MDCT Angiographic Evaluation of Celiac Axis, Common Heaptic Artery and its Branches

Dr A Padmaja; Dr V Karuna; Dr T Koushik; Dr D Ankamma Rao

Volume : VI, Issue : IV, April - 2016

MDCT Angiographic Evaluation of Celiac Axis, Common Heaptic Artery and its Branches

Dr A Padmaja, Dr V Karuna, Dr T Koushik, Dr D Ankamma Rao

Abstract :

Purpose of the study is to identify and evaluate the spectrum and prevalence of celiac axis (CA) and common hepatic artery (CHA) variations by using MDCT. Materials and Methods: A retrospective review of multidetector computerised tomographic (MDCT) angiography scan of patients sent for various liver and abdominal pathologies between July 2015 and December 2015 was performed. CHA, ambiguous celiac axis, course and divisions of CHA, replaced hepatic artery, accessory hepatic artery and middle hepatic artery were analysed based on the definitions proposed by Song et al.(1), Convey et al.(2) and Wang et al.(3). The patterns of aortic origin of celiac axis, common hepatic artery and its anches were analysed. Results: Six types of anatomic variations of celiac axis were identified. A total of 270 out of 300 patients had a normal celiac axis anatomy. Anatomic variations were seen in 10% patients. Ambiguous anatomy was observed in 2.66% patients. 92.6% patients have CHA originated from celiac axis. Variations of origin of CHA were seen 7.4% cases. Normal suprapancreatic preportal course of CHA was seen in 94.23%, transpancreatic preportal in 2.03%, suprapancreatic retroportal in 1.69%, infrapancreatic preportal in 1.33% and infrapancreatic retroportal in 0.67% of the patients. Normal origin of right hepatic artery(RHA) from HAP was seen in 86%. Replaced origin of RHA was seen in 14% patients. Accessory origin of RHA was seen in 0.33% patients. Normal origin of Left hepatic artery (LHA) from HAP was seen in 83.66% patients. Replaced origin of LHA was seen in 16.33% patients. Accessory origin of LHA was seen in 1% patients. Middle hepatic artery (MHA) originated from RHA in 40% cases, LHA in 27.3% cases and CHA in 6% cases. Origin of MHA could not be defined in 26.6% cases. GDA (Gastroduodenal artery) originated from CHA in 97% cases, from celiac axis in 0.66% cases, from SMA in 1.33% cases and from LHA in 0.66% cases. Origin of GDA could not be defined in 0.33% cases. Conclusion: CT Angiography is highly sensitive and accurate modality for the evaluation of arterial anatomy and its variants.