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. 2015 Nov-Dec;48(6):358-62.
doi: 10.1590/0100-3984.2014.0100.

Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography

Severino Aires Araujo Neto  1 , Henrique Almeida Franca  2 , Carlos Fernando de Mello Júnior  3 , Eulâmpio José Silva Neto  4 , Gustavo Ramalho Pessoa Negromonte  2 , Cláudia Martina Araújo Duarte  2 , Bartolomeu Fragoso Cavalcanti Neto  2 , Rebeca Danielly da Fonseca Farias  2
Affiliations

Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography

Severino Aires Araujo Neto et al. Radiol Bras. 2015 Nov-Dec.

Abstract
in English, Portuguese

Objective: To analyze the prevalence of anatomical variations of celiac arterial trunk (CAT) branches and hepatic arterial system (HAS), as well as the CAT diameter, length and distance to the superior mesenteric artery.

Materials and methods: Retrospective, cross-sectional and predominantly descriptive study based on the analysis of multidetector computed tomography images of 60 patients.

Results: The celiac trunk anatomy was normal in 90% of cases. Hepatosplenic trunk was found in 8.3% of patients, and hepatogastric trunk in 1.7%. Variation of the HAS was observed in 21.7% of cases, including anomalous location of the right hepatic artery in 8.3% of cases, and of the left hepatic artery, in 5%. Also, cases of joint relocation of right and left hepatic arteries, and trifurcation of the proper hepatic artery were observed, respectively, in 3 (5%) and 2 (3.3%) patients. Mean length and caliber of the CAT were 2.3 cm and 0.8 cm, respectively. Mean distance between CAT and superior mesenteric artery was 1.2 cm (standard deviation = 4.08). A significant correlation was observed between CAT diameter and length, and CAT diameter and distance to superior mesenteric artery.

Conclusion: The pattern of CAT variations and diameter corroborate the majority of the literature data. However, this does not happen in relation to the HAS.

Objetivo: Analisar a prevalência de variações anatômicas da ramificação do tronco arterial celíaco (TAC) e do sistema arterial hepático (SAH), o diâmetro e comprimento do TAC e sua distância para a artéria mesentérica superior.

Materiais e métodos: Estudo retrospectivo, transversal, predominantemente descritivo, baseado na análise de imagens de tomografia computadorizada de 60 pacientes.

Resultados: A anatomia do TAC foi normal em 90% dos casos. Cinco (8,3%) pacientes apresentaram o tronco hepatoesplênico e um (1,7%) apresentou o tronco hepatogástrico. O SAH variou em 21,7% dos casos. Desses, 8,3% foram na localização anômala da artéria hepática direita e 5% da artéria hepática esquerda. Ainda foram encontrados 3 (5%) casos de relocalização conjunta da artéria hepática direita e artéria hepática esquerda e 2 (3,3%) de trifurcação da artéria hepática própria. A média de comprimento e o calibre médio do TAC foram, respectivamente, 2,33 cm e 0,8 cm. A distância média entre o TAC e a artéria mesentérica superior foi 1,2 cm, com desviopadrão de 4,08. Houve correlação significativa entre diâmetro e comprimento do TAC, e diâmetro do TAC e distância deste para a artéria mesentérica superior.

Conclusão: O padrão de variação do TAC e seu diâmetro corroboram a maioria dos dados da literatura, embora o mesmo não tenha ocorrido em relação ao SAH.

Keywords: Anatomy; Celiac trunk; Hepatic artery; Multidetector computed tomography.

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Figures

Figure 1
Figure 1
Contrast-enhanced CT with volume rendering shows normal anatomy of the celiac trunk comprising the left gastric artery (LGA), splenic artery (SA) and common hepatic artery (CHA).
Figure 2
Figure 2
Contrast-enhanced CT with volume rendering demonstrating hepatosplenic trunk with left gastric artery (LGA) originating in the aorta, immediately above the trunk. The splenic artery (SA) and common hepatic artery (CHA) originate from the same trunk.
Figure 3
Figure 3
Contrast-enhanced CT with volume rendering showing normal anatomy of the hepatic arterial system. Common hepatic artery (CHA) originating the hepatic artery proper (HAP), after emergence of the gastroduodenal artery (GDA), right hepatic artery (RHA) and left hepatic artery (LHA) originating from HAP.
Figure 4
Figure 4
Contrast-enhanced CT with volume rendering identifying variation of the right hepatic artery (RHA) that emerges from the superior mesenteric artery (SMA). (LGA, left gastric artery; SA, splenic artery; HAP, hepatic artery proper; GDA, gastroduodenal artery).
Figure 5
Figure 5
Axial, contrast-enhanced CT showing the longer length of the celiac trunk observed in the present study.
Figure 6
Figure 6
Axial contrast-enhanced CT showing the largest diameter observed in the present study.
See this image and copyright information in PMC

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