HEPATIC ARTERIAL ANATOMY VARIATIONS IN PATIENTS WITH HEPATOCELLULAR CARCINOMA EVALUATED BY COMPUTED TOMOGRAPHY
N Onashvili1, M Kutateladze1, N Tugushi1
1Tbilisi State Medical University, Department of Radiology; "Aversi Clinic" ltd; "S. Khechinashvili University Clinic"; University Clinical Department of Diagnostic and Interventional Radiology, Georgia.
Insights
Hepatocellular carcinoma patients frequently have hepatic arterial variations. Understanding these anomalies is crucial for planning liver surgery and endovascular procedures.
Area of Science:
- Radiology
- Vascular Anatomy
- Hepatobiliary Surgery
Background:
- Hepatocellular carcinoma (HCC) is a common liver malignancy.
- Hepatic arterial anatomy is critical for liver interventions like surgery and endovascular procedures.
Purpose of the Study:
- To determine the prevalence of hepatic arterial variations in patients with HCC.
- To assess the frequency of specific anatomical anomalies.
Main Methods:
- Analysis of multiphase Computed Tomography (CT) scans from 78 HCC patients.
- Identification and classification of hepatic arterial supply variations.
Main Results:
- 40 out of 78 patients (51.3%) exhibited hepatic arterial variations.
- Common variations included replaced right hepatic artery (RHA) from the superior mesenteric artery (SMA) in 14 patients and replaced left hepatic artery (LHA) to the left gastric artery (LGA) in 7 patients.
- Multiple variations were observed in 7 patients.
Conclusions:
- Hepatic arterial anatomical variations are highly prevalent in HCC patients.
- Preoperative imaging (CTA) for hepatic artery mapping is essential for safe and effective interventional procedures.
- Knowledge of these variations aids in surgical and endovascular planning.
Abstract:
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and one of the major reasons for performing percutaneous endovascular procedures or liver surgery. Hepatic arterial anatomy is of major importance in performing these procedures on the liver. The aim of our study was to estimate the prevalence of various hepatic arterial variants in HCC patients. 78 patients were included in the study. Abdominal multiphase Computed Tomography scans of all patients have been assessed for presence of the hepatic arterial supply anatomical variations. Prevalent variant of arterial anatomy in each group and subgroup has been determined. Standard anatomy was seen in 38 patients. The rest 40 patients had anatomical variations. Among those 7 patients had left hepatic artery (LHA) replaced to the left gastric artery (LGA). 14 patients were found to have replaced right hepatic artery (RHA) from the superior mesenteric artery (SMA). Replaced LHA and RHA were found in 1 patient. Accessory LHA originating from the left gastric artery was found in 5 patients. Accessory RHA arising from the SMA was seen in 5 patients. Simultaneous existence of the replaced RHA and accessory LHA was encountered in 6 cases. Preoperative knowledge of the range of hepatic arterial anomalies and their specific frequencies is of great importance in planning and performance of endovascular interventional procedures. High prevalence of the hepatic arterial anatomy variations favors performing pre-embolization and pre-surgical CTA for the mapping of the hepatic arteries and is in consensus with other authors.
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