Abstract

Purpose: The study was conducted to identify and evaluate the spectrum of anatomical variations of the  coeliac axis (CA) and common hepatic artery(CHA) seen in multi detector computed tomography (MDCT) images .

Materials and Methods: The pattern of origin, course and branching of coeliac axis and common hepatic artery were evaluated in CT images of patients in Dept of Radiodiagnosis, Government Medical College, Trivandrum. A pre described nomenclature system is used for the systematic description of coeliac axis and common hepatic artery variations.CHA was defined as an arterial trunk containing at least one segmental hepaticartery and the gastroduodenal artery.

After assessing the coeliac axis anatomy the branching pattern of the downstream hepatic arteries including their origin site, anatomic course specifically of the common hepatic, left and right hepatic arteries and the gastroduodenal artery was studied.

Results: A total of 149 out of 150 cases had a normal celiac axis anatomy which appeared as a hepatogastrosplenic trunk and SMA originating separately from the aorta (HSpM+SM). Variant identified was a hepatogastric trunk with splenomesenteric trunk (HG+SpM). 137 patients had a normal CHA anatomy in which the CHA originated from the celiac axis, and had a suprapancreatic preportal course. In the remaining 13 patients variations in its origin and /or anatomic course were noted.

Conclusion: With a clear definition of normal and variant CHA, we were able to perform a systematic analysis of CT images using nomenclature system and summarize the observed variations.

Keywords: Coeliac axis, Common hepatic artery , systematic analysis ,nomenclature system.