Hepatic arterial variations detected at multidetector computer tomography angiography in the Romanian population

Folia Morphol (Warsz). 2023 Jul 31. doi: 10.5603/FM.a2023.0050. Online ahead of print.

Abstract

Background: Our purpose was to determine the prevalence of normal hepatic vascularization and variations of the hepatic arteries using multidetector computed tomography (MDCT) angiography. These variants should be known before any surgery of the upper abdomen, the downside being that there aren't many studies on large groups of patients using high-specialized imaging.

Materials and methods: This study was carried out on 4192 patients. We performed MDCT angiography on each one of the patients and had a specialized team observe the images.

Results: Using Michels' classification, the normal anatomy (type I) was present in 3392 (80.91%) cases, while abnormal hepatic arteries were observed in 800 (19.08%) cases. The variations were distributed as follows: type II in 40 (0.95%) cases, type III in 442 (10.54%) cases, type IV in 13 (0.31%) cases, type V in 285 (6.79%) cases, type VI in 12 (0.28%) cases, type VII in 3 (0.07%) cases, type VIII in 108 (2.57%) cases, type IX in 6 (0.14%) cases and type X in one case (0.02%). 170 (4.05%) unclassified cases were observed. Using Hiatt's classification, the variations were: type II in 325 (7.75%) cases, type III in 454 (10.83%) cases, type IV in 124 (2.95%) cases, type V in 6 cases (0.14%) and type VI in 69 (1.64%) cases. 102 (2.43%) unclassified cases were observed.

Conclusions: We observed well-known variations of the hepatic arterial pattern and also found a large number of rare, unclassified cases.

Keywords: aberrant artery; anatomical variations; hepatic patterns; multidetector computed tomography angiography.