Strunk H, von Falkenhausen M, Hofer U, Remig J, König R, Wilhelm K, Textor J
Radiologische Universitätsklinik Bonn.
Ultraschall Med. 1999 Feb;20(1):26-30. doi: 10.1055/s-1999-14252.
Detection of hepatic artery variants is of great clinical importance, for instance, pre liver transplantation, pre intraarterial chemotherapy or for measurement of the Doppler perfusion index. We therefore investigated how accurate variants of the hepatic artery can be detected using color-coded sonography pre and post Levovist injection.
52 patients (21-78 years) were examined using color-coded sonography pre and post Levovist injection. After the sonographic examination, intraarterial digital subtraction angiography was performed and the results were compared.
Using angiography 14 variants of the hepatic artery were detected in 13 patients. The most common variant in 10 patients were hepatic arteries originating from the superior mesenteric artery. This could be detected with unenhanced color-coded sonography in 8 and with enhanced sonography in 9 patients. In one patient in addition, a hepatogastric trunk was noted by angiography, this was not recognized by sonography. In 2 patients with a hepatogastric trunk, this variant was sonographically seen after Levovist injection in both but with unenhanced sonography in only 1 patient.
Most variants of the arterial hepatic blood supply can be diagnosed using conventional color-coded sonography. In some cases enhanced sonography provides additional information, but even with these techniques all variations cannot be detected.
肝动脉变异的检测具有重要的临床意义，例如在肝移植前、动脉内化疗前或用于测量多普勒灌注指数时。因此，我们研究了在注射声诺维前后使用彩色编码超声检查检测肝动脉变异的准确性。
对52例患者（年龄21 - 78岁）在注射声诺维前后进行彩色编码超声检查。超声检查后，进行动脉内数字减影血管造影，并比较结果。
通过血管造影在13例患者中检测到14种肝动脉变异。10例患者中最常见的变异是肝动脉起源于肠系膜上动脉。在未增强的彩色编码超声检查中，8例患者可检测到这种变异，在增强超声检查中，9例患者可检测到。另外，血管造影发现1例患者存在肝胃干，超声检查未识别出。在2例存在肝胃干的患者中，注射声诺维后，两者均能通过超声检查发现这种变异，但仅1例患者在未增强超声检查时发现。
大多数肝动脉血供变异可通过传统的彩色编码超声检查诊断。在某些情况下，增强超声检查可提供额外信息，但即使使用这些技术也无法检测到所有变异。
