Replaced or right accessory hepatic artery: can ultrasound replace angiography?
The accuracy of ultrasonography in detecting the right hepatic artery was prospectively assessed in 128 patients undergoing abdominal angiography. Twenty-five (19%) of the ultrasound studies were technically inadequate mainly because of gas superimposition. Of the remaining 103 cases, 14 had a replaced hepatic artery, which was diagnosed in 10 cases with ultrasound (sensitivity 71%). Eighty-nine did not have a replaced hepatic artery and the ultrasound assessment was falsely positive in four of them (specificity 96%). Two of the four false negative results could be explained by a stenosis of the superior mesenteric artery in front of the origin of the replaced hepatic artery. Two of the four false positive results could be explained by the presence of a stenosis of the celiac trunk with hypertrophy of the pancreaticoduodenal arteries, one of them being misdiagnosed as a replaced hepatic artery.
Bret
P M
PM
Department of Radiology, Montreal General Hospital, Quebec, Canada.
Reinhold
C
C
Herba
M
M
Atri
M
M
Challender
J
J
Edde
D
D
Casola
G
G
Kintzen
G
G
Withers
C
C
Remy
H
H
D000792:Angiography; D002445:Celiac Artery / Q000473:pathology; D003951:Diagnostic Errors; D006499:Hepatic Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008099:Liver / Q000098:blood supply*; D008638:Mesenteric Arteries / Q000473:pathology; D011169:Portal Vein / Q000473:pathology; D014463:Ultrasonography