Arunthathy Thangarajah1, Ramesh Parthasarathy2. 1. Assistant Professor, Department of Radiology, Sri Muthukumaran Medical College and Research Institute , Chikkarayapuram, Near Mangadu, Chennai, India . 2. Senior Resident, Department of Radiology, Sri Muthukumaran Medical College and Research Institute , Chikkarayapuram, Near Mangadu, Chennai, India .
Abstract
INTRODUCTION: With the increase in the hepatobiliary, pancreatic surgeries and liver transplantation, being aware of the anatomic variations of the celiac axis and the hepatic arteries is of paramount importance. AIM: To illustrate the normal anatomy and variants of the celiac axis and the hepatic arteries with multidetector computed tomographic (MDCT) angiography in South Indian population and determine the potential variations in the celiac axis anatomy and the hepatic arteries, thus assisting the hepatobiliary surgeon and the interventional radiologist in avoiding iatrogenic injury to the arteries. MATERIALS AND METHODS: Two hundred patients undergoing abdominal CT angiography from July 2014 till July 2015 were retrospectively studied for hepatic arterial and celiac axis anatomical variation. The anatomic variations in our study were correlated with other studies. RESULTS: The celiac axis (CA) and the hepatic artery (HA) variations were analysed as per criteria laid by Song et al., and Michel. Out of 15 possible CA variations, 5 types of celiac artery variations were seen in 14 patients. A normal CA was seen in 179(89.5%) patients of the 200 patients. In the remaining 7 patients, the CA anatomy was classified as ambiguous since there was separate origin of the right and left hepatic arteries from the CA with absent common hepatic artery (CHA). The CHA originated normally from the celiac axis in 94% of the cases. Variation of CHA origin was seen in 5 patients. Normal HA anatomy was seen in 114 (57%) patients. Variation in HA anatomy was seen in 86 (43%) patients. Origin of the right hepatic artery (RHA) from the hepatic artery proper was seen in 182 (91%) patients and replaced origin of RHA from the superior mesenteric artery (SMA) was seen in 18 (9%) of the cases. Accessory RHA was seen in 7(3.5%) patients. The left hepatic artery (LHA) originated from the hepatic artery proper in 186 (93%) patients and replaced origin of LHA from the left gastric artery (LGA) was found in 14 (7%) patients. Accessory left hepatic artery was found in 22(11%) cases. Double hepatic artery seen in 7(3.5%) patients. CHA replaced to LGA was seen in 1 patient (0.5%). CHA trifurcation was seen in 11 (5.5%) patients. CHA was replaced to SMA in 4 (2%) cases. CONCLUSION: Our study identified the normal anatomy and variations in celiac axis and hepatic arterial anatomy in South Indian population, which correlated well with studies in other populations.
INTRODUCTION: With the increase in the hepatobiliary, pancreatic surgeries and liver transplantation, being aware of the anatomic variations of the celiac axis and the hepatic arteries is of paramount importance. AIM: To illustrate the normal anatomy and variants of the celiac axis and the hepatic arteries with multidetector computed tomographic (MDCT) angiography in South Indian population and determine the potential variations in the celiac axis anatomy and the hepatic arteries, thus assisting the hepatobiliary surgeon and the interventional radiologist in avoiding iatrogenic injury to the arteries. MATERIALS AND METHODS: Two hundred patients undergoing abdominal CT angiography from July 2014 till July 2015 were retrospectively studied for hepatic arterial and celiac axis anatomical variation. The anatomic variations in our study were correlated with other studies. RESULTS: The celiac axis (CA) and the hepatic artery (HA) variations were analysed as per criteria laid by Song et al., and Michel. Out of 15 possible CA variations, 5 types of celiac artery variations were seen in 14 patients. A normal CA was seen in 179(89.5%) patients of the 200 patients. In the remaining 7 patients, the CA anatomy was classified as ambiguous since there was separate origin of the right and left hepatic arteries from the CA with absent common hepatic artery (CHA). The CHA originated normally from the celiac axis in 94% of the cases. Variation of CHA origin was seen in 5 patients. Normal HA anatomy was seen in 114 (57%) patients. Variation in HA anatomy was seen in 86 (43%) patients. Origin of the right hepatic artery (RHA) from the hepatic artery proper was seen in 182 (91%) patients and replaced origin of RHA from the superior mesenteric artery (SMA) was seen in 18 (9%) of the cases. Accessory RHA was seen in 7(3.5%) patients. The left hepatic artery (LHA) originated from the hepatic artery proper in 186 (93%) patients and replaced origin of LHA from the left gastric artery (LGA) was found in 14 (7%) patients. Accessory left hepatic artery was found in 22(11%) cases. Double hepatic artery seen in 7(3.5%) patients. CHA replaced to LGA was seen in 1 patient (0.5%). CHA trifurcation was seen in 11 (5.5%) patients. CHA was replaced to SMA in 4 (2%) cases. CONCLUSION: Our study identified the normal anatomy and variations in celiac axis and hepatic arterial anatomy in South Indian population, which correlated well with studies in other populations.
Authors: Soon-Young Song; Jin Wook Chung; Yong Hu Yin; Hwan Jun Jae; Hyo-Cheol Kim; Ung Bae Jeon; Baik Hwan Cho; Young Ho So; Jae Hyung Park Journal: Radiology Date: 2010-04 Impact factor: 11.105
Authors: Onofrio A Catalano; Anandkumar H Singh; Raul N Uppot; Peter F Hahn; Cristina R Ferrone; Dushyant V Sahani Journal: Radiographics Date: 2008 Mar-Apr Impact factor: 5.333
Authors: Nazli Erbay; Vassilios Raptopoulos; Elizabeth A Pomfret; Ihab R Kamel; Jonathan B Kruskal Journal: AJR Am J Roentgenol Date: 2003-07 Impact factor: 3.959
Authors: Tae Won Choi; Jin Wook Chung; Hyo-Cheol Kim; Myungsu Lee; Jin Woo Choi; Hwan Jun Jae; Saebeom Hur Journal: Radiol Cardiothorac Imaging Date: 2021-08-19
Authors: Shamir O Cawich; Alexander Sinanan; Maria Gosein; Neil Pearce; Rahul Deshpande; Fawwaz Mohammed; Vijay Naraynsingh; Maurice Fortune; Fidel Rampersad Journal: Radiol Res Pract Date: 2021-10-15