Baba Y, Miyazono N, Ueno K, Kanetsuki I, Nishi H, Inoue H, Nakajo M
Department of Radiology, Faculty of Medicine, Kagoshima University, Japan.
Acta Radiol. 2000 Jul;41(4):329-33. doi: 10.1080/028418500127345596.
To determine the frequency of hepatic falciform artery (HFA) occurrence on celiac or hepatic angiograms and elucidate the anatomy and clinical importance.
Among 1,250 patients who underwent celiac or hepatic arteriography, we encountered 25 patients (2%) with a HFA. Prospectively, CT hepatic falciform arteriography (CTHA) was performed in 4 patients. Indigocarmine dye was injected into the HFA in 6 patients to evaluate whether the abdominal skin was stained. Embolization of the HFA before chemoembolization for hepatocellular carcinoma was performed in 4 patients to prevent abdominal wall injury.
Among 25 patients, the HFA arose as a terminal branch of the middle hepatic artery in 14 patients (56%) and of the left hepatic artery in 11 patients (44%). The vessel was single in 18 patients (72%) and double in 7 patients (28%). Two vessels ran side by side along the hepatic falciform ligament. On CTHA, the HFA ran within the hepatic falciform ligament and the branches were connected with the liver around the hepatic falciform ligament. After indigocarmine dye injection, the stain of abdominal skin was recognized in all 6 patients. No abdominal wall injury occurred in any of the 4 patients who were subjected to hepatic chemoembolization.
HFA is an extrahepatic pathway which runs to the abdominal wall. Before chemoembolization of the middle or left hepatic artery for hepatic malignancy, the HFA should be recognized.
确定在腹腔动脉或肝血管造影中肝镰状动脉（HFA）出现的频率，并阐明其解剖结构及临床意义。
在1250例行腹腔动脉或肝动脉造影的患者中，我们发现25例（2%）存在HFA。前瞻性地，对4例患者进行了CT肝镰状动脉造影（CTHA）。对6例患者的HFA注射靛胭脂染料，以评估腹壁是否被染色。对4例肝细胞癌患者在化疗栓塞前进行HFA栓塞，以预防腹壁损伤。
25例患者中，14例（56%）HFA起源于肝中动脉的终末分支，11例（44%）起源于肝左动脉。18例（72%）血管为单支，7例（28%）为双支。两支血管沿肝镰状韧带并行。在CTHA上，HFA走行于肝镰状韧带内，分支在肝镰状韧带周围与肝脏相连。注射靛胭脂染料后，所有6例患者均出现腹壁染色。4例接受肝化疗栓塞的患者均未发生腹壁损伤。
HFA是一条通向腹壁的肝外通道。在对肝恶性肿瘤进行肝中动脉或肝左动脉化疗栓塞前，应识别HFA。
