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Left branch of hepatic portal vein

The left branch of the hepatic portal vein is the major intrahepatic division of the portal vein that supplies the left lobe of the liver. After the portal vein enters the porta hepatis, it bifurcates into right and left branches. The left portal vein courses horizontally to the left, running within the hepatoduodenal ligament and then into the left lobe.

It further divides into medial (segment IV) and lateral (segments II and III) branches. A small caudate lobe branch (segment I) may also arise from the left portal vein in many individuals. The left branch forms intrahepatic portal venous arcades with the right portal vein in some cases, contributing to collateral circulation.

This vessel is crucial in portal hypertension, hepatic resections, liver transplantation, and interventional radiology procedures (e.g., TIPS, embolization).

Synonyms

  • Left portal vein

  • Ramus sinister venae portae hepatis

  • Left intrahepatic portal vein branch

Function

  • Supplies portal venous blood (nutrient-rich blood from GI tract and spleen) to the left lobe of liver (segments II, III, IV ± I)

  • Contributes to metabolic and detoxification processes in the left lobe

  • Plays an essential role in liver resections, transplant planning, and shunt procedures

MRI Appearance

T1-weighted images:

  • Left portal vein appears as a flow void (dark lumen) running horizontally toward left lobe

  • Surrounded by bright periportal fat, aiding identification

T2-weighted images:

  • Lumen appears as a signal void; thrombus appears as intermediate or hyperintense depending on clot age

STIR:

  • Suppresses fat signal, delineating the vessel course more clearly

  • Highlights surrounding edema or inflammation as bright hyperintensity

T1 Fat-Saturated (Pre-contrast):

  • Lumen demonstrates intermediate signal, standing out against suppressed fat planes in the porta hepatis

T1 Fat-Saturated Post-Contrast (Gadolinium):

  • Left portal vein enhances brightly in the portal venous phase

  • Useful in evaluating patency, thrombosis, tumor invasion, or collateral formation

MRV (Magnetic Resonance Venography):

  • Demonstrates portal vein bifurcation and intrahepatic branching

  • Provides 3D mapping of left portal venous system and segmental distribution

  • Valuable in portal hypertension assessment, pre-transplant mapping, and venous obstruction

CT Appearance

CT Pre-Contrast:

  • Left portal vein visible as a tubular soft-tissue density in porta hepatis and left lobe

  • Thrombosis may appear as hyperdense intraluminal material

CT Post-Contrast:

  • Enhances during portal venous phase, showing the horizontal course and segmental branches

  • Detects patency, thrombosis, cavernous transformation, or tumor encasement

CTV (CT Venography):

  • Gold standard for non-invasive evaluation of portal venous system

  • Provides detailed 3D reconstructions of left branch course, segmental distribution, and variants

  • Critical in surgical planning (hepatic resection, transplant), portal hypertension, and TIPS procedures

MRI images

Left branch of hepatic portal vein MRI coronal anatomy image -img-00000-00000

MRI images

Left branch of hepatic portal vein MRI sag anatomy image -img-00000-00000

CT image

Left branch of hepatic portal vein ct axial anatomy image -img-00000-00000

CT image

Left branch of hepatic portal vein ct image