ABSTRACT
AIM: To visualize the segment IV hepatic artery and to evaluate the variations in anatomy using multidetector computed tomography (MDCT) angiography. MATERIALS AND METHODS: Six hundred and seventeen patients (381 men and 236 women; mean age 62.7 ± 8.1 years; age range 22-92 years) who underwent MDCT angiography performed using a 128-section MDCT system were included in the study. The segment IV hepatic arteries of 453 patients with adequate image quality were displayed using volume rendering (VR), maximum intensity projection (MIP), and multiplanar reconstruction (MPR), and were analysed regarding the origination and variation of the arteries by two radiologists and an anatomist retrospectively. RESULTS: Segment IV arteries were categorized into five different types according to their points of origin: left hepatic artery (LHA, 51.66%), right hepatic artery (RHA, 30.68%), proper hepatic artery (PHA, 5.3%), dual (12.14%), and triple (0.22%). Segment IV arteries arising from normal LHA, RHA, and PHA were found in 73.73% of patients, and those arising from variant LHA or RHA were found in 26.27%. The patterns RN2, LA2, LA3, LA4, PN2, PV1, DA1, DA2, DV3, and DV4 were first reported in the present study. CONCLUSIONS: MDCT angiography can evaluate normal as well as anatomical variants of segment IV arteries. Predicting arterial patterns of segment IV of the liver is important in planning and performing all radiological and surgical procedures in the liver, especially in hemi-liver graft procedures.
Subject(s)
Angiography , Hepatic Artery/diagnostic imaging , Imaging, Three-Dimensional , Liver/diagnostic imaging , Multidetector Computed Tomography , Adult , Aged , Aged, 80 and over , Female , Hepatic Artery/anatomy & histology , Hepatic Artery/pathology , Humans , Liver/anatomy & histology , Liver/pathology , Liver Transplantation/methods , Male , Middle Aged , Observer Variation , Reproducibility of Results , Retrospective Studies , Sensitivity and SpecificityABSTRACT
PURPOSE: The purpose of this study was to evaluate the morphology of xiphoid process by dissection and using radiography of cadavers and multidetector computed tomography (MDCT) in patients. METHODS: The xiphoid processes of 41 cadavers were dissected and taken by radiography. Other 902 patients examined by MDCT were revealed by image post-processing used with multiple planar reconstruction, maximum intensity projection and volume rendering. RESULTS: Xiphoid processes displayed pointed shape in 422 cases (44.75 %), oval shape in 387 cases (41.04 %), and forked shape in 134 cases (14.21 %). The sagittal shape of the xiphoid process was observed as ventrally deviated in 217 cases (23.01 %), dorsally deviated in 191 cases (20.25 %), S-shaped (ahead ventral, then dorsal) in 21 cases (2.23 %), and resembling a hook in 14 of ventral deviated patients and in 19 of those dorsal deviated patients. The foramen of xiphoid processes was found in 544 cases (57.69 %). The pattern L (a large foramen with a diameter of more than 5 mm) appeared in 302 cases (55.51 %), pattern S (a small foramen with a diameter of no more than 5 mm) in 155 cases (28.49 %), pattern LS (a mixture of a large and a small foramina) in 37 cases (6.80 %), and pattern SS (two or more small foramina) in 50 cases (9.19 %). CONCLUSION: Human xiphoid process appeared in morphological diversity. The anatomic structure and ossification degree of xiphoid process was well evaluated by MDCT. Our data may be used for diagnosis and surgical treatment of xiphoid process-related diseases.
