Published online before print April 3, 2003, 10.1148/radiol.2272012033
(Radiology 2003;227:391.)
A more recent version of this article appeared on May 1, 2003
Hepatic Arteries in Potential Donors for Living Related Liver Transplantation: Evaluation with Multi–Detector Row CT Angiography1
Seung Soo Lee, MD,
Tae Kyoung Kim, MD,
Jae Ho Byun, MD,
Hyun Kwon Ha, MD,
Pyo Nyun Kim, MD,
Ah Young Kim, MD,
Sung Gyu Lee, MD and
Moon-Gyu Lee, MD
1 From the Departments of Radiology (S.S.L., T.K.K., J.H.B., H.K.H., P.N.K., A.Y.K., M.G.L.) and Surgery (S.G.L), Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-dong, Songpa-gu, Seoul, 138-736, Korea. Received December 12, 2001; revision requested February 25, 2002; revision received July 8; accepted August 15. Address correspondence to T.K.K. (e-mail: tkkim@amc.seoul.kr).
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Figure 1a. Images in a 22-year-old man, a potential liver donor, with typical hepatic arterial anatomy. (a) Coronal oblique MIP image demonstrates the classic branching pattern of the hepatic artery. (Complete opacification of the hepatic artery was achieved at CT angiography.) Right and left hepatic arteries (thick straight arrows) arise from the proper hepatic artery (curved arrow). The artery (arrowheads) supplying segment IV is seen arising from the right hepatic artery. Second-order branches of both hepatic arteries (thin straight arrows) are also well depicted. (b) Conventional angiogram reveals findings identical to those seen at CT angiography, including the artery (arrowheads) to segment IV arising from the right hepatic artery.
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Figure 1b. Images in a 22-year-old man, a potential liver donor, with typical hepatic arterial anatomy. (a) Coronal oblique MIP image demonstrates the classic branching pattern of the hepatic artery. (Complete opacification of the hepatic artery was achieved at CT angiography.) Right and left hepatic arteries (thick straight arrows) arise from the proper hepatic artery (curved arrow). The artery (arrowheads) supplying segment IV is seen arising from the right hepatic artery. Second-order branches of both hepatic arteries (thin straight arrows) are also well depicted. (b) Conventional angiogram reveals findings identical to those seen at CT angiography, including the artery (arrowheads) to segment IV arising from the right hepatic artery.
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Figure 2a. Images in a 29-year-old man, a potential liver donor, with a replaced left hepatic artery arising from the left gastric artery and an accessory right hepatic artery arising from the gastroduodenal artery. (a) Volume-rendered coronal oblique CT image shows the replaced left hepatic artery (thin arrows) arising from the left gastric artery (black arrow). Second-order branches of the left hepatic artery are well visualized. The artery (arrowheads) supplying segment IV arises from the common hepatic artery (thick white arrow). (b) Coronal oblique targeted MIP image obtained at CT angiography with a slab thickness of 29 mm demonstrates that an accessory right hepatic artery (arrowheads) arises from the gastroduodenal artery (arrows). Although the proximal portion of this accessory artery is obscured by the inferior vena cava, the origin (black arrowhead) and peripheral portion (white arrowhead) of this artery are well visualized. (c) Conventional angiogram confirms the variations in hepatic arterial anatomy demonstrated at CT angiography, including the replaced left hepatic artery (arrows) and the accessory right hepatic artery (white arrowheads). The artery (black arrowheads) supplying segment IV arises from the common hepatic artery.
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Figure 2b. Images in a 29-year-old man, a potential liver donor, with a replaced left hepatic artery arising from the left gastric artery and an accessory right hepatic artery arising from the gastroduodenal artery. (a) Volume-rendered coronal oblique CT image shows the replaced left hepatic artery (thin arrows) arising from the left gastric artery (black arrow). Second-order branches of the left hepatic artery are well visualized. The artery (arrowheads) supplying segment IV arises from the common hepatic artery (thick white arrow). (b) Coronal oblique targeted MIP image obtained at CT angiography with a slab thickness of 29 mm demonstrates that an accessory right hepatic artery (arrowheads) arises from the gastroduodenal artery (arrows). Although the proximal portion of this accessory artery is obscured by the inferior vena cava, the origin (black arrowhead) and peripheral portion (white arrowhead) of this artery are well visualized. (c) Conventional angiogram confirms the variations in hepatic arterial anatomy demonstrated at CT angiography, including the replaced left hepatic artery (arrows) and the accessory right hepatic artery (white arrowheads). The artery (black arrowheads) supplying segment IV arises from the common hepatic artery.
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Figure 2c. Images in a 29-year-old man, a potential liver donor, with a replaced left hepatic artery arising from the left gastric artery and an accessory right hepatic artery arising from the gastroduodenal artery. (a) Volume-rendered coronal oblique CT image shows the replaced left hepatic artery (thin arrows) arising from the left gastric artery (black arrow). Second-order branches of the left hepatic artery are well visualized. The artery (arrowheads) supplying segment IV arises from the common hepatic artery (thick white arrow). (b) Coronal oblique targeted MIP image obtained at CT angiography with a slab thickness of 29 mm demonstrates that an accessory right hepatic artery (arrowheads) arises from the gastroduodenal artery (arrows). Although the proximal portion of this accessory artery is obscured by the inferior vena cava, the origin (black arrowhead) and peripheral portion (white arrowhead) of this artery are well visualized. (c) Conventional angiogram confirms the variations in hepatic arterial anatomy demonstrated at CT angiography, including the replaced left hepatic artery (arrows) and the accessory right hepatic artery (white arrowheads). The artery (black arrowheads) supplying segment IV arises from the common hepatic artery.
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Figure 3a. Images in a 27-year-old man, a potential liver donor, in whom an accessory right hepatic artery was missed at a technically inadequate CT angiographic examination. (a) Volume-rendered coronal oblique CT image shows severe respiratory motion artifact that interferes with evaluation of the hepatic arterial anatomy. (b) Conventional angiogram shows an accessory right hepatic artery (arrows) arising from the gastroduodenal artery.
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Figure 3b. Images in a 27-year-old man, a potential liver donor, in whom an accessory right hepatic artery was missed at a technically inadequate CT angiographic examination. (a) Volume-rendered coronal oblique CT image shows severe respiratory motion artifact that interferes with evaluation of the hepatic arterial anatomy. (b) Conventional angiogram shows an accessory right hepatic artery (arrows) arising from the gastroduodenal artery.
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Figure 4a. Images in a 39-year-old woman, a potential liver donor, in whom an accessory right hepatic artery was missed at CT angiography. (a) Volume-rendered coronal oblique CT image demonstrates normal hepatic arterial anatomy. Second-order branches of the left hepatic artery are not visualized, and only the anterior segmental branch (arrows) of the right hepatic artery is seen. Although the artery (arrowheads) supplying segment IV is faintly visualized, the origin of this artery cannot be determined. (b) Conventional angiogram demonstrates an accessory right hepatic artery (arrows) arising from the gastroduodenal artery and the artery (arrowheads) supplying segment IV arising from the left hepatic artery.
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Figure 4b. Images in a 39-year-old woman, a potential liver donor, in whom an accessory right hepatic artery was missed at CT angiography. (a) Volume-rendered coronal oblique CT image demonstrates normal hepatic arterial anatomy. Second-order branches of the left hepatic artery are not visualized, and only the anterior segmental branch (arrows) of the right hepatic artery is seen. Although the artery (arrowheads) supplying segment IV is faintly visualized, the origin of this artery cannot be determined. (b) Conventional angiogram demonstrates an accessory right hepatic artery (arrows) arising from the gastroduodenal artery and the artery (arrowheads) supplying segment IV arising from the left hepatic artery.
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Figure 5a. Images in a 26-year-old woman, a potential liver donor, in whom the right hepatic artery arose directly from the celiac trunk. (a) Volume-rendered coronal oblique CT image shows a variation in the hepatic arterial anatomy. The right hepatic artery (arrows) arises directly from the celiac trunk, and the common hepatic artery, which arises from the celiac artery, bifurcates into the gastroduodenal and the left hepatic arteries. Second-order branches of both hepatic arteries are well visualized, and the artery (arrowheads) supplying segment IV is clearly visualized arising from the left hepatic artery. (b) Conventional angiogram confirms the hepatic arterial anatomic variation demonstrated at CT angiography. The branching pattern of the right (arrows) and left hepatic arteries, as well as the origin of the artery (arrowheads) supplying segment IV, are identical to those seen at CT angiography.
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Figure 5b. Images in a 26-year-old woman, a potential liver donor, in whom the right hepatic artery arose directly from the celiac trunk. (a) Volume-rendered coronal oblique CT image shows a variation in the hepatic arterial anatomy. The right hepatic artery (arrows) arises directly from the celiac trunk, and the common hepatic artery, which arises from the celiac artery, bifurcates into the gastroduodenal and the left hepatic arteries. Second-order branches of both hepatic arteries are well visualized, and the artery (arrowheads) supplying segment IV is clearly visualized arising from the left hepatic artery. (b) Conventional angiogram confirms the hepatic arterial anatomic variation demonstrated at CT angiography. The branching pattern of the right (arrows) and left hepatic arteries, as well as the origin of the artery (arrowheads) supplying segment IV, are identical to those seen at CT angiography.
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Copyright © 2003 by the Radiological Society of North America.
