[The liver. Anatomo-radiologic review]

Abstract

A precise knowledge of the sectorial anatomy of the liver and its variations is essential in order to be able to localize lesions in the parenchyma and to guide segmental resection of the liver. The hepatic systematization proposed by Couinaud and the nomenclature of the segments, which are numbered from I to VIII, are of obvious practical value and are used routinely by surgeons and radiologists. However, they do not take into account the exact position of the liver in the abdominal cavity. For this reason, we prefer to use a topographical nomenclature, based on J. Hureau's classification, consisting of a right posterior column, corresponding to Couinaud's right lateral sector (segments VI and VII), a right lateral column, corresponding to the right paramedian sector (segments V and VIII), a right paramedian column, corresponding to segment IV, a left lobe column, corresponding to segments III and II, and a dorsal sector corresponding to the caudate lobe or segment I. This nomenclature, which takes into account the position of the liver in the abdominal cavity, constitutes a compromise between the Anglo-Saxon nomenclature and Couinaud's segmental classification. It clearly emphasizes the posterior nature of the right lateral sector, the lateral position of the right para-median sector and the anterior position of the two sectors of the left lobe.