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Pediatr Radiol (2010) 40:438441 DOI 10.1007/s00247-009-1518-9
REVIEW
Cross-sectional imaging of pediatric biliary disorders
Kathleen H. Emery
# Springer-Verlag 2010
Abstract The liver is the largest organ in the abdomen taking up a relatively greater area in infants and young children. It is a unique organ with a dual blood supply and amazing regenerative capacity. The liver has a number of important functions with regard metabolism, detoxification, and immune function. The internal anatomy of this organ is orderly and highly structured around the basic functional unitthe hepatic lobule and portal triad. Numerous pathologic conditions can involve the liver. In this article, we will focus on etiologic, clinical, and cross-sectional imaging features of several childhood congenital and acquired disorders of one component of the portal triad the biliary system.
Keywords Choledochal cyst . Cystic biliary atresia . Sclerosing cholangitis . MRCP
Anatomy
The hepatic lobule is the basic functional unit of the liver. Anatomically the liver is divided into segments, classically
along planes depicted by the venous anatomy. Claude Couinaud, a French surgeon, is credited with defining the surgically relevant segmental anatomy that bears his name [1] and which is widely accepted as the preferred method of defining liver anatomy. The liver is divided into eight segments, each with its own portal venous supply and hepatic venous drainage [1]. Segment I is the caudate lobe that is situated between the fissure for the ligamentum venosum and the inferior vena cava. The middle hepatic vein divides the right and left portions of the liver into the remaining segments. Segments II, III, and IV constitute the left lobe (supplied by the left portal vein) and segments VVIII make up the right lobe (supplied by the right portal vein). The left hepatic vein divides segments III and IV anteriorly from segment II posteriorly. The falciform ligament defines the separation of segments III and IV. The right hepatic vein divides the anterior segments V and VIII from the posterior segments VI and VII in the right liver. These segments are further subdivided by the horizontal portion of the right portal vein into superior (VII and VIII) and inferior segments (V and VI).
Since the bile ducts are intimately associated with the portal venous branches, this segmental anatomic approach works well for...