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01-11-2009 | Vascular-Interventional

Anatomic variations of the hepatic arteries in 250 patients studied with 64-row CT angiography

Authors: Carlo Nicola De Cecco, Riccardo Ferrari, Marco Rengo, Pasquale Paolantonio, Fabrizio Vecchietti, Andrea Laghi

Published in: European Radiology | Issue 11/2009

Abstract

The aim of our study was to determine the frequency of different hepatic arterial variants identified on abdominal CT angiography (CTA) with a 64-row CT system and a high resolution protocol. A total of 250 consecutive abdominal CTAs performed on a 64-row CT system were evaluated. Two radiologists in consensus analyzed arterial phase images; the anatomical findings were grouped according to Michels’ classification. An anomalous arterial pattern was observed in 34% of the cases. The most common anomaly was Michels type III (9.2%), followed by types II and V (5.2%), type VI (4.0%), types IV, VII, and IX (2.0%), and type VIII (0.6%). No cases of type X were detected. Unclassified variations were observed in 3.3% of the cases. The new generation of 64-row MDCT allows optimal visualization of splanchnic vascular anomalies with a minimally invasive examination. This visualization is extended to those vessels with a small caliber and slow flow resulting in difficult recognition by classic angiographic studies. The knowledge of anomalous arterial patterns could be very useful in the preoperative planning of surgical and interventional liver procedures.

Kornblith PL, Boley SJ, Whitehouse BS (1992) Anatomy of the splanchnic circulation. Surg Clin North Am 72:1–30PubMed

Soin AS, Friend PJ, Rasmussen A, Saxena R, Tokat Y, Alexander GJM, Jamieson NV, Calne RY (1996) Donor arterial variations in liver transplantation: management and outcome of 527 consecutive grafts. Br J Surg 83:637–641CrossRefPubMed

Kadir S (1991) Atlas of normal and variant angiographic anatomy. Saunders, Philadelphia

Abouljoud MS, Kim DY, Yoshida A, Arenas J, Jerius J, Malinzak L, Raoufi M, Brown KA, Moonka DK (2005) Impact of aberrant arterial anatomy and location of anastomosis on technical outcomes after liver transplantation. J Gastrointest Surg 9:672–678CrossRefPubMed

VanDamme JP (1993) Behavioral anatomy of the abdominal arteries. Surg Clin North Am 73:699–725PubMed

Weiglein AH (1996) Variations and topography of the arteries in the lesser omentum in humans. Clin Anat 9:143–150CrossRefPubMed

Klingler PJ, Seelig MH, Floch NR, Branton SA, Freund MC, Katada N, Hinder RA (2004) Aberrant left hepatic artery in laparoscopic antireflux procedures. Surg Endosc 18:807–811CrossRefPubMed

Hemming AW, Finley RJ, Evans KG, Nelems B, Fradet G (1992) Esophagogastrectomy and the variant left hepatic artery. Ann Thorac Surg 54:166–168PubMed

Kapoor V, Brancatelli G, Federle MP, Katyal S, Marsh JW, Geller DA (2003) Multidetector CT arteriography with volumetric three-dimensional rendering to evaluate patients with metastatic colorectal disease for placement of a floxuridine infusion pump. AJR 181:455–463PubMed

10.

Allen PJ, Stojadinovic A, Ben-Porat L, Gonen M, Kooby D, Blumgart L, Paty P, Fong Y (2002) The management of variant arterial anatomy during hepatic arterial infusion pump placement. Ann Surg Oncol 9:875–880CrossRefPubMed

11.

Michels NA (1966) Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg 112:337–347CrossRefPubMed

12.

Laghi A, Iannaccone R, Catalano C, Passariello R (2001) Multislice spiral computed tomography angiography of mesenteric arteries. Lancet 358:638–639CrossRefPubMed

13.

Song SY, Chung JW, Lim HG, Park JH (2006) Nonhepatic arteries originating from the hepatic arteries: angiographic analysis in 250 patients. J Vasc Interv Radiol 17:461–469PubMedCrossRef

14.

Guiney MJ, Kruskal JB, Sosna J, Hanto DW, Goldberg SN, Raptopoulos V (2003) Multi-detector row CT of relevant vascular anatomy of the surgical plane in split-liver transplantation. Radiology 229:401–407CrossRefPubMed

15.

