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MDCT Anatomic Assessment of Right Inferior Phrenic Artery Origin Related to Potential Supply to Hepatocellular Carcinoma and its Embolization

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Abstract

Purpose

To prospectively assess the anatomic variation of the right inferior phrenic artery (RIPA) origin with multidetector computed tomography (MDCT) scans in relation to the technical and angiographic findings during transcatheter arterial embolization of hepatocellular carcinoma (HCC).

Methods

Two hundred patients with hepatocellular carcinomas were examined with 16-section CT during the arterial phase. The anatomy of the inferior phrenic arteries was recorded, with particular reference to their origin. All patients with subcapsular HCC located at segments VII and VIII underwent arteriography of the RIPA with subsequent embolization if neoplastic supply was detected.

Results

The RIPA origin was detected in all cases (sensitivity 100%), while the left inferior phrenic artery origin was detected in 187 cases (sensitivity 93.5%). RIPAs originated from the aorta (49%), celiac trunk (41%), right renal artery (5.5%), left gastric artery (4%), and proper hepatic artery (0.5%), with 13 types of combinations with the left IPA. Twenty-nine patients showed subcapsular HCCs in segments VII and VIII and all but one underwent RIPA selective angiography, followed by embolization in 7 cases.

Conclusion

MDCT assesses well the anatomy of RIPAs, which is fundamental for planning subsequent cannulation and embolization of extrahepatic RIPA supply to HCC.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Ospedale Ferrarotto, via Citelli 14, 95124, Catania, Italy

    Antonio Basile & Maria Teresa Patti

  2. Department of Radiology, University Hospital of Heraklion, Medical School of Crete, Heraklion, Greece

    Dimitrios Tsetis

  3. Department of Infectious Diseases, Ospedale Ferrarotto, via Citelli 14, 95124, Catania, Italy

    Arturo Montineri

  4. Department of General Surgery, Ospedale Vittorio Emanuele, via Plebiscito 125, 95124, Catania, Italy

    Stefano Puleo

  5. Department of Radiology, Policlinico S. Matteo, Pavia, Italy

    Cesare Massa Saluzzo

  6. Department of Radiology, University Hospital Paolo Giaccone, Palermo, Italy

    Giuseppe Runza & Francesco Coppolino

  7. Department of Radiology, University Hospital, Catania, Italy

    Giovanni Carlo Ettorre

Authors
  1. Antonio Basile
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  2. Dimitrios Tsetis
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  3. Arturo Montineri
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  4. Stefano Puleo
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  5. Cesare Massa Saluzzo
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  6. Giuseppe Runza
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  7. Francesco Coppolino
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  8. Giovanni Carlo Ettorre
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  9. Maria Teresa Patti
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Correspondence to Antonio Basile.

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Basile, A., Tsetis, D., Montineri, A. et al. MDCT Anatomic Assessment of Right Inferior Phrenic Artery Origin Related to Potential Supply to Hepatocellular Carcinoma and its Embolization. Cardiovasc Intervent Radiol 31, 349–358 (2008). https://doi.org/10.1007/s00270-007-9236-x

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  • DOI: https://doi.org/10.1007/s00270-007-9236-x

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