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Hepatic arterial anatomy in transplantation candidates: evaluation with three-dimensional CT arteriography
T C Winter1, P C Freeny, H V Nghiem
1Department of Radiology, University of Washington Medical Center, Seattle 98195, USA.
Insights
Three-dimensional (3D) CT arteriography accurately evaluates hepatic arterial anatomy for liver transplant candidates, proving safer and more cost-effective than conventional angiography.
Area of Science:
- Radiology
- Medical Imaging
- Hepatobiliary Surgery
Background:
- Accurate assessment of hepatic arterial anatomy is crucial for liver transplantation.
- Conventional angiography is the standard but carries risks.
Purpose of the Study:
- To evaluate three-dimensional (3D) helical computed tomographic (CT) arteriography as a substitute for conventional angiography.
- To assess its utility in patients considered for liver transplantation.
Main Methods:
- 3D CT arteriograms were performed on 115 patients.
- Seventeen patients had both 3D CT arteriography and conventional angiography.
- Sixteen patients underwent 3D CT arteriography followed by hepatic transplantation.
Main Results:
- 106 of 115 (92%) 3D CT arteriograms successfully visualized major hepatic arteries.
- Only one significant discrepancy was noted between 3D CT arteriography and conventional angiography in 17 patients.
- No significant discrepancies were found between 3D CT arteriography and surgical findings in 16 patients.
Conclusions:
- Successful 3D CT arteriography is accurate for assessing hepatic arterial anatomy in liver transplant candidates.
- It offers advantages over conventional angiography, including improved safety, convenience, and tolerability.
- The combined cost of 3D CT arteriography and conventional CT is significantly lower than conventional CT and angiography.
Purpose:
To assess the utility of three-dimensional (3D) hepatic helical computed tomographic (CT) arteriography as a replacement for conventional angiography in the evaluation of the arterial anatomy of patients being considered for liver transplantation.
Materials And Methods:
Three-dimensional CT arteriograms were obtained in 115 patients. Seventeen patients also underwent conventional angiography, and 16 patients who did not undergo angiography underwent hepatic transplantation.
Results:
Among the 3D CT arteriograms, 106 delineated the major arteries that supplied the liver. Nine were considered technical failures. In the 17 patients with angiographic correlation, there was only one marked disagreement with 3D CT arteriography. In the 16 patients with surgical correlation, no marked discrepancies were found.
Conclusion:
In transplantation candidates, successful 3D CT arteriography was as accurate as angiography in the assessment of hepatic arterial anatomy. It was also safer, more convenient, and more easily tolerated. Conventional CT plus 3D CT arteriography was only 25% as expensive as the cost of conventional CT and conventional angiography.