Hepatic falciform ligament artery in patients with chronic liver diseases: detection on computed tomography hepatic arteriography.
BACKGROUND
The detection rate of hepatic falciform ligament artery (FLA) has been reported as ranging from 2-25%. The rate of FLA on laparotomy, however, is reported to be higher, at 68%.


OBJECTIVE
To compare the detection rate of FLA on computed tomography hepatic arteriography (CTHA) with that on angiography and dynamic CT, and to clarify the clinical significance of FLA in patients with chronic liver disease.


METHODS
126 consecutive patients underwent CTHA angiography and dynamic CT to evaluate suspected liver tumors. Liver function was classified as follows: normal, n=5; Child-Pugh class A, n=94; B, n=21; and C, n=6. All CT images were obtained using multidetector (MDCT) scanners (Aquilion; Toshiba, Tokyo, Japan). For CTHA, CT images were obtained during contrast material injection through the left hepatic, proper, or common hepatic artery. On CT, FLAs were retrospectively identified within the hepatic falciform ligament and the hepatic round ligament by the paging method on a workstation (TWS-5000; Toshiba, Tokyo, Japan). The detection rates were compared among the three modalities (hepatic arterial phase of dynamic CT, CTHA, and angiography). The calibers of FLA were also correlated with the hepatic function of the patients.


RESULTS
The detection rates of FLA by angiography, dynamic CT, and CTHA were 37% (47/126), 10% (13/126), and 77% (97/126), respectively. The calibers of FLA increased as the hepatic function deteriorated (P=0.001).


CONCLUSIONS
The detection rates of FLA with CTHA are far higher than those with angiography and dynamic CT. Careful interpretation with recognition of FLA on CTHA images is important, as inadvertent embolization or chemotherapeutic infusion of the FLA may result in supraumbilical skin rash.
Tajima
T
T
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. ttajima@med.kyushu-u.ac.jp
Yoshimitsu
K
K
Irie
H
H
Nishie
A
A
Hirakawa
M
M
Ishigami
K
K
Ushijima
Y
Y
Okamoto
D
D
Honda
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D003287:Contrast Media; D006521:Hepatitis, Chronic / Q000000981:diagnostic imaging*; D006801:Humans; D008022:Ligaments / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed
D003287:Contrast Media