Evaluation of celiac artery and common hepatic artery variations by CT-angiography and new classification model.

IF 1.2 4区医学 Q3 ANATOMY & MORPHOLOGY Surgical and Radiologic Anatomy Pub Date : 2023-08-01 DOI:10.1007/s00276-023-03180-1

Zeliha Türkyılmaz, Osman Kula, Ahmet Onur Çelik, Tuğrul Demirel, Burak Günay

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Abstract

Purpose: Knowledge of anatomical variations is important in all interventional procedures. This study aims to evaluate the variations and prevalence of celiac trunk (CeT) and its branches.

Methods: The computerized tomography-angiography (CT-A) findings of 941 adult patients were evaluated retrospectively. Variations of the CeT and common hepatic artery (CHA) were evaluated according to the number of branches and their origin. Findings were compared with classical classification methods. A new classification model has been defined.

Results: Normal (complete) trifurcation was detected in 856 (90.9%) of them, where left gastric artery (LGA), splenic artery (SpA) and CHA branches were derived from the CeT. Among 856 complete trifurcation cases, 773 (90.3%) had non-classical trifurcation patterns. The rate of classic trifurcation was 8.8%, while non-classic trifurcation was 82.1% in all cases. In one case (0.1%), LGA and left hepatic artery together and right hepatic artery and SpA together appeared as a double bifurcation. Complete celiacomesenteric trunk was observed only in 4 (0.42%) cases. In seven cases (0.7%), LGA, SpA and CHA were coming out of abdominal aorta (AAo) independently. CHA normal anatomy (Michels Type I) was detected in 618 (65.5%) patients. We found that 49 (5.2%) of our cases were ambiguous according to the Michels Classification. We have described five different variations of hepatic arteries directly arising from the AAo.

Conclusion: Preoperative recognition of anatomical variations of CeT, superior mesenteric artery and CHA is of primary importance in both surgical and radiological procedures. With careful evaluation of CT-angiographies, it is possible to detect rare variations.

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ct血管造影对腹腔动脉和肝动脉病变的评价及新分类模型。

目的:解剖变异知识在所有介入手术中都很重要。本研究旨在评估腹腔干(CeT)及其分支的变异和流行情况。方法:对941例成人患者的CT-A检查结果进行回顾性分析。根据肝总动脉(CHA)分支的数量和来源来评估其变化。比较经典分类方法的结果。定义了一种新的分类模型。结果:856例(90.9%)三分叉正常(完全)，其中胃左动脉(LGA)、脾动脉(SpA)和CHA分支来源于CeT。856例完整三分型中，773例(90.3%)为非经典三分型。经典三分岔发生率为8.8%，非经典三分岔发生率为82.1%。1例(0.1%)LGA与左肝动脉合并、右肝动脉与SpA合并出现双分叉。仅4例(0.42%)腹腔-肠系膜干完整。7例(0.7%)LGA、SpA、CHA均独立出腹主动脉(AAo)。618例(65.5%)患者检出CHA正常解剖(Michels I型)。我们发现49例(5.2%)的病例根据Michels分类有歧义。我们已经描述了直接由AAo引起的五种不同的肝动脉变异。结论:术前识别CeT、肠系膜上动脉和CHA的解剖变异对外科和放射治疗都至关重要。仔细评估ct血管造影，有可能发现罕见的变异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical and Radiologic Anatomy ANATOMY & MORPHOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

2.70

自引率

14.30%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.