Hepatic Artery and Portal Vein Variations using Contrast Enhanced Computed Tomography Abdominal Angiography

Introduction: Normal hepatic vascular anatomy and its variants carry considerable importance during liver transplants, laparoscopic surgeries, penetrating abdominal trauma, and radiological abdominal interventions. The occurrence of iatrogenic hepatic vascular injury increases in case of atypical an...

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Main Authors: Pugazhendhi Sambath, Elamparidhi Padmanaban, Umamageswari Amirthalingam, AM Anand, Pitchumani Sudhakar, Rajasree Dhinadhayalan, Rintu George, Rekha Danassegarane
Format: Article
Language:English
Published: JCDR Research and Publications Pvt. Ltd. 2022-07-01
Series:International Journal of Anatomy Radiology and Surgery
Subjects:
Online Access:https://ijars.net/article_fulltext.aspx?issn=0973-709x&year=2022&month=July&volume=11&issue=3&page=RO20%20-%20RO24&id=2798
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author Pugazhendhi Sambath
Elamparidhi Padmanaban
Umamageswari Amirthalingam
AM Anand
Pitchumani Sudhakar
Rajasree Dhinadhayalan
Rintu George
Rekha Danassegarane
author_facet Pugazhendhi Sambath
Elamparidhi Padmanaban
Umamageswari Amirthalingam
AM Anand
Pitchumani Sudhakar
Rajasree Dhinadhayalan
Rintu George
Rekha Danassegarane
author_sort Pugazhendhi Sambath
collection DOAJ
description Introduction: Normal hepatic vascular anatomy and its variants carry considerable importance during liver transplants, laparoscopic surgeries, penetrating abdominal trauma, and radiological abdominal interventions. The occurrence of iatrogenic hepatic vascular injury increases in case of atypical anatomy and variations. Aim: To determine the prevalence of common hepatic artery and portal vein variants by using Multidetector Computed Tomography (MDCT). Materials and Methods: This is a hospital based retrospective study done in Sri Mankula Vinayagar Medical College and Hospital, Puducherry, India, between July 2019 and July 2020. The Contrast Enhanced Computed Tomography (CECT) abdominal angiography of 350 patients was taken for the study. The MDCT abdominal angiography was performed using 16 slice PHILIPS MX16 CT scanner with intravenous administration of non ionic iodinated contrast, having iodine content of 300 mg/mL at the dosage of 1.5 mL/kg body weight, using automated pressure injector at a rate of 3.5 mL/sec. Arterial phase and portal venous phase images were obtained at 25 and 55 seconds respectively. The hepatic artery anatomical types were classified according to Michel's classification and the portal vein according to Covey AM et al., classification. Data obtained was entered in EPI INFO version 7.2.1.0 and analysed using Statistical Package for the Social Sciences (SPSS) software version 24.0. Results: Hepatic artery proper (right and left hepatic arteries arising from common hepatic artery) (Type I) was seen in 222 (63.4%) of cases. The most common variant was replaced Left Hepatic Artery (LHA) from the left gastric artery (Type II) with a prevalence of 46 (13.1%). A normal portal vein branching pattern (Type I) was seen in 201 (57.4%) of cases. The most common variation was trifurcation (Type II) with a prevalence of 68 (19.4%). Conclusion: Knowledge about normal hepatic artery, portal vein, and its variants is important in hepatic interventions and CT angiography is the modality of choice for evaluating the vascular anatomy.