Brennan DD, Zamboni G, Sosna J, Callery MP, Vollmer CMV, Raptopoulos V, Kruskal JB (2007) Virtual Whipple: preoperative surgical planning with volume-rendered MDCT images to identify arterial variants relevant to the Whipple procedure. AJR 188:W451–W455CrossRefPubMed

16.

Kamel IR, Kruskal JB, Pomfret EA, Keogan MT, Warmbrand G, Raptopoulos V (2001) Impact of multidetector CT on donor selection and surgical planning before living adult right lobe liver transplantation. AJR 176:193–200PubMed

17.

Kawamoto S, Montgomery RA, Lawler LP, Horton KM, Fishman EK (2003) Multidetector CT angiography for preoperative evaluation of living laparoscopic kidney donors. AJR 180:1633–1638PubMed

18.

Covey AM, Brody LA, Maluccio MA, Getrajdman GI, Brown KT (2002) Variant hepatic arterial anatomy revisited: digital subtraction angiography performed in 600 patients. Radiology 224:542–547CrossRefPubMed

19.

Koops A, Wojciechowski B, Broering DC, Adam G, Krupski-Berdien G (2004) Anatomic variations of the hepatic arteries in 604 selective celiac and superior mesenteric angiographies. Surg Radiol Anat 26:239–244CrossRefPubMed

20.

Winston CB, Lee NA, Jarnagin WR, Teitcher J, DeMatteo RP, Fong Y, Blumgart LH (2007) CT angiography for delineation of celiac and superior mesenteric artery variants in patients undergoing hepatobiliary and pancreatic surgery. AJR 188:W13–W19CrossRef

21.

Coskun M, Kayahan EM, Özbek O, Çakır B, Dalgıç A, Haberal M (2005) Imaging of hepatic arterial anatomy for depicting vascular variations in living related liver transplant donor candidates with multidetector computed tomography: comparison with conventional angiography. Transplant Proc 37:1070–1073CrossRefPubMed

22.

Stemmler BJ, Paulson EK, Thornton FJ, Winters SR, Nelson RC, Clary BM (2004) Dual-phase 3D MDCT angiography for evaluation of the liver before hepatic resection. AJR 183:1551–1557PubMed

23.

Ishigami K, Yoshimitsu K, Irie H, Tajima T, Asayama Y, Hirakawa M, Honda H (2006) Accessory left gastric artery from left hepatic artery shown on MDCT and conventional angiography: correlation with CT hepatic arteriography. AJR 187:1002–1009CrossRefPubMed

24.

Kemeny MM, Hogan JM, Goldberg DA et al (1986) Continuous hepatic artery infusion with an implantable pump: problems with hepatic arterial anomalies. Surgery 99:501–504PubMed

25.

Uva P, Arvelakis A, Rodriguez-Laiz G, Lerner S, Emre S, Gondolesi G (2007) Common hepatic artery arising from the left gastric artery: a rare anatomic variation identified on a cadaveric liver donor. Surg Radiol Anat 29:93–95CrossRefPubMed

26.

Sahani DV, Krishnamurthy SK, Kalva S, Cusack J, Hahn PF, Santilli J, Saini S, Mueller PR (2004) Multidetector-row computed tomography angiography for planning intra-arterial chemotherapy pump placement in patients with colorectal metastases to the liver. J Comput Assist Tomogr 28:478–484CrossRefPubMed

27.

28.

Murthy R, Nunez R, Szklaruk J, Erwin W, Madoff DC, Gupta S, Ahrar K, Wallace MJ, Cohen A, Coldwell DM, Kennedy AS, Hicks ME (2005) Yttrium-90 microsphere therapy for hepatic malignancy: devices, indications, technical considerations, and potential complications. Radiographics 25:S41–S55CrossRefPubMed

Title: Anatomic variations of the hepatic arteries in 250 patients studied with 64-row CT angiography
Authors: Carlo Nicola De Cecco
Riccardo Ferrari
Marco Rengo
Pasquale Paolantonio
Fabrizio Vecchietti
Andrea Laghi
Publication date: 01-11-2009
Publisher: Springer-Verlag
Published in: European Radiology / Issue 11/2009
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-009-1458-7

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Anatomic variations of the hepatic arteries in 250 patients studied with 64-row CT angiography

Abstract

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Abstract

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