Y Z Xie1, Jun Liu2, Gung Ho Chung3, Xue Kong4, Xiu Juan Li3, Li Tao Zhang5, Zhen Bo Ma4, Ok Hee Chai6, Hyoung Tae Kim6, Chang Ho Song7. 1. Department of Anatomy, Chonbuk National University Medical School, Jeonju, Republic of Korea; Department of Radiology, Taishan Medical University Taishan Hospital, Taian, China. 2. Department of Hepatobiliary Surgery, Taishan Medical University Taishan Hospital, Taian, China. 3. Department of Radiology, Chonbuk National University Medical School, Jeonju, Republic of Korea. 4. Department of Radiology, Taishan Medical University Taishan Hospital, Taian, China. 5. Department of Surgery, Chonbuk National University Medical School, Jeonju, Republic of Korea. 6. Department of Anatomy, Chonbuk National University Medical School, Jeonju, Republic of Korea. 7. Department of Anatomy, Chonbuk National University Medical School, Jeonju, Republic of Korea. Electronic address: asch@jbnu.ac.kr.
Abstract
AIM: To visualize the segment IV hepatic artery and to evaluate the variations in anatomy using multidetector computed tomography (MDCT) angiography. MATERIALS AND METHODS: Six hundred and seventeen patients (381 men and 236 women; mean age 62.7 ± 8.1 years; age range 22-92 years) who underwent MDCT angiography performed using a 128-section MDCT system were included in the study. The segment IV hepatic arteries of 453 patients with adequate image quality were displayed using volume rendering (VR), maximum intensity projection (MIP), and multiplanar reconstruction (MPR), and were analysed regarding the origination and variation of the arteries by two radiologists and an anatomist retrospectively. RESULTS: Segment IV arteries were categorized into five different types according to their points of origin: left hepatic artery (LHA, 51.66%), right hepatic artery (RHA, 30.68%), proper hepatic artery (PHA, 5.3%), dual (12.14%), and triple (0.22%). Segment IV arteries arising from normal LHA, RHA, and PHA were found in 73.73% of patients, and those arising from variant LHA or RHA were found in 26.27%. The patterns RN2, LA2, LA3, LA4, PN2, PV1, DA1, DA2, DV3, and DV4 were first reported in the present study. CONCLUSIONS: MDCT angiography can evaluate normal as well as anatomical variants of segment IV arteries. Predicting arterial patterns of segment IV of the liver is important in planning and performing all radiological and surgical procedures in the liver, especially in hemi-liver graft procedures.
AIM: To visualize the segment IV hepatic artery and to evaluate the variations in anatomy using multidetector computed tomography (MDCT) angiography. MATERIALS AND METHODS: Six hundred and seventeen patients (381 men and 236 women; mean age 62.7 ± 8.1 years; age range 22-92 years) who underwent MDCT angiography performed using a 128-section MDCT system were included in the study. The segment IV hepatic arteries of 453 patients with adequate image quality were displayed using volume rendering (VR), maximum intensity projection (MIP), and multiplanar reconstruction (MPR), and were analysed regarding the origination and variation of the arteries by two radiologists and an anatomist retrospectively. RESULTS: Segment IV arteries were categorized into five different types according to their points of origin: left hepatic artery (LHA, 51.66%), right hepatic artery (RHA, 30.68%), proper hepatic artery (PHA, 5.3%), dual (12.14%), and triple (0.22%). Segment IV arteries arising from normal LHA, RHA, and PHA were found in 73.73% of patients, and those arising from variant LHA or RHA were found in 26.27%. The patterns RN2, LA2, LA3, LA4, PN2, PV1, DA1, DA2, DV3, and DV4 were first reported in the present study. CONCLUSIONS: MDCT angiography can evaluate normal as well as anatomical variants of segment IV arteries. Predicting arterial patterns of segment IV of the liver is important in planning and performing all radiological and surgical procedures in the liver, especially in hemi-liver graft procedures.