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Ligamentum venosum

The ligamentum venosum is a fibrous remnant of the ductus venosus, a vital fetal vascular channel that connects the left portal vein to the inferior vena cava (IVC) via the left hepatic vein, allowing oxygenated blood from the umbilical vein to bypass the liver and reach systemic circulation. After birth, the ductus venosus closes and is replaced by the ligamentum venosum.

Anatomically, the ligamentum venosum lies in the fissure for the ligamentum venosum on the inferior surface of the liver, separating the left lobe from the caudate lobe. It extends from the left branch of the portal vein upward to the IVC.

Clinically, it is an important surgical and radiologic landmark for segmental liver anatomy, particularly in identifying segment I (caudate lobe) and guiding hepatic resections, transplant surgery, and interventional radiology procedures.

Synonyms

  • Remnant of ductus venosus

  • Fibrous ligament of ductus venosus

  • Ligamentum venosum hepatis

Function

  • Remnant of fetal circulation that once shunted blood from umbilical vein to IVC

  • Acts as an anatomical landmark in liver segmentation, dividing the left lobe from the caudate lobe

  • Guides surgeons and radiologists in hepatic surgery and transplant planning

MRI Appearance

T1-weighted images:

  • Appears as a linear hypointense fibrous band between the left portal vein and IVC

  • Adjacent fat provides contrast to delineate the ligament

T2-weighted images:

  • Remains low signal intensity due to fibrous composition

  • Useful for distinguishing from vascular structures and cystic lesions

STIR:

  • Ligamentum venosum remains dark hypointense

  • Helps exclude surrounding edema or pathology, which appear hyperintense

T1 Fat-Saturated (Pre-contrast):

  • Linear fibrous band shows low signal intensity against suppressed fat background

  • Improves conspicuity within the hepatic fissure

T1 Fat-Saturated Post-Contrast (Gadolinium):

  • Ligament itself does not enhance, but surrounding vessels and parenchyma enhance

  • Helps confirm its fibrous, avascular nature

MRI Non-Contrast 3D Imaging:

  • Provides clear 3D visualization of the fissure of ligamentum venosum

  • Useful in segmental mapping for surgery or transplant

CT Appearance

CT Pre-Contrast:

  • Seen as a thin linear soft-tissue density within the fissure of ligamentum venosum

  • Sometimes better defined with adjacent fat planes

CT Post-Contrast:

  • Does not enhance significantly

  • Contrast highlights surrounding portal vein and IVC, making the ligament more conspicuous

  • Acts as a landmark in identifying caudate lobe boundaries

CT image

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