic segment V (27 of 28 patients, 96%) and segment IV (26 of 28, 93%). In order of decreasing frequency, cholecystic venous blood also drained to segments I, VI, VIII, III, and VII. Cholecystic venous blood subsequently drained into the middle hepatic vein (21 of 28, 75%) or right hepatic vein (20 of 28, 71%). In two patients with adenocarcinoma involving the gallbladder associated with multiple liver metastases, cholecystic venous drainage was seen around each metastatic focus. In the nine patients in whom both cholecystic artery CT and CTAP were performed, nontumorous portal perfusion defects were attributable to cholecystic venous drainage. CONCLUSION. Recognition of cholecystic venous drainage as a possible pathway for spread of disease from the gallbladder to the liver and also as one of the causes of non-tumorous portal perfusion defects seen on CTAP is important.

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