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Fissure for ligamentum teres

The fissure for ligamentum teres is a narrow, sagittal groove on the visceral (inferior) surface of the liver extending from the inferior hepatic margin to the left portal vein at the porta hepatis. It contains the ligamentum teres hepatis (round ligament), the fibrotic remnant of the obliterated left umbilical vein. The fissure delineates the plane between left hepatic segments III (lateral) and IV (medial) and serves as a reliable external and internal landmark for segmental orientation in imaging and surgery.

Synonyms

  • Umbilical fissure of the liver

  • Fissure for the round ligament

  • Fissura ligamenti teretis

Function

  • Houses the ligamentum teres hepatis (fetal left umbilical vein remnant)

  • Serves as a lobar/segmental landmark separating left lateral (III) from left medial (IV) segments

  • Guides hepatic resection, transplantation, and interventional planning

MRI Appearance

T1-weighted images:

  • Ligamentum teres: thin low-signal fibrous cord.

  • Fissure as a whole: often a bright linear cleft because periligamentous fat within the groove is T1-hyperintense; the dark cord sits within this bright cleft.

T2-weighted images (corrected):

  • On standard (non–fat-sat) T2, fat is relatively high signal, so the fissure commonly appears as a hyperintense linear cleft; the **ligamentum teres itself remains a thin hypointense cord within it.

  • On fat-suppressed T2, the fat brightness is removed: the fissure/ligament complex appears low signal, and only fluid or edema in/adjacent to the fissure remains hyperintense.

STIR:

  • Fat is suppressed, making the ligamentum teres and fissure dark; edema, inflammation, or fluid along the fissure appears bright, improving detection of perifissural pathology.

T1 Fat-Saturated (Pre-contrast):

  • Ligament: low to intermediate signal; surrounding fat is suppressed, improving conspicuity of the cord and margins of the groove.

T1 Fat-Saturated Post-Contrast (Gadolinium):

  • Ligamentum teres shows no intrinsic enhancement (fibrous).

  • Adjacent parenchyma, vessels, or lesions enhance normally, helping confirm perifissural masses, fibrosis, or vascular encasement.

MRI Non-Contrast 3D Imaging:

  • Whole-liver 3D datasets clearly depict the course of the fissure from the inferior margin to the left portal vein, aiding preoperative segmental mapping.

CT Appearance

CT Pre-Contrast:

  • The fissure appears as a linear hypodense groove on the inferior surface; the ligamentum teres is a soft-tissue density strand within it.

CT Post-Contrast:

  • No intrinsic enhancement of the ligament; surrounding parenchymal enhancement delineates the cleft.

  • Helpful for assessing cirrhotic remodeling, lobar atrophy/hypertrophy, or lesions abutting/crossing the fissure.

CT 3D Reconstructions:

  • Sagittal/coronal MPRs and VR clearly show the sagittal groove separating segments III and IV, useful for segmental resection and transplant planning.

CT image

Fissure for ligamentum teres CT coronal image

MRI image

Fissure for ligamentum teres MRI axial anatomy image-img-00000-00000

MRI image

Fissure for ligamentum teres MRI coronal anatomy image-img-00000-00000