Study of anatomical variations of hepatic vasculature using multidetector computed tomography angiography
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ORIGINAL ARTICLE
Study of anatomical variations of hepatic vasculature using multidetector computed tomography angiography Abeer Syed Anwar1 · Jwala Srikala1 · Amber S Papalkar1 · Mohd Qurram Parveez2,3 · Ankur Sharma2 Received: 6 April 2020 / Accepted: 9 July 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Purpose Preoperative evaluation of the hepatic vasculature is necessary to minimize mortality and morbidity during various surgeries due to the complexity of liver anatomy. The purpose of our investigation is to determine the anatomical variations in the hepatic vascular system by using multidetector computed tomography. Methods In this observational study, 500 patients aged between 1 and 86 years were randomly chosen from a patient population referred for computed tomography angiography for various clinical indications. Multidetector computed tomography angiography examinations were performed using a 128 detector scanner. The area from the lower thoracic spine to symphysis pubis level, with the patient in a supine position, was adopted as the field of view. The percentage of occurrence of each of the vascular variant was determined. Results Normal arterial anatomy [Type I] was seen in 306 patients [61.2%]. Replaced left hepatic artery from the left gastric artery was the most common variant in our study, which was seen in 57 patients [11.4%]. Classic hepatic venous anatomy was found in 261 [52.2%] patients. An accessory inferior right hepatic vein was found in 110 [22%] patients. A large early branch of segment VIII into middle hepatic vein was found in 157 patients [31.4%]. Extraparenchymal branching of the right anterior portal vein from the left portal vein was the most common anomaly found in 12 [2.4%] patients. Conclusions Computed tomography angiography can be used in preoperative evaluation in various hepatobiliary surgeries and interventional procedures, which give a lot of information regarding parenchyma and vascular system. Keywords Hepatic vasculature · Liver · Multidetector computed tomography · Angiography
Introduction
* Ankur Sharma [email protected] Abeer Syed Anwar [email protected] Jwala Srikala [email protected] Amber S Papalkar [email protected] Mohd Qurram Parveez [email protected] 1
Krishna Institute of Medical Sciences, Secunderabad, India
2
Institute of Liver and Biliary Sciences, New Delhi, India
3
Present Address: Northwick Park Hospital, Harrow, UK
Hepatic vascular variants have been subject to research for many decades. In 1955, Michel devised a classification for hepatic artery variants after dissecting 200 cadavers [14]. Knowledge of anatomical variations of the hepatic vasculature is of utmost importance in the surgical planning and success of liver transplantation. Preoperative evaluation of hepatic vascular anatomy has importance in other surgeries also like hepatic resection, laparoscopic cholecystectomy, and in interventional procedures like transcatheter arterial chemoembolization [TACE], transar
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