Anatomical variation of celiac axis, superior mesenteric artery, and hepatic artery: Evaluation with multidetector computed tomography angiography.
BACKGROUND
The celiac axis, superior mesenteric artery (SMA), and hepatic artery are the most important branches of abdominal aorta due to their vascularization field. The aim of our study was to evaluate the prevalence of different anatomical variation of celiac axis, SMA, hepatic artery, and its branches with multidetector computed tomography (MDCT) angiography of upper abdomen arteries.


METHODS
MDCT of 607 kidney donor and traumatic patients that referred to MDCT unit at Al Zahra Hospital in Isfahan from 2012 to 2015 were retrospectively evaluated. We excluded patients with history of abdominal vascular surgery and hepatic or pancreatic surgery. Computed tomography images of the patient were obtained with 64-row MDCT scanner and anatomical variations were analyzed.


RESULTS
Three hundred and eighty-eight (63.9%) of the 607 patients had classic arterial anatomy and 219 (36.1%) patients had variant types. The most common type of variation was the origin of the right hepatic artery (RHA) from SMA (9.6%), and the next common variation was the origin of the left hepatic artery (LHA) from the left gastric artery (6.9%). Variations in the origin of the common hepatic artery (CHA) were seen in 16 (2.6%) patients. Buhler arc was identified in two patients. The RHA originated from the celiac axis in 11 (1.8%) patients and from the aorta in 8 (1.3%) patients. Trifurcation of CHA into gastroduodenal artery, RHA, and LHA was detected in 11 (1.8%) patients.


CONCLUSIONS
The results of the present study showed that anatomical variation occurs in a high percentage of patients. Detection of these variations can guide surgical and radiological interventional planning.
Department of Radiology and Imaging, Isfahan University of Medical Sciences, Isfahan, Iran.
Maryam
M
Farghadani
Department of Radiology and Imaging, Isfahan University of Medical Sciences, Isfahan, Iran.
Mohammad
M
Momeni
Department of Radiology and Imaging, Isfahan University of Medical Sciences, Isfahan, Iran.
Ali
A
Hekmatnia
Department of Radiology and Imaging, Isfahan University of Medical Sciences, Isfahan, Iran.
Fateme
F
Momeni
Department of Radiology and Imaging, Isfahan University of Medical Sciences, Isfahan, Iran.
Mohammad Mehdi
MM
Baradaran Mahdavi
Major branches of abdominal aorta; multidetector computed tomography angiography; normal variation; prevalence