title: Clinically relevant anatomical parameters of the replaced right hepatic artery (RRHA).
abstract: OBJECTIVE
  Vascular anatomy of the liver is subjected to many variations. The most common hepatic artery (HA) replacement is the right hepatic artery (RRHA). Variations of the HA are particularly important consideration when choosing the best surgical procedure or if radiological abdominal intervention is required. In this study, we evaluated the anatomical details of the RRHA origin.
  
  
  METHODS
  Retrospective investigation of clinical data from 1569 patients who underwent an abdominal MDCT was performed. The anatomy of RRHA origin was described based on four parameters measured: D--the distance between SMA origin and the RRHA origin, L--the lumen at the place of origin, AH--the origin angle from the SMA in horizontal plane, and AV--the origin angle from the SMA in vertical plane.
  
  
  RESULTS
  RRHA arising from SMA was detected in 10.13 % of cases (159/1569) and its anatomy was subjected to variations. Mean (±SD) of parameters D, L, AH and AV was 27.34 mm ± 6.83, 3.29 mm ± 1.17, 97.27º ± 26.69 and 89.73º ± 20.81, respectively. Values of parameters D and L were significantly higher in males compared to females.
  
  
  CONCLUSIONS
  Although radiologists are not always aware of the clinical significance of the RRHA origin, the evaluation of its anatomy is thought to help reduce the risk of inadvertent vascular injury, especially in pancreatoduodenectomy. Detection and evaluation of the RRHA does not necessarily require angio-CT examination. Our study demonstrated that the MDCT, the standard imaging modality for diagnosing the abdominal symptoms, is sufficient to provide the knowledge of the HA abnormalities.
authors.affiliation: Department of Human Anatomy, Medical University of Lublin, Jaczewskiego 4, 20-094, Lublin, Poland.|Department of Radiology and Nuclear Medicine, Medical University of Lublin, Lublin, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Staśkiewicz
authors.affiliation: Department of Human Anatomy, Medical University of Lublin, Jaczewskiego 4, 20-094, Lublin, Poland. kamiltorres@wp.pl.|Department of General Surgery, District Specialist Hospital, Lublin, Poland. kamiltorres@wp.pl.
authors.forename: Kamil
authors.initials: K
authors.lastname: Torres
authors.affiliation: Department of Human Anatomy, Medical University of Lublin, Jaczewskiego 4, 20-094, Lublin, Poland.
authors.forename: Marta
authors.initials: M
authors.lastname: Denisow
authors.affiliation: Department of Human Anatomy, Medical University of Lublin, Jaczewskiego 4, 20-094, Lublin, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Torres
authors.affiliation: Department of Radiology and Nuclear Medicine, Medical University of Lublin, Lublin, Poland.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Czekajska-Chehab
authors.affiliation: Department of Radiology and Nuclear Medicine, Medical University of Lublin, Lublin, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Drop
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006499:Hepatic Artery / Q000033:anatomy & histology* / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012189:Retrospective Studies; D055815:Young Adult
keywords: Anatomy; Liver vascularization; Pancreatoduodenectomy; Replaced right hepatic artery; Vascular anomalies