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Published on: September 13, 2014
The hepatic capsular arteries: imaging features and clinical significance
Kenji Ibukuro1, Masaya Mori2, Keiichi Akita3
1Department of Radiology, School of Medicine, Nihon University, 30-1, Oyaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan. kj-ibkr@qd6.so-net.ne.jp.
Insights
Hepatic capsular arteries form a vascular network on the liver surface, crucial for collateral circulation and subcapsular hematomas. These arteries connect intra- and extra-hepatic vessels, aiding blood supply during hepatic artery occlusion.
Area of Science:
- Vascular anatomy
- Radiology
- Surgical anatomy
Background:
- Hepatic capsular arteries' anatomical features are known, but their radiological and clinical significance remains under-documented.
- This study aims to elucidate the radiological and clinical importance of hepatic capsular arteries.
Purpose of the Study:
- To investigate the anatomical and functional significance of hepatic capsular arteries.
- To highlight their role in collateral circulation and clinical conditions like subcapsular hematomas.
Main Methods:
- Barium sulfate injection into cadaveric intra- and extra-hepatic arteries to visualize hepatic capsular arteries.
- Review of radiology database and clinical cases to assess clinical relevance.
Main Results:
- Hepatic capsular arteries, derived from peripheral hepatic arteries, form a web-like network on the liver surface.
- Anastomoses exist between intra- and extra-hepatic arteries (inferior phrenic, superior falciform ligament, cystic arteries) via hepatic capsular arteries.
- Collateral vessels develop via hepatic capsular arteries during hepatic artery occlusion, and bleeding from them can extend subcapsular hematomas.
Conclusions:
- Hepatic capsular arteries form a significant vascular network on the liver surface.
- They play a vital role in collateral circulation in various clinical scenarios, including hepatic artery occlusion.
- Understanding these arteries is crucial for managing conditions involving subcapsular hematomas and liver vasculature.
Background:
Although the anatomical features of the hepatic capsular arteries have been previously reported, the radiological and clinical importance of these arteries has not been well documented.
Imaging Findings:
We injected barium sulfate into the intra- and extra-hepatic arteries in cadavers to investigate the hepatic capsular arteries. The web-like hepatic capsular arteries derived from the capsular branch of the peripheral hepatic arteries are called isolated arteries. There were anastomoses between the intra- and extra-hepatic arteries (inferior phrenic artery, superior falciform ligament artery, and cystic artery) through the hepatic capsular arteries.
Clinical Significance:
We reviewed the radiology database and assessed clinical cases. When the hepatic artery is occluded, the collateral vessels, such as the inferior phrenic artery and the superior falciform ligament artery, develop via the hepatic capsular arteries at the right triangular ligament and falciform ligament, respectively. Bleeding from capsular arteries causes extensions of the subcapsular hematoma.
Conclusion:
The hepatic capsular arteries spread along the hepatic surface and constitute the vascular network throughout the liver. These arteries play an important role in collateral circulation in various clinical situations, as well as subcapsular hematoma.
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