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Published online before print June 28, 2002, 10.1148/radiol.2242011283
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(Radiology 2002;224:542-547.)
© RSNA, 2002

Vascular and Interventional Radiology

Variant Hepatic Arterial Anatomy Revisited: Digital Subtraction Angiography Performed in 600 Patients1

Anne M. Covey, MD, Lynn A. Brody, MD, Mary A. Maluccio, MD, MPH, George I. Getrajdman, MD and Karen T. Brown, MD

1 From the Department of Diagnostic Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021 (A.M.C., L.A.B., G.I.G., K.T.B.); and Department of Surgery, New York Presbyterian Hospital, New York, NY (M.A.M.). Received July 26, 2001; revision requested September 4; revision received October 23; accepted December 11. Address correspondence to A.M.C. (e-mail: coveya@mskcc.org).

PURPOSE: To evaluate and describe the prevalence of hepatic arterial variants seen at digital subtraction angiography in a large series of patients.

MATERIALS AND METHODS: Data were collected prospectively by using an arterial anatomy database questionnaire that was completed at the time each visceral angiographic examination was performed from May 1996 to October 2000.

RESULTS: Six hundred patients underwent at least one visceral angiographic examination at one institution during the study period. Three hundred sixty-eight (61.3%) patients had the standard hepatic arterial anatomy. One hundred nineteen (19.8%) patients had variant left hepatic arteries (LHAs), and 89 (14.8%) had variant right hepatic arteries (RHAs). Twenty-eight (4.7%) patients had a variant anatomy involving both the LHA and the RHA. Twenty-four (4.0%) patients had a variant origin of the common hepatic artery (CHA) arising from either the superior mesenteric artery (SMA) or the aorta. In two patients, the proper hepatic artery (PHA) was the first branch of the SMA and the gastroduodenal artery (GDA) was a branch of the celiac axis. Double hepatic arteries were seen in 22 (3.7%) patients. Trifurcation or quadrifurcation of the GDA was seen in 50 (8.3%) patients, and the GDA originated distal to one hepatic artery in 25 (4.2%) patients in whom both hepatic arteries originated from the CHA.

CONCLUSION: A replaced LHA was less common than has been previously reported, and in two cases, the PHA arose from the SMA. Digital subtraction visceral angiographic results are comparable to results of seminal angiographic studies in which the cut-film technique was used.

© RSNA, 2002

Index terms: Angiography, 952.122 • Hepatic arteries, 952.132, 952.92




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