De Santis M, Ariosi P, Calò G F, Romagnoli R
Dipartimento di Scienze Mediche, Oncologiche e Radiologiche dell'Università , Sezione di Scienze Radiologiche, Modena e Reggio Emilia.
Radiol Med. 2000 Sep;100(3):145-51.
We investigated the frequency of anatomical variants of the hepatic artery, which can influence interventional angiographic procedures.
We reviewed 150 consecutive angiograms performed for the treatment of primary (112) or metastatic (38) liver tumors and evaluated the frequency of anatomical variants of the hepatic artery based on the classification proposed by Michels in 1955, which describes 10 variants. The so-called typical anatomy, which is in fact only found in 55% of cases, is indicated as type I.
The typical anatomy (type I variant) was seen in 78 patients (52%) and variants were seen in the other 72 (48%). We found 15 type II variants (10%), 23 type III (15.5%), 1 type IV and 1 type V (0.6%), 3 type VI (2%), 1 type VII (0.6%) and finally 6 type IX (4%). There were no type VIII or X variants, but in 22 patients (14.7%) vascular anatomy did not fit Michaels' classification.
In our series the typical hepatic artery anatomy was found in 52%, which is in agreement with Michels' findings, while the frequency of the individual anatomical variants differed. Not all of the variants reported by Michels were seen in our series and we found 22 patients with different variants. Disagreement might be due to the fact that Michels' was an autoptic series while our patients were cancer patients only and thus variability could be at least partly accounted for by neoplastic neovascularization. We believe that thourough knowledge of the anatomical variants of the hepatic artery is fundamental to angiographic practice, in particular for interventional procedures, because such variants can influence the choice of vascular technique and of materials.
我们研究了肝动脉解剖变异的发生率，其可影响介入血管造影操作。
我们回顾了150例连续的血管造影图像，这些图像用于治疗原发性（112例）或转移性（38例）肝肿瘤，并根据1955年米歇尔提出的分类法评估肝动脉解剖变异的发生率，该分类法描述了10种变异类型。所谓的典型解剖结构（实际上仅在55%的病例中发现）被标记为I型。
78例患者（52%）可见典型解剖结构（I型变异），另外72例（48%）可见变异。我们发现15例II型变异（10%），23例III型（15.5%），1例IV型和1例V型（0.6%），3例VI型（2%），1例VII型（0.6%），最后6例IX型（4%）。没有VIII型或X型变异，但22例患者（14.7%）的血管解剖结构不符合米歇尔的分类。
在我们的系列研究中，52%的患者发现典型的肝动脉解剖结构，这与米歇尔的研究结果一致，但各解剖变异的发生率有所不同。我们的系列研究中并未见到米歇尔报告的所有变异，并且我们发现22例患者有不同的变异。差异可能是由于米歇尔的研究是尸检系列，而我们的患者仅为癌症患者，因此变异至少部分可由肿瘤新生血管形成来解释。我们认为，全面了解肝动脉的解剖变异对于血管造影实践至关重要，尤其是对于介入操作，因为此类变异可影响血管技术和材料的选择。
