Hepatic Arterial Anatomy Variations in Patients with Hepatocellular Carcinoma Evaluated by Computed Tomography Angiography

Abstract Aim of the Work To highlight the role of CT angiography in evaluation of hepatic artery variations in patients with hepatocellular carcinoma. Patients and Methods The study was conducted from November 2022 to August 2023, 80 patient referred from oncology to radiology department at Ain Shams university hospitals for preoperative evaluation of hepatic artery anatomical variations. Results Our study included Egyptian patients who were retrospectively analyzed came for triphasic CT of the liver, the mean age of this study population is 50.06 years. It was identified normal hepatic arterial anatomy in patients (31.3The other 27 patients (42.2%) showed some variation. Regarding Michels classification, the most frequently observed abnormalities were: right hepatic artery branch of the superior mesenteric artery (Type III, n = 10, 15.6 %); left hepatic artery branch of the left gastric artery (Type II, n = 8, 12.5%); Accessory left hepatic artery of the left gastric artery (Type V, n = 5, 7.8%). Accessory right hepatic artery of the superior mesenteric artery (Type VI, n = 2, 3.1%). Replaced right hepatic artery of superior mesenteric artery and Accessory left hepatic artery of the left gastric artery (Type VIII, n = 2, 3.1%). Conclusion Hepatic arteries variations are not uncommon findings, with different anatomic variants being reported. Thus, the importance of knowing the possible variations of this structure is emphasized, which may have implications for pre-surgical, pre-laparoscopic, or even pre-interventional and this can be achieved using MSCT to minimize and avoid the major vascular complications and decrease the morbidity of patients.