Anatomical Variations of Celiac Trunk and Hepatic Arterial System Using Multidetector Computed Tomography in Egyptians

Document Type : Original Article

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The Departments of Anatomy & Embryology* and Radiology**, Faculty of Medicine, Mansoura University.

Abstract

Background: The classic anatomic pattern of the Celiac trunk is present in 86-89% of cases in several studies. Major variations of the celiac trunk are common and should be antic-ipated before radiological and surgical interventions such as: hepatopancreatobiliary surgery, liver transplant, and interven-tional radiology. Uflacker’s classification system of variations of coeliac trunk is one of the commonly used systems. The normal hepatic artery arises from celiac trunk and di-vides into three main branches; the right hepatic, left hepatic and middle hepatic. Many variations of the normal anatomy of hepatic artery exist. Michel’s classification for hepatic artery variants describes nine arterial anatomical variations. Preoper-ative identification of hepatic artery variations reduces intraop-erative bleeding complications and improve postoperative sur-gical outcomes in many surgeries such as liver tumor resection, liver transplantation, pancreatic tumor resection, pancreatoduo-denectomy and biliary surgeries. Multidetector computed tomography angiography has shown great ability in defining the vascular anatomy and detect-ing any anomalies and variants before the surgical interference with much less side effects. Aim of Study: The aim of the work is to study the variations of the normal anatomy of the celiac trunk and the hepatic artery among Egyptians using MDCT. Material and Methods: This Descriptive cross-sectional study was carried out on 380 patients who underwent MDCT scan by Toshiba Aquilion Prime Series CT Scanner -80 slice per rotation for abdominal and hepatic assessment. Results: According to Uflacker’s classification of celiac trunk variants, Type I (classic and non-classic patterns) was the most common variant in 91.07% of the cases. Followed by type V in 30 cases (7.89%). Other variants were type II in 4 cases (1.05%). Type III, VI, IV, VII and VIII weren’t reported among the included cases. According to Michel’s classification for hepatic artery vari-ants, Type I (Classic Anatomy) was the most common variant in 80.2% of the cases. Followed by Type III in 42 cases (11.05%). Type V in 15 cases (3.94%), Type II in 10 cases (2.63%), Type ΙΧin 7 cases (1.84%) and Type VΙ in 1 case (0.26%). Type IV, VΙΙ, VΙΙΙ and Χ weren’t reported in the cases of the study. Conclusions: Based on the results of the current study, it is concluded that Multidetector Computed Tomography could be used as an efficient diagnostic technique in assessment of variants of the celiac trunk and hepatic artery.

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