Extrahepatic arterial supply to the liver: observation with a unified CT and angiography system during temporary balloon occlusion of the proper hepatic artery.
OBJECTIVE
To evaluate routes of potential extrahepatic arterial supply to the liver.


METHODS
Twenty-three patients with liver tumors underwent computed tomographic (CT) arteriography of extrahepatic arteries before and after temporary balloon occlusion of the proper hepatic artery. The right inferior phrenic artery (RIPA), left inferior phrenic artery (LIPA), superior mesenteric artery (SMA), celiac axis, and left gastric artery (LGA) were evaluated.


RESULTS
During temporary balloon occlusion of the proper hepatic artery, extrahepatic arterial supply was immediately evident in 22 of 23 patients (96%). The liver was supplied by the RIPA in 17 of 20 patients (85%), by the LIPA in five of six (83%), by the SMA in eight of 16 (50%), by the celiac axis in two of 10 (20%), and by the LGA in one of six (17%). There was no apparent relationship between the enhanced zones supplied by extrahepatic arteries and the presence or absence of nearby tumors.


CONCLUSIONS
Extrahepatic arterial supply to the liver was readily evident in a large proportion of patients during temporary balloon occlusion of the proper hepatic artery. This finding suggests a need for consideration of extrahepatic arterial supply when angiographic intervention for liver tumors is contemplated.
Department of Diagnostic Radiology, Aichi Cancer Center Hospital, Nagoya, Japan.
Y
Y
Takeuchi
Y
Y
Arai
Y
Y
Inaba
K
K
Ohno
T
T
Maeda
Y
Y
Itai
D000368:Aged; D000792:Angiography / Q000295:instrumentation / Q000379:methods; D015901:Angiography, Digital Subtraction / Q000295:instrumentation / Q000379:methods; D001158:Arteries; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging; D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000379:methods*; D003287:Contrast Media; D005260:Female; D006499:Hepatic Artery / Q000502:physiology*; D006801:Humans; D007479:Iopamidol; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods
D003287:Contrast Media; D007479:Iopamidol