Abstract
Aim To evaluate whether right inferior phrenic artery (RIPA) is a source of extrahepatic
arterial supply to the liver in cirrhotic patients without hepatocellular carcinoma
(HCC) using 256 slice computed tomography (CT).
Materials and Methods Institutional review board approval was obtained for this retrospective study. A
total of 262 consecutive cirrhotic patients (male:female–172:90; mean age 56.45 ±
12.96 years) without HCC and hepatic vascular invasion, and who underwent technically
successful multiphase CT, were included in the study. Additionally, 280 noncirrhotic
patients (male:female–169:111; mean age 54.56 ± 14.21 years) who underwent abdominal
multiphase CT scans for indications other than liver disease and did not have focal
liver lesions or hepatic vascular disease were included as a control group. The RIPA
and left inferior phrenic artery (LIPA) diameters were measured at the level of the
ascending segment of IPA located anterior to the diaphragmatic crus. The relationship
between RIPA diameters and Child–Pugh score was assessed.
Results The cirrhotic patient group and control group were matched for age (p = 0.11) and gender (p = 0.20). The mean diameter of RIPA in the cirrhotic group (1.93 ± 0.4 mm) was significantly
higher than in the control group (1.50 ± 0.5 mm), p < 0.001. The mean diameter of LIPA in the cirrhotic group (1.34 ± 0.5 mm) was not
significantly higher than in the control group (1.30 ± 0.5 mm), p = 0.32. We found a statistically linear and moderate degree relationship between
RIPA diameter values and Child–Pugh scores (p = 0.002, r = 0.593).
Conclusion RIPA is hypertrophied in patients with cirrhosis without HCC. It may be an important
contributor to the blood flow to the liver in cirrhotic patients even without HCC,
especially with portal hypertension.
Keywords aorta - cirrhosis - portal hypertension - multidetector computed tomography - inferior
phrenic artery - celiac artery - chemoembolization
