Evaluation of Celiac Trunk, Hepatic Artery Variations, and Their Collateral Arteries by Multi-Slice Computed Tomography

Objectives: Celiac Trunk (CT) is a vital artery and the first unmatched branch of the abdominal aorta, providing blood to upper abdominal structures, particularly the liver, stomach, and spleen. It is essential to know its anatomy in terms of pancreas, spleen, gallbladder, liver surgeries, and interventional radiological procedures such as chemoembolization. The aim of our study is to contribute to the literature with the measurements of distances between the diaphragmatic crus and vascular structures with their diameters, which have been studied insufficiently, and to detect the possible relationships between vascular variations and collateral branches.
Methods: Imaging findings of 200 patients (114 males and 86 females), who underwent Multi-Section Computed Tomography examination with various indications in our center between June 2016 and July 2020, were retrospectively analyzed. The statistical relations between CT and Hepatic Artery variations, collateral formations, age, and gender were evaluated with the Spearman’s Rho Correlation Coefficient Test.
Results: The distance between the crus of diaphragm and CT was 4–60 mm (mean 24.3 mm), the distance between CT and superior mesenteric artery (SMA) was 2.5–35 mm (mean 8.6 mm), CT diameter was 4.6–9.4 mm (mean 7.3 mm), and the main hepatic artery diameter was 2.4–5.8 mm (mean 4.1 mm). There was no correlation in our study between CT, Hepatic Artery variations, and their collaterals (r in range of −20,124–0.116, p>0.05). It can be said that in cases of the single accessory left hepatic artery originating from the left gastric artery, such as Michel’s Type V and Type VIII, collaterals between common hepatic artery and SMA were relatively more frequent (p=0.1).
Conclusion: Our study contributed to the literature by measuring the distance between diaphragmatic crus-vascular structures, which has been little studied in the past. Frequencies of CT and Hepatic Artery variations that have been detected in our study are similar to the results of the previous studies with non-malignancy patient groups.

Çölyak trunk, hepatik arter varyasyonlarinin ve kollateral arterlerinin çok kesitli bilgisayarli tomografi ile deðerlendirilmesi

Amaç: Çölyak Trunk abdominal aortun ilk eþleþmemiþ dalý olup, baþta karaciðer, mide ve dalak olmak üzere üst karýn yapýlarýna kan saðlar. Pankreas, dalak, safra kesesi, karaciðer ameliyatlarý ve kemoembolizasyon gibi giriþimsel radyolojik iþlemler öncesinde varyant anatomileri bilmek önemlidir. Çalýþmamýzýn amacý, yeterince çalýþýlmamýþ diyafragmatik krus ile vasküler yapýlar arasýndaki mesafelerin ölçülmesi ve vasküler varyasyonlar ile kollateral dallar arasýndaki muhtemel iliþkilerin saptanmasýdýr.
Yöntem: Haziran 2016 - Temmuz 2020 tarihleri arasýnda, merkezimizde, Çok Kesitli Bilgisayarlý Tomografi incelemesi yapýlan 200 kolorektal kanserli hastanýn (114 erkek, 86 kadýn) görüntüleme bulgularý retrospektif olarak incelendi. Çölyak Trunk, Hepatik Arter varyasyonlarý, kollateral oluþumlar, yaþ, cinsiyet arasýndaki iliþkiler Spearman’s Rho test ile deðerlendirildi.
Bulgular: Diyafram krusu ile çölyak trunk arasýndaki mesafe 4-60 mm (ortalama 24,3 mm), çölyak trunk ile superior mezenterik arter (SMA) arasýndaki mesafe 2,5-35 mm (ortalama 8,6 mm), çölyak trunk çapý 4,6-9,4 mm (ortalama 7,3 mm) ve ana hepatik arter (CHA) çapý 2,4-5,8 mm (ortalama 4,1 mm) ölçüldü. Çalýþmamýzda Çölyak Trunk, Hepatik Arter varyasyonlarý ile kollateral arterler arasýnda istatistiksel olarak anlamlý korelasyon (r -0,124 - 0.116 aralýðýnda, p> 0.05) saptanmamakla beraber Michel's tip V ve tip VIII gibi sol gastrik arterden çýkan tek aksesuar sol hepatik arter olgularýnda CHA ve SMA arasýndaki kollaterallerin nispeten daha sýk olduðu söylenebilir (p = 0,1).
Sonuç: Çalýþmamýz geçmiþte çok az çalýþýlan diyafragmatik krus-vasküler yapýlar arasýndaki mesafeleri tespit ederek literatüre katký saðlamýþtýr. Çalýþmamýzda tespit ettiðimiz Çölyak Trunk ve Hepatik Arter varyasyonlarýnýn sýklýklarý, malignitesi olmayan hasta gruplarýyla yapýlmýþ önceki çalýþmalarýn sonuçlarý ile benzerdir. (SETB-2021-03-074)