Department of Radiology, Faculty of Medicine, Eskişehir Osmangazi University, Meşelik Yerleşkesi, 26480, Eskisehir, Turkey.
Surg Radiol Anat. 2021 Aug;43(8):1385-1389. doi: 10.1007/s00276-021-02730-9. Epub 2021 Mar 8.
Considering that the knowledge of variations in the hepatic vascular structure is essential for hepatic surgery and liver transplantation, we aimed to present a rare case of the anatomic variation of arterial blood supply to the liver to help prevent complications and choose suitable donors.
We present a novel variant in this case report (living liver donor), an accessory right hepatic artery (supplying segment 6) originating from the dorsal pancreatic artery and a middle hepatic artery (supplying segment 4) arising from the pancreaticoduodenal artery (first branch of the gastroduodenal artery). Preoperative diagnosis was made using computed tomography angiography (CTA) with multiplanar reformate (MPR) images, curved planar reformate (CPR), maximum intensity projection (MIP) images and three-dimensional volume renderings (3D VR).
To the best of our knowledge, this is the first case in the English literature describing this type of variation. A search for new donors began since the living liver donor was not suitable due to the very thin segment 4 artery, posing potential risks for the donor and the thin segment 6 artery being a complicating factor for anastomosis.
The preoperative knowledge of liver blood supply has great importance in planning surgery and transplantation. CTA, reformate and reconstruction techniques allow for the evaluation of difficult and complex anatomic variations.
鉴于肝血管结构变异的知识对于肝外科手术和肝移植至关重要，我们旨在介绍一种罕见的肝动脉血供解剖变异病例，以帮助预防并发症并选择合适的供体。
我们在本病例报告中呈现了一种新的变异（活体肝供体），即来自胰背动脉的副右肝动脉（供应段 6）和来自胰十二指肠动脉（胃十二指肠动脉的第一分支）的中肝动脉（供应段 4）。术前诊断使用计算机断层血管造影（CTA）结合多平面重建（MPR）图像、曲面重建（CPR）、最大密度投影（MIP）图像和三维容积再现（3D VR）进行。
据我们所知，这是首例在英文文献中描述这种变异类型的病例。由于非常细的段 4 动脉，活体肝供体不适合，且细的段 6 动脉可能给供体带来风险，为吻合带来并发症，因此开始寻找新的供体。
术前了解肝脏血液供应对于手术和移植计划具有重要意义。CTA、重建和重建技术可用于评估困难和复杂的解剖变异。
