Visualization of the segment IV hepatic artery using 128-section MDCT angiography

• Segment IV artery was evaluate and mapped by using MDCT angiography.
• Segment IV arteries were categorized into five different types: RHA, LHA, PHA, Dual, and Triple.
• The patterns of RN2, LA2, LA3, LA4, DA1, DA2, DN4, DV3 and DV4 were first reported.
• Predicting arterial patterns of segment IV is helpful for segmental hepatectomy, LDLT, SLT, and TACE.

AimTo visualize the segment IV hepatic artery and to evaluate the variations in anatomy using multidetector computed tomography (MDCT) angiography.Materials and methodsSix 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.ResultsSegment 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.ConclusionsMDCT 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.