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spelling doaj.art-92abecb15c5f412aa64fd5861849ff8c2023-02-22T11:28:14ZengJCDR Research and Publications Pvt. Ltd.International Journal of Anatomy Radiology and Surgery2277-85432455-68742022-07-01113RO20RO2410.7860/IJARS/2022/52502.2798Hepatic Artery and Portal Vein Variations using Contrast Enhanced Computed Tomography Abdominal AngiographyPugazhendhi Sambath0Elamparidhi Padmanaban1Umamageswari Amirthalingam2AM Anand3Pitchumani Sudhakar4Rajasree Dhinadhayalan5 Rintu George6Rekha Danassegarane7Junior Resident, Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.Associate Professor, Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.Professor, Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.Associate Professor, Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.Senior Resident, Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.Senior Resident, Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.Senior Resident, Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.Senior Resident, Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, IndiaIntroduction: Normal hepatic vascular anatomy and its variants carry considerable importance during liver transplants, laparoscopic surgeries, penetrating abdominal trauma, and radiological abdominal interventions. The occurrence of iatrogenic hepatic vascular injury increases in case of atypical anatomy and variations. Aim: To determine the prevalence of common hepatic artery and portal vein variants by using Multidetector Computed Tomography (MDCT). Materials and Methods: This is a hospital based retrospective study done in Sri Mankula Vinayagar Medical College and Hospital, Puducherry, India, between July 2019 and July 2020. The Contrast Enhanced Computed Tomography (CECT) abdominal angiography of 350 patients was taken for the study. The MDCT abdominal angiography was performed using 16 slice PHILIPS MX16 CT scanner with intravenous administration of non ionic iodinated contrast, having iodine content of 300 mg/mL at the dosage of 1.5 mL/kg body weight, using automated pressure injector at a rate of 3.5 mL/sec. Arterial phase and portal venous phase images were obtained at 25 and 55 seconds respectively. The hepatic artery anatomical types were classified according to Michel's classification and the portal vein according to Covey AM et al., classification. Data obtained was entered in EPI INFO version 7.2.1.0 and analysed using Statistical Package for the Social Sciences (SPSS) software version 24.0. Results: Hepatic artery proper (right and left hepatic arteries arising from common hepatic artery) (Type I) was seen in 222 (63.4%) of cases. The most common variant was replaced Left Hepatic Artery (LHA) from the left gastric artery (Type II) with a prevalence of 46 (13.1%). A normal portal vein branching pattern (Type I) was seen in 201 (57.4%) of cases. The most common variation was trifurcation (Type II) with a prevalence of 68 (19.4%). Conclusion: Knowledge about normal hepatic artery, portal vein, and its variants is important in hepatic interventions and CT angiography is the modality of choice for evaluating the vascular anatomy.https://ijars.net/article_fulltext.aspx?issn=0973-709x&year=2022&month=July&volume=11&issue=3&page=RO20%20-%20RO24&id=2798classificationlaparoscopic surgeriesmichel's classificationmultidetecter computed tomography
spellingShingle Pugazhendhi Sambath
Elamparidhi Padmanaban
Umamageswari Amirthalingam
AM Anand
Pitchumani Sudhakar
Rajasree Dhinadhayalan
Rintu George
Rekha Danassegarane
Hepatic Artery and Portal Vein Variations using Contrast Enhanced Computed Tomography Abdominal Angiography
International Journal of Anatomy Radiology and Surgery
classification
laparoscopic surgeries
michel's classification
multidetecter computed tomography
title Hepatic Artery and Portal Vein Variations using Contrast Enhanced Computed Tomography Abdominal Angiography
title_full Hepatic Artery and Portal Vein Variations using Contrast Enhanced Computed Tomography Abdominal Angiography
title_fullStr Hepatic Artery and Portal Vein Variations using Contrast Enhanced Computed Tomography Abdominal Angiography
title_full_unstemmed Hepatic Artery and Portal Vein Variations using Contrast Enhanced Computed Tomography Abdominal Angiography
title_short Hepatic Artery and Portal Vein Variations using Contrast Enhanced Computed Tomography Abdominal Angiography
title_sort hepatic artery and portal vein variations using contrast enhanced computed tomography abdominal angiography
topic classification
laparoscopic surgeries
michel's classification
multidetecter computed tomography
url https://ijars.net/article_fulltext.aspx?issn=0973-709x&year=2022&month=July&volume=11&issue=3&page=RO20%20-%20RO24&id=2798
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