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Published on: July 21, 2023
Evaluation of Celiac Trunk, Hepatic Artery Variations, and Their Collateral Arteries by Multi-Slice Computed
Fatih Cankal1, Mustafa Kaya2, Mehmet Ali Guner3
1Department of Anatomy, Ankara Medipol University Faculty of Medicine, Ankara, Turkey.
Insights
This study measured distances between the diaphragm and celiac trunk (CT) and its arteries, finding no significant correlation between CT variations and collateral formations. These anatomical measurements are crucial for abdominal surgeries and interventional radiology.
Area of Science:
- Vascular anatomy
- Radiology
- Surgical anatomy
Background:
- The celiac trunk (CT) is a critical artery supplying the upper abdomen.
- Accurate anatomical knowledge of the CT and its relationship with surrounding structures is vital for surgical and interventional procedures.
- Previous studies have insufficiently explored the distances between diaphragmatic crus and vascular structures.
Purpose of the Study:
- To measure distances between the diaphragmatic crus and the celiac trunk (CT) and its associated vascular structures.
- To determine the diameters of the CT and the main hepatic artery.
- To investigate potential relationships between vascular variations, collateral branches, and patient demographics.
Main Methods:
- Retrospective analysis of Multi-Section Computed Tomography (MSCT) imaging from 200 patients.
- Measurement of distances between diaphragmatic crus and vascular structures, and their diameters.
- Statistical evaluation using Spearman's Rho Correlation Coefficient Test to assess relationships between CT variations, collaterals, age, and gender.
Main Results:
- Mean distance from diaphragmatic crus to CT: 24.3 mm; CT to SMA: 8.6 mm.
- Mean CT diameter: 7.3 mm; Mean main hepatic artery diameter: 4.1 mm.
- No significant correlation found between CT/hepatic artery variations and their collaterals (p>0.05); however, a trend suggested increased collaterals in specific accessory left hepatic artery variations (p=0.1).
Conclusions:
- The study provides valuable anatomical measurements of the diaphragmatic crus-vascular structures, addressing a gap in existing literature.
- The observed frequencies of CT and hepatic artery variations align with previous findings in non-malignancy patient cohorts.
- These detailed anatomical data enhance understanding for surgical planning and interventional radiology in the upper abdomen.
Objectives:
Celiac Trunk (CT) is a vital artery and the first unmatched branch of the abdominal aorta, providing blood to upper abdominal structures, particularly the liver, stomach, and spleen. It is essential to know its anatomy in terms of pancreas, spleen, gallbladder, liver surgeries, and interventional radiological procedures such as chemoembolization. The aim of our study is to contribute to the literature with the measurements of distances between the diaphragmatic crus and vascular structures with their diameters, which have been studied insufficiently, and to detect the possible relationships between vascular variations and collateral branches.
Methods:
Imaging findings of 200 patients (114 males and 86 females), who underwent Multi-Section Computed Tomography examination with various indications in our center between June 2016 and July 2020, were retrospectively analyzed. The statistical relations between CT and Hepatic Artery variations, collateral formations, age, and gender were evaluated with the Spearman's Rho Correlation Coefficient Test.
Results:
The distance between the crus of diaphragm and CT was 4-60 mm (mean 24.3 mm), the distance between CT and superior mesenteric artery (SMA) was 2.5-35 mm (mean 8.6 mm), CT diameter was 4.6-9.4 mm (mean 7.3 mm), and the main hepatic artery diameter was 2.4-5.8 mm (mean 4.1 mm). There was no correlation in our study between CT, Hepatic Artery variations, and their collaterals (r in range of -20,124-0.116, p>0.05). It can be said that in cases of the single accessory left hepatic artery originating from the left gastric artery, such as Michel's Type V and Type VIII, collaterals between common hepatic artery and SMA were relatively more frequent (p=0.1).
Conclusion:
Our study contributed to the literature by measuring the distance between diaphragmatic crus-vascular structures, which has been little studied in the past. Frequencies of CT and Hepatic Artery variations that have been detected in our study are similar to the results of the previous studies with non-malignancy patient groups.
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