Multi-slice computed tomographic angiography in preoