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

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

doi:10.1590/0100-3984.2014.0100

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Original Articles • Radiol Bras 48 (6) • Nov-Dec 2015 • https://doi.org/10.1590/0100-3984.2014.0100 copy

Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography^* * Study developed at Universidade Federal da Paraíba (UFPB), João Pessoa, PB, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

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.

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

Study	Country	N of the study	Method	Normal pattern	Variation
Current study	Brazil	60	Multidetector CT	90%	10%
Iezzi et al.⁽⁹9 Iezzi R, Cotroneo AR, Giancristofaro D, et al. Multidetector-row CT angiographic imaging of the celiac trunk: anatomy and normal variants. Surg Radiol Anat. 2008;30:303-10.⁾	Italy	555	Multidetector CT	72.1%	27.9%
Koops et al.⁽¹⁸18 Koops A, Wojciechowski B, Broering DC, et al. Anatomic variations of the hepatic arteries in 604 selective celiac and superior mesenteric angiographies. Surg Radiol Anat. 2004;26:239-44.⁾	Germany	604	Multidetector CT	79.1%	20.9%
Panagouli et al.⁽¹⁰10 Panagouli E, Lolis E, Venieratos D. A morphometric study concerning the branching points of the main arteries in humans: relationships and correlations. Ann Anat. 2011;193:86-99.⁾	Greece, Caucasians	62	Cadaver dissection	88.5%	11.5%
Prakash et al.⁽³3 Prakash, Rajini T, Mokhasi V, et al. Coeliac trunk and its branches: anatomical variations and clinical implications. Singapore Med J. 2012;53:329-31.⁾	India	50	Cadaver dissection	86%	14%
Silveira et al.⁽¹¹11 Silveira LA, Silveira FBC, Fazan VPS. Arterial diameter of the celiac trunk and its branches. Anatomical study. Acta Cir Bras. 2009;24:43-7.⁾	Brazil	21	Cadaver dissection	71.4%	28.6%
Song et al.⁽¹³13 Song SY, Chung JW, Yin YH, et al. Celiac axis and common hepatic artery variations in 5002 patients: systematic analysis with spiral CT and DSA. Radiology. 2010;255:278-88.⁾	South Korea	5002	Multidetector CT	89.1%	10.1%
Sureka et al.⁽¹⁴14 Sureka B, Mittal M, Mittal A, et al. Variations of celiac axis, common hepatic artery and its branches in 600 patients. Indian J Radiol Imaging. 2013;23:223-33.⁾	India	600	Multidetector CT	94.5%	5.5%
Ugurel et al.⁽⁶6 Ugurel MS, Battal B, Bozlar U, et al. Anatomical variations of hepatic arterial system, coeliac trunk and renal arteries: an analysis with multidetector CT angiography. Br J Radiol. 2010;83:661-7.⁾	Turkey	100	Multidetector CT	89%	11%

Study	Country	N of the study	Method	Normal pattern	Variation
Perez-Saborido et al.⁽¹⁵15 Pérez-Saborido B, Pacheco-Sánchez D, Barrera Rebollo A, et al. Incidence of hepatic artery variations in liver transplantation: does it really influence short- and long- term results? Transplant Proc. 2012;44:2606-8.⁾	Spain	325	Surgical	78%	22%
Gumus et al.⁽¹⁶16 Gümüs H, Bükte Y, Özdemir E, et al. Variations of the celiac trunk and hepatic arteries: a study with 64-detector computed tomographic angiography. Eur Rev Med Pharmacol Sci. 2013;17:1636-41.⁾	Turkey	820	Multidetector CT	76.8%	23.2%
Sebben et al.⁽⁷7 Sebben GA, Rocha SL, Sebben MA, et al. Variações da artéria hepática: estudo anatômico em cadáveres. Rev Col Bras Cir. 2012;40:221-6.⁾	Brazil	30	Cadaver dissection	60%	40%
Freitas et al.⁽¹⁹19 Freitas ACT, Coelho JCU, Matias JEF, et al. Anatomia arterial hepática: estudo em 150 transplantes hepáticos. Rev Col Bras Cir. 2001;28:13-6.⁾	Brazil	246	Surgical	76.8%%	23.2%
Bertevello et al.⁽²⁰20 Bertevello PL, Chaib E. Variações do sistema arterial hepático e sua aplicabilidade na bipartição do fígado. Estudo anatômico em cadáveres. Arq Gastroenterol. 2002;39:81-5.⁾	Brazil	60	Cadaver dissection	68.3%	31.7%
Chambers et al.⁽¹⁷17 Chambers TP, Fishman EK, Bluemke DA, et al. Identification of the aberrant hepatic artery with axial spiral CT. J Vasc Interv Radiol. 1995;6:959-64.⁾	United States of America	50	Multidetector CT	84%	16%
Koops et al.⁽¹⁸18 Koops A, Wojciechowski B, Broering DC, et al. Anatomic variations of the hepatic arteries in 604 selective celiac and superior mesenteric angiographies. Surg Radiol Anat. 2004;26:239-44.⁾	Germany	604	Multidetector CT	79.1%	20.9%
Sureka et al.⁽¹⁴14 Sureka B, Mittal M, Mittal A, et al. Variations of celiac axis, common hepatic artery and its branches in 600 patients. Indian J Radiol Imaging. 2013;23:223-33.⁾	India	600	Multidetector CT	79.6%	20.4%
Song et al.⁽¹³13 Song SY, Chung JW, Yin YH, et al. Celiac axis and common hepatic artery variations in 5002 patients: systematic analysis with spiral CT and DSA. Radiology. 2010;255:278-88.⁾	South Korea	5002	Multidetector CT	58%	42%
Ugurel et al.⁽⁶6 Ugurel MS, Battal B, Bozlar U, et al. Anatomical variations of hepatic arterial system, coeliac trunk and renal arteries: an analysis with multidetector CT angiography. Br J Radiol. 2010;83:661-7.⁾	Turkey	100	Multidetector CT	52%	48%

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Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography* * Study developed at Universidade Federal da Paraíba (UFPB), João Pessoa, PB, Brazil.

Abstract

Objective:

Materials and Methods:

Results:

Conclusion:

Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography^* * Study developed at Universidade Federal da Paraíba (UFPB), João Pessoa, PB, Brazil.