Quick Links
How   to   cite   this   Article:    Pallavi,   Ravichandra   V.    AN   EVALUATION   OF   VARIATIONS   OF   THE   RIGHT   HEPATIC   ARTERY   USING   MULTI   DETECTOR COMPUTED TOMOGRAPHY (MDCT).  Int J Anatomy Res 2016;4(4):3122-3128. DOI: 10.16965/ijar.2016.416.
Type of Article: Original Research DOI: http://dx.doi.org/10.16965/ijar.2016.416 Page No.:  3122-3128
AN EVALUATION OF VARIATIONS OF THE RIGHT HEPATIC ARTERY USING MULTI DETECTOR COMPUTED TOMOGRAPHY (MDCT) Pallavi * 1 , Ravichandra V 2 . *1 Assistant Professor, Department of Anatomy, Father Muller Medical College, Mangalore, Karnataka, India. 2  Associate Professor, Department of Pharmacology, K.S Hegde Medical Academy, Deralakatte, Mangalore, Karnataka, India. Address   for   correspondence:   Dr.Pallavi,   Assistant   Professor,   Department   of   Anatomy,   Father   Muller   Medical   College,   Kankanady,   Mangalore   –   575002, Karnataka, India. E-Mail:  dr.m_pallavi@yahoo.co.in ABSTRACT: Background:    The   study   on   the   variations   of   the   hepatic   artery   dates   back   to   1917   when   Lipshutz   B   reported   the   variations   of   celiac   artery   and   its   branches. These   variations   result   from   the   persistence   and/or   abnormal   regression   of   parts   of   primitive   arterial   system.   Owing   to   the   greater   variability   of   the   right intrahepatic   vascular   anatomy,   resections   extensively   involving   the   right   hepatic   lobe   rely   heavily   on   preoperative   assessment   of   origin   and   branching pattern of right hepatic artery (RHA). Aim:    The   present   study   was   intended   to   provide   numerical   parameters   of   the   frequency   of   occurrence   of   the   right   hepatic   artery   variations   in   a   given   study population. Materials   and   Methods:    The   present   study   was   conducted   using   Multi   detector   computed   tomography   (MDCT)   angiography   images   of   200   patients,   in   the department   of   Radiodiagnosis   and   imaging,   Kasturba   medical   college,   Manipal,   India.   MDCT   arterial   phase   images   of   abdominal   aorta   done   for   various clinical indications routinely were evaluated to describe the origin and branching pattern of the RHA. Presence of an accessory RHA was documented. Results:    Variations   in   the   origin   of   the   RHA   were   encountered   in   26   cases   (13%)   out   of   which,   16   were   male   patients   and   10   were   female   patients.   RHA arose   from   the   superior   mesenteric   artery   (SMA)   in   19   cases   (9.5%),   directly   from   the   coeliac   trunk   in   one   case   (0.5%)   and   aorta   in   one   case   (0.5%). Accessory RHA arising from the SMA was seen in 5 cases (2.5%). Conclusion:    A   detailed   knowledge   of   the   hepatic   angioarchitecture   is   considered   a   prerequisite   for   planning   and   conducting   uncomplicated   biliary   tract operations,   liver   transplants,   chemo-embolization   of   a   liver   neoplasm,   as   well   as   other   procedures   performed   in   this   region.   Hepatic   arterial   anatomy   must be defined precisely to ensure optimal donor hepatectomy and graft revascularization. KEY WORDS: right hepatic artery, variations, MDCT, right hepatic lobe resection, accessory hepatic arteries. References 1 . Frachon SC, Scoazec JY. Vascular development and differentiation during   human liver organogenesis. Anat Rec. 2008;291(Suppl 6):614-627. 2 . Seco   M,   Donato   P,   Costa   J,   Bernardes   A,   Caseiro-Alves   F.   Vascular   liver   anatomy   and   main   variants:   what   the   radiologist   must    know.   JBR-BTR. 2010;93(Suppl 4):215-223. 3 . Lang    H,    Radtke    A,    Hindennach    M    et    al.,    Impact    of    virtual    tumor    resection    and    computer    assisted    risk    analysis    on    operation    planning    and intraoperative strategy in major hepatic resection.  Arch Surg. 2005;140 (Suppl 7):629-638. 4 . Covey   AM,   Brody   LA,   Maluccio   MA,   Brown   KT.   