Department of Diagnostic and Interventional Radiology, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
BMC Med Imaging. 2012 Dec 21;12:36. doi: 10.1186/1471-2342-12-36.
We performed this study in order to investigate the shape of the origin of the celiac artery in maximum intensity projection (MIP) using routine 64 multidetector-row computed tomography (MDCT) data in order to plan for the implantation of an intra-arterial hepatic port system.
A total of 1,104 patients with hepatocellular carcinoma were assessed with MDCT. In the definition of the branching angle, the anterior side of the abdominal aorta was considered the baseline, and the cranial and caudal sides were designated as 0 and 180 degrees, respectively. The angles between 0 and 90 degrees and between 90 and 180 degrees from the cranial side were considered upward and downward, respectively, and the branching angle of the celiac artery was classified every 30 degrees. The subclavian arterial route was used for the implantation of an intra-arterial hepatic port system in patients with branching angles of 150 degrees or more (sharp downward).
The median branching angle was (median ± standard deviation) 135 ± 23 (range, 51-174) degrees. The branching was upward in 77 patients (7%) and downward in 1,027 patients (93%). The branching was downward with an angle of 120 to 150 degrees in most patients (n = 613). The branching was sharply downward with an angle of 150 degrees or more in 177 patients (16%). A total of 10 patients were referred for interventional placement of an intra-arterial hepatic port system. The subclavian arterial route was used for implantation of an intra-arterial hepatic port system in 2 patients with sharp downward branching.
The branching angle of the celiac artery can be easily determined by the preparation of MIP images from routine MDCT data. MIP may provide useful information for the selection of the catheter insertion route in order to avoid a sharp branching angle of the celiac artery.
我们进行这项研究是为了通过常规 64 层多层螺旋 CT（MDCT）数据的最大密度投影（MIP）来研究腹腔动脉的起源形状，以便规划肝内动脉门系统的植入。
共对 1104 例肝细胞癌患者进行 MDCT 评估。在分支角度的定义中，腹主动脉的前侧被视为基线，头侧和尾侧分别指定为 0 和 180 度。从头侧 0 到 90 度和 90 到 180 度之间的角度分别被认为是向上和向下的，腹腔动脉的分支角度每 30 度分类一次。对于分支角度为 150 度或更高（急剧向下）的患者，采用锁骨下动脉途径植入肝内动脉门系统。
中位分支角度为（中位数±标准差）135±23（范围 51-174）度。77 例（7%）患者分支向上，1027 例（93%）患者分支向下。大多数患者（n=613）的分支角度为 120-150 度，呈向下弯曲。177 例（16%）患者的分支角度为 150 度或更大，呈急剧向下弯曲。共有 10 例患者转介入科行肝内动脉门系统植入。2 例分支角度急剧向下的患者采用锁骨下动脉途径植入肝内动脉门系统。
通过常规 MDCT 数据的 MIP 图像准备，可以轻松确定腹腔动脉的分支角度。MIP 可能为选择导管插入途径提供有用的信息，以避免腹腔动脉的急剧分支角度。
