Imaging of hepatic arterial anatomy for depicting vascular variations in living related liver transplant donor candidates with multidetector computed tomography: comparison with conventional angiography.

AIMS: The aim of this study was to evaluate liver arteries to depict variations by using multidetector computed tomography (CT) in donor candidates for living related liver transplantation.

METHODS: Computed tomographic hepatic angiography was carried out using a multidetector 16-row CT scanner (Sensation 16; Siemens) in 48 candidates between April 2003 and August 2004. Multidetector CT was performed after intravenous injection of 150 mL of contrast material at a rate of 4 mL/s. Arterial phase images were acquired after contrast injection. Afterward, maximum intensity projections and volume-rendered images were produced from the axial image data. Twenty-eight of these patients underwent conventional catheter angiography.

RESULTS: Excellent arterial opacification was shown on multidetector CT scans in all patients; arteries up to tertiary branches were identified with CT. Of 28 patients who had both multidetector CT angiography and conventional angiography, only a branch of hepatic artery originating from superior mesenteric artery that supplied the posterior segment of the right lobe was not identified on multidetector CT angiography. In 27 donors, hepatic arterial anatomy depicted at multidetector CT angiography was identical to that at conventional angiography. We identified hepatic vascular variants in 22 of 48 patients with multidetector CT. The most common arterial variant was an accessory hepatic artery arising from the left gastric artery.

CONCLUSIONS: Preoperative imaging evaluation of hepatic vascular anatomy is crucial for surgical planning in living related transplant donors. Multidetector CT is useful to depict hepatic arterial anatomy with high accuracy.