Topics

Topic

design image
Right hepatic vein

The right hepatic vein is the largest of the three major hepatic veins (along with the middle and left hepatic veins). It drains blood from the right lobe of the liver into the inferior vena cava (IVC) just below the diaphragm.

The RHV courses within the intersegmental plane between the anterior and posterior sectors of the right lobe. It is formed by the confluence of anterior tributaries (segments V and VIII) and posterior tributaries (segments VI and VII). Near the IVC, it has a short extrahepatic portion before entering the cava at the hepatic venous confluence.

Anatomically, the RHV is crucial because it defines the plane of right hepatectomy, separating anterior and posterior sectors. It is also a key reference in liver transplantation, hepatic resections, and interventional radiology. Accessory right hepatic veins may also drain directly into the IVC, which is an important surgical consideration.

Synonyms

  • RHV

  • Right vena hepatica

  • Major right hepatic vein

Function

  • Drains venous blood from the right hepatic lobe (segments V–VIII)

  • Serves as a boundary marker between right anterior and posterior sectors

  • Maintains venous outflow from the liver into the IVC

  • Provides essential landmarks for hepatic surgery and transplantation

Tributaries

  • Anterior tributaries: segments V and VIII

  • Posterior tributaries: segments VI and VII

  • Occasional accessory right hepatic veins draining directly into the IVC

MRI Appearance

T1-weighted images:

  • RHV appears as a signal void (black lumen) coursing toward the IVC

  • Surrounded by hyperintense perihepatic fat planes, aiding localization

T2-weighted images:

  • Flowing blood produces a signal void

  • Thrombosis, if present, appears intermediate-to-high signal intensity depending on clot age

STIR:

  • Suppresses fat to highlight venous structures against hepatic parenchyma

  • Perivenous edema or inflammatory changes appear hyperintense

T1 Post-Gadolinium (Gd-enhanced MRI):

  • RHV lumen enhances brightly and homogeneously with venous phase contrast

  • Filling defects indicate thrombus, tumor invasion (e.g., HCC, RCC extension), or stenosis

  • Helps confirm patency and surgical planning for venous outflow

MRI Non-Contrast 3D Cardiac/Respiratory-Gated Imaging:

  • Allows 3D visualization of RHV origin, course, and drainage into IVC

  • Useful in patients with contrast contraindications

  • Applied in pre-transplant venous mapping

MRA (Magnetic Resonance Angiography):

  • Contrast-enhanced MRA delineates hepatic venous anatomy, variants, and collateral pathways

  • Important for Budd–Chiari syndrome evaluation

CT Appearance

Non-contrast CT:

  • RHV appears as a tubular low-density structure within liver parenchyma, not always clearly visible without contrast

CT Post-Contrast (CT Venography / Hepatic Phase):

  • RHV enhances brightly in the venous phase, draining into the suprahepatic IVC

  • Multiplanar/3D reconstructions demonstrate intrahepatic tributaries, extrahepatic portion, and IVC confluence

  • Essential for detecting hepatic vein thrombosis, tumor invasion, stenosis, or accessory veins

  • Critical for transplant planning and hepatic segmental surgery

MRI images

Right hepatic vein anatomy MRI axial

MRI images

Right hepatic vein anatomy MRI coronal image -img-00000-00000

CT image

Right hepatic vein ct axial image