Ozaki Kumi, Kobayashi Satoshi, Matsui Osamu, Minami Tetsuya, Koda Wataru, Gabata Toshifumi
Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8640, Japan.
Department of Quantum Medicine Technology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Cardiovasc Intervent Radiol. 2017 Jun;40(6):822-830. doi: 10.1007/s00270-017-1568-6. Epub 2017 Jan 12.
To investigate the prevalence and site of origin of extrahepatic arteries originating from hepatic arteries on early phase CT during hepatic arteriography (CTHA) was accessed. Visualization of these elements on digital subtraction hepatic angiography (DSHA) was assessed using CTHA images as a gold standard.
A total of 943 patients (mean age 66.9 ± 10.3 years; male/female, 619/324) underwent CTHA and DSHA. The prevalence and site of origin of extrahepatic arteries were accessed using CTHA and visualized using DSHA.
In 924 (98.0%) patients, a total of 1555 extrahepatic branches, representing eight types, were found to originate from hepatic arteries on CTHA. CTHA indicated the following extrahepatic branch prevalence rates: right gastric artery, 890 (94.4%); falciform artery, 386 (40.9%); accessory left gastric artery, 161 (17.1%); left inferior phrenic artery (IPA), 43 (4.6%); posterior superior pancreaticoduodenal artery, 33 (3.5%); dorsal pancreatic artery, 26 (2.8%); duodenal artery, 12 (1.3%); and right IPA, 4 (0.4%). In addition, 383 patients (40.6%) had at least one undetectable branch on DSHA. The sensitivity, specificity, and accuracy of visualization on DSHA were as follows: RGA, 80.0, 86.8, and 80.4%; falciform artery, 53.9, 97.7, and 80.0%; accessory LGA, 64.6, 98.6, and 92.3%; left IPA, 76.7, 99.8, and 98.7%; PSPDA, 100, 99.7, and 99.9%; dorsal pancreatic artery, 57.7, 100, and 98.8%; duodenal artery, 8.3, 99.9, and 98.7%; and right IPA, 0, 100, and 99.6%, respectively.
Extrahepatic arteries originating from hepatic arteries were frequently identified on CTHA images. These arteries were frequently overlooked on DSHA.
在进行肝动脉造影CT（CTHA）时，研究起源于肝动脉的肝外动脉的发生率及起源部位。以CTHA图像作为金标准，评估数字减影肝血管造影（DSHA）上这些血管的显影情况。
共有943例患者（平均年龄66.9±10.3岁；男/女，619/324）接受了CTHA和DSHA检查。利用CTHA确定肝外动脉的发生率及起源部位，并通过DSHA观察其显影情况。
在924例（98.0%）患者中，CTHA发现共有1555支肝外分支起源于肝动脉，分为8种类型。CTHA显示的肝外分支发生率如下：胃右动脉，890支（94.4%）；镰状动脉，386支（40.9%）；副左胃动脉，161支（17.1%）；左膈下动脉（IPA），43支（4.6%）；胰十二指肠后上动脉，33支（3.5%）；胰背动脉，26支（2.8%）；十二指肠动脉，12支（1.3%）；右膈下动脉，4支（0.4%）。此外，383例患者（40.6%）在DSHA上至少有一支分支未显影。DSHA显影的敏感度、特异度和准确度如下：胃右动脉，分别为80.0%、86.8%和80.4%；镰状动脉，分别为53.9%、97.7%和80.0%；副左胃动脉，分别为64.6%、98.6%和92.3%；左膈下动脉，分别为76.7%、99.8%和98.7%；胰十二指肠后上动脉，分别为100%、99.7%和99.9%；胰背动脉，分别为57.7%、100%和98.8%；十二指肠动脉，分别为8.3%、99.9%和98.7%；右膈下动脉，分别为0%、100%和99.6%。
CTHA图像上常可发现起源于肝动脉的肝外动脉。这些动脉在DSHA上常被遗漏。
