Evaluation of Celiac Trunk, Hepatic Artery Variations, and Their Collateral Arteries by Multi-Slice Computed Tomography

Sisli Etfal Hastan Tip Bul. 2021 Jul 2;55(2):217-223. doi: 10.14744/SEMB.2021.90698. eCollection 2021.

Abstract

Objectives: Celiac Trunk (CT) is a vital artery and the first unmatched branch of the abdominal aorta, providing blood to upper abdominal structures, particularly the liver, stomach, and spleen. It is essential to know its anatomy in terms of pancreas, spleen, gallbladder, liver surgeries, and interventional radiological procedures such as chemoembolization. The aim of our study is to contribute to the literature with the measurements of distances between the diaphragmatic crus and vascular structures with their diameters, which have been studied insufficiently, and to detect the possible relationships between vascular variations and collateral branches.

Methods: Imaging findings of 200 patients (114 males and 86 females), who underwent Multi-Section Computed Tomography examination with various indications in our center between June 2016 and July 2020, were retrospectively analyzed. The statistical relations between CT and Hepatic Artery variations, collateral formations, age, and gender were evaluated with the Spearman's Rho Correlation Coefficient Test.

Results: The distance between the crus of diaphragm and CT was 4-60 mm (mean 24.3 mm), the distance between CT and superior mesenteric artery (SMA) was 2.5-35 mm (mean 8.6 mm), CT diameter was 4.6-9.4 mm (mean 7.3 mm), and the main hepatic artery diameter was 2.4-5.8 mm (mean 4.1 mm). There was no correlation in our study between CT, Hepatic Artery variations, and their collaterals (r in range of -20,124-0.116, p>0.05). It can be said that in cases of the single accessory left hepatic artery originating from the left gastric artery, such as Michel's Type V and Type VIII, collaterals between common hepatic artery and SMA were relatively more frequent (p=0.1).

Conclusion: Our study contributed to the literature by measuring the distance between diaphragmatic crus-vascular structures, which has been little studied in the past. Frequencies of CT and Hepatic Artery variations that have been detected in our study are similar to the results of the previous studies with non-malignancy patient groups.

Keywords: Anatomical variation; celiac trunk; collateralization; hepatic artery.