Variant   hepatic   arterial   anatomy   revisited:   digital   subtraction   angiography   performed   in   600   patients. Radiology. 2002;224(Suppl 2):542-547. 5 . Stemmler   B   J,   Paulson   EK,   Thornton   FJ,   Winters   SR,   Nelson   RC,   Clary   BM.   Dual-phase   3D   MDCT   angiography   for   evaluation   of   the   liver   before   hepatic resection. AJR. 2004;183(Suppl 6):1551-1557. 6 . Prabhasavat   K,   Homgade   C.   Variation   of   hepatic   artery   by   3D   reconstruction   MDCT   scan   of   liver   in   Siriraj   hospital.   J   Med   Assoc   Thai.   2008;91(Suppl 11):1748-1752. 7 . McDonald   DB,   Haider   MA,   Khalili   K,   Kim   TK,   O’Malley   M,   Greig   PD   et   al.,   Relationship   between   vascular   and   biliary   anatomy      in   living   liver   donors.   AJR. 2005;185(Suppl 1):247-252. 8 . Ugurel   MS,   Battal   B,   Bozlar   U,   Nural   MS,   Tasar   M,   Ors   F,   Saglam   M   and   Karademir   I.   Anatomical   variations   of   hepatic   arterial   system,   coeliac   trunk   and renal arteries: an analysis with multidetector CT angiography. The British Journal of Radiology. 2010;83(Suppl 992):661-667. 9 . Winter   TC,   Nghiem   HV,   Freeny   PC,   Hommeyer   SC,   Mack   LA.   Hepatic   arterial   anatomy:   Demonstration   of   normal   supply   and   vascular   variants   with three-dimensional CT angiography. Radiographics. 1995;15 (Suppl 4):771-780. 1 0 . Rawat   K   S.   CT   angiography   in   evaluation   of   vascular   anatomy   and   prevalence   of   vascular   variants   in   upper   abdomen   in   cancer   patients.   IJRI. 2006;16(Suppl 4):457- 461.  1 1 . Sahani   D,   Saini   S,   Pena   C,   Nichols   S,   Prasad   SR,   Hahn   PF   et   al.,   Using   multidetector   CT   for   preoperative   vascular   evaluation   of   liver   neoplasms: Technique and results. AJR, 2002;179(1): 53-59. 1 2 . Bhardwaj N. Anomalous origins of hepatic artery and its significance for hepatobiliary surgery. J. Anat. Soc. India 2010;5(Suppl 2):173-176. 1 3 . Lee   SS,   Kim   TK,   Byun   JH,   Ha   HK,   Kim   PN,   Kim   AY,   Lee   SG,   Lee   MG.   Hepatic   arteries   in   potential   donors   for   living   related   Liver   transplantation: Evaluation with multi-detector row CT angiography. Radiology. 2003;227(Suppl 2):391-399. 1 4 . Erbay   N,   Raptopoulos   V,   Pomfret   EA,   Kamel   IR.   Living   donor   liver   transplantation   in   adults;   vascular   variants   important   in   surgical   planning   for   donors and recipients. AJR Am J Roentgenol. 2003;181(Suppl 1):109-114. 1 5 . Michels N.A. Newer anatomy of the liver and variant blood supply and collateral circulation. Am. J. Surg. 1966;112(Suppl 3):337-347. 1 6 . Erden   A,   Düşünceli   E,   Üstüner   E,   Genç   Y.   The   significance   of   the   right   hepatic   artery   originating   from   the   superior   mesenteric   artery   in   patients   with cavernous transformation of the portal vein.  Diagn Interv Radiol. 2009;15 (Suppl 1):31–35. 1 7 . Yoshida   A,   Okuda   K,   Sakai   H,   Kinoshita   H,   Aoyagi   S.   3D   anatomical   variations   of   hepatic   vasculature   and   bile   duct   for   right   lateral   sector   of   liver   with special reference to transplantation. Kurume Medical Journal. 2008; 55(Suppl 3-4):43-53. 1 8 . Xiao XU, Zheng S. Variations and reconstruction of the hepatic artery in liver transplantation. Hepatobiliary Pancreat Dis Int. 2006;5(Suppl 2):170-172. 1 9 . Moon   JJ,   Wijdicks   CA,   Williams   JM.   Right   hepatic   artery   branching   off   the   superior   mesenteric   artery   and   its   potential   implications.   International Journal of Anatomical Variations. 2009;2:143-146. 2 0 . Jones RM, Hardy KJ. The hepatic artery: a reminder of surgical anatomy. J.R.Coll.Surg.Edinb., 2001;46(Suppl 3):168-170. 21. Bertevello PL, Chaib E. Hepatic artery system variations correlated to split-liver surgery: anatomic study in cadavers. Arq Gastroenterology. 2002;39(Suppl 2):81-85.
Volume 4 |Issue 4.2 |  2016 Date of Publication:  30 November 2016