Hepatic Arterial Supply in 1297 CT-Angiographies

Abstract

Purpose: Analysis, evaluation and classification of hepatic arterial supply variants and determination of their frequency distribution in CT-angiographies.

Materials and Methods: CT-angiographies of 1,568 patients were evaluated retrospectively for the period between January 1, 2010 and August 30, 2012. The hepatic arterial anatomy was assessed and categorized according to Michels’s classification. So far unclassified variants were considered separately.

Results: CT-angiographies of 1297 patients were included in the study. Type I according to Michels was seen in 937 cases (72.2 %), followed by type V in 114 patients (8.8 %) and type III in 83 patients (6.4 %). Type X could not be found in any of the patients. Not yet classified variants were discovered in 26 patients. The most frequent variant in this connection was a right hepatic artery originating from the superior mesenteric artery with the left hepatic artery originating from the left gastric artery (n = 10).

Conclusion: Michels’s classification could be largely confirmed on the basis of a radiologically examined patient population. Not yet classified variants were categorized into subgroups of the existing classification.

Key points:

• Imaging of hepatic arterial supply variants using CT-angiography

• Distribution of variations of arterial liver supply in a general patient population

• Expansion of Michels’s classification to include new variations of the arterial liver supply

Citation Format:

• Löschner C, Nagel SN, Kausche S et al. Hepatic Arterial Supply in 1297 CT-Angiographies. Fortschr Röntgenstr 2015; 187: 276 – 282

Zusammenfassung

Ziel: Analyse, Auswertung und Klassifikation von Varianten der arteriellen Leberversorgung und die Bestimmung deren Häufigkeitsverteilung in CT-Angiografien.

Material und Methoden: Die CT-Angiografien von 1568 Patienten wurden für den Zeitraum zwischen 1.1.2010 und 30.8.2012 retrospektiv ausgewertet. Die arterielle Leberversorgung wurde untersucht und entsprechend der Klassifikation nach Michels eingeteilt. Bisher nicht klassifizierte Varianten wurden gesondert berücksichtigt.

Ergebnisse: Die CT-Angiografien von 1297 Patienten konnten in die Studie eingeschlossen werden. Typ I nach Michels fand sich in 937 Fällen (72,2 %), gefolgt von Typ V bei 114 Patienten (8,8 %) und Typ III bei 83 Patienten (6,4 %). Einzig Typ X konnte bei keinem Patienten gefunden werden. Bei 26 Patienten wurden bisher nicht klassifizierte Varianten gefunden. Die häufigste Variante hierbei war eine Arteria hepatica dextra mit Ursprung aus der Arteria mesenterica superior bei Ursprung der Arteria hepatica sinistra aus der Arteria gastrica sinistra (n = 10).

Schlussfolgerung: Die Klassifikation von Michels konnte anhand eines radiologisch untersuchten Patientenkollektivs weitgehend bestätigt werden. Bisher unklassifizierte Varianten wurden in Untergruppen in die bestehende Klassifikation eingeordnet.

Key words

hepatic arteries - CT-angiography - anatomy

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