Replaced common hepatic artery from the superior mesenteric artery: multidetector computed tomography (MDCT) classification focused on pancreatic penetration and the course of travel
Replaced common hepatic artery from the superior mesenteric artery: multidetector computed tomography (MDCT) classification focused on pancreatic penetration and the course of travel
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DOI：
10.1007/s00276-016-1618-9
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发表时间：
2016-08-01
影响因子：
1.4
通讯作者：
Jeon, Jang Yong
中科院分区：
文献类型：
--
作者：
Ha, Hong Il;Kim, Min-Jeong;Jeon, Jang Yong
应用多层螺旋CT对34例替代肝总动脉(RCHA)进行了多层螺旋CT检查。我们根据胰腺穿透和通过途径将其分为三种RCHA亚型。应用先进的三维成像软件测量肠系膜上动脉(SMA)口至RCHA分叉处(D(SMA-RCHA))的距离。A型(n=17，50%)指RCHA穿透胰腺实质，均穿过肠系膜上静脉(SMV)背侧。其中3例合并门静脉周围胰腺。B型(n=10，29%)为未穿入胰腺实质、与门静脉主干(MPV)或SMV背侧交叉的RCHA。C型(n=7，21%)为RCHA，未穿透胰腺实质，与MPV或SMV腹侧相交。各亚型的平均D(SMA-RCHA)分别为：A型3.13 cm[95%可信区间(CI)2.70~3.57]，B型2.04 cm[95%CI 1.40~2.68]，C型2.14 cm[95%CI 2.23~2.92]。RCHA穿透性胰腺实质的D(SMA-RCHA)较非穿透性胰腺实质的D(SMA-RCHA)明显延长(P=0.007)，半数穿透胰腺实质的RCHA为A型，且A型较未穿透胰腺实质的RCHA距SMA更远。
We categorize the subtypes of the replaced common hepatic artery (RCHA) and evaluate the clinical implications.Thirty-four cases of the RCHA were evaluated retrospectively using multidetector computed tomography. We categorized them into the three RCHA subtypes according to pancreatic penetration and the passing routes. The distance between the orifice of the superior mesenteric artery (SMA) and RCHA bifurcation (D (SMA-RCHA)) was measured using advanced 3D imaging software. Analysis of variance was used to evaluate the difference in D (SMA-RCHA) according to the RCHA subtype.Type A (n = 17, 50 %) referred to RCHA penetrating the pancreatic parenchyma, all crossing the dorsal aspect of the superior mesenteric vein (SMV). Among them, three cases were accompanied by the circumportal pancreas. Type B (n = 10, 29 %) referred to RCHA without penetration of the pancreatic parenchyma and crossing of the dorsal aspect of the main portal vein (MPV) or SMV. Type C (n = 7, 21 %) referred to RCHA without penetration of the pancreas parenchyma and crossing of the ventral aspect of the MPV or SMV. The mean D (SMA-RCHA) of each subtype was as follows: type A, 3.13 cm [95 % confidence interval (CI) 2.70-3.57]; type B, 2.04 cm [95 % CI 1.40-2.68]; and type C, 2.14 cm [95 % CI 2.23-2.92]. The D (SMA-RCHA) of the penetrating pancreatic parenchyma of the RCHA was significantly longer than that of the non-penetrating pancreatic parenchyma (P = 0.007).Half of RCHA show penetrating the pancreatic parenchyma, which was categorized as type A, and this type A takes off from the SMA more distally than RCHA without intrapancreatic penetration.