Identification of the aberrant hepatic artery with axial spiral CT.
OBJECTIVE
To determine whether axial spiral computed tomography (CT) allows detection of the replaced hepatic artery as part of preoperative planning for pancreatic tumor resection.


METHODS
Axial spiral CT scans (8-mm section thickness, 4-mm overlapping reconstructions) were obtained in 50 patients with periampullary tumor and were examined by three radiologists. Readers' interpretations were compared with angiographic results.


RESULTS
Eight patients had an aberrant hepatic artery. Two of the three readers detected or suspected all of these abnormalities (100% sensitivity), and one reader identified seven of eight aberrant arteries (88% sensitivity). However, readers requested angiographic confirmation in 14 of 24 tests. Sensitivity, specificity, and accuracy were 96%, 87%, and 88%, respectively, for all readers.


CONCLUSIONS
Axial spiral CT may simplify preoperative evaluation of periampullary tumors. However, angiographic support was necessary in most cases in this study. Improvements in CT techniques may eventually allow spiral CT to replace angiography in the examination of these patients.
Chambers
T P
TP
Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD, USA.
Fishman
E K
EK
Bluemke
D A
DA
Urban
B
B
Venbrux
A C
AC
D014670:Ampulla of Vater / Q000601:surgery; D000792:Angiography; D001011:Aorta / Q000002:abnormalities; D002445:Celiac Artery / Q000002:abnormalities / Q000000981:diagnostic imaging; D003138:Common Bile Duct Neoplasms / Q000601:surgery; D006499:Hepatic Artery / Q000002:abnormalities / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D017538:Mesenteric Artery, Superior / Q000002:abnormalities / Q000000981:diagnostic imaging; D015588:Observer Variation; D010190:Pancreatic Neoplasms / Q000601:surgery; D010347:Patient Care Planning; D011300:Preoperative Care; D011856:Radiographic Image Enhancement; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*