Nghiên cứu đặc điểm giải phẫu động mạch thân tạng và hệ động mạch gan ở người trưởng thành bằng X quang cắt lớp vi tính

Anatomical study of celiac artery and hepatic arterial system in adults: an analysis using multidectector computed tomography

SUMMARY

Objectives: The aim of the present study was to evaluate the anatomical chacracteristics of celiac artery (CA) and hepatic arterial system (HAS) in Vietnamese adults by using multidetector computed tomography (MDCT).

Materials and Methods: Retrospective, cross-sectional and predominantly descriptive study based on the analysis of arterial phase contrast-enhanced CT images of 600 patients between July 2016 and November 2016, at the Radiology Department, University Medical Center, Ho Chi Minh City (UMC HCMC).

Results: The CA arises variably from the aorta at the level between lower 1/3 11th thoracic and upper 1/3 2nd lumbar vertebrae with more than 70% at the level of lower 1/3 12th thoracic, T12 – L1 junction and upper 1/3 1st lumbar vertebra. The celiac trunk anatomy was normal (Uflacker type 1) in 87.7% of cases and variation of CA was observed in 12.3% with the form of hepatosplenic trunk (Uflacker type 2) was the most common type (4.0%). Ambiguous celiac axis anatomy was seen in 3.1% of patients. CHA originated from celiac axis in 92.7% of cases, followed by SMA (4.0%) and aorta (1.2%). The HAS was described as normal (Michels type 1) in 73% of patients and several variations were noted in 23%. The most common variation was Michels type 2 (7.0%), followed by type 3 (5.7%), type 9 (3.8%) and others. Type\

10 was not observed in our series. We have noted additional, unclassified variations in 19 cases (3.2%). Mean length and diameter of CA were 28.29 ± 6.68mm and 7.33 ± 1.15mm. Mean distance between CA and SMA was 20.51 ± 4.17mm. Normal measures of CA in women were smaller than in men (p<0.05). Mean length and diameter of CHA were 32.43 ± 8.49mm and

5.40 ± 1.04mm. Mean diameter of PHA was 4.45 ± 0.87mm. Normal measures of hepatic artery in women were smaller than in men (p<0.05). In the presence of anatomical variations, there was a decrease in the arterial diameters of the CA and HAS, decrease in the CA length, but increase in CHA length (p<0.05). In addition, a significant correlation was observed between CA diameter and length; CA diameter and distance to SMA; CHA diameter and length; and CHA diameter and PHA diameter (p<0.05).

Conclusion: The knowledge of anatomic characteristics of the celiac artery and hepatic arterial system, including the most common variations of these arteries in population may assist in the selection of treatmen options và surgical planning. As a reliable non invasive method, MDCT can accurately provide detailed information of celiac artery and hepatic arterial system.

Keywords: Anatomical variations; Celiac artery (CA); Hepatic arterial system (HAS); Common hepatic artery (CHA), Proper hepatic artery (PHA); Multidetector computed tomography (MDCT).