MDCT anatomic assessment of right inferior phrenic artery origin related to potential supply to hepatocellular carcinoma and its embolization.
OBJECTIVE
To prospectively assess the anatomic variation of the right inferior phrenic artery (RIPA) origin with multidetector computed tomography (MDCT) scans in relation to the technical and angiographic findings during transcatheter arterial embolization of hepatocellular carcinoma (HCC).


METHODS
Two hundred patients with hepatocellular carcinomas were examined with 16-section CT during the arterial phase. The anatomy of the inferior phrenic arteries was recorded, with particular reference to their origin. All patients with subcapsular HCC located at segments VII and VIII underwent arteriography of the RIPA with subsequent embolization if neoplastic supply was detected.


RESULTS
The RIPA origin was detected in all cases (sensitivity 100%), while the left inferior phrenic artery origin was detected in 187 cases (sensitivity 93.5%). RIPAs originated from the aorta (49%), celiac trunk (41%), right renal artery (5.5%), left gastric artery (4%), and proper hepatic artery (0.5%), with 13 types of combinations with the left IPA. Twenty-nine patients showed subcapsular HCCs in segments VII and VIII and all but one underwent RIPA selective angiography, followed by embolization in 7 cases.


CONCLUSIONS
MDCT assesses well the anatomy of RIPAs, which is fundamental for planning subsequent cannulation and embolization of extrahepatic RIPA supply to HCC.
Basile
Antonio
A
Department of Diagnostic and Interventional Radiology, Ospedale Ferrarotto, via Citelli 14, 95124, Catania, Italy. antodoc@yahoo.com
Tsetis
Dimitrios
D
Montineri
Arturo
A
Puleo
Stefano
S
Massa Saluzzo
Cesare
C
Runza
Giuseppe
G
Coppolino
Francesco
F
Ettorre
Giovanni Carlo
GC
Patti
Maria Teresa
MT
D000328:Adult; D000368:Aged; D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D003097:Collateral Circulation; D003287:Contrast Media; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D003287:Contrast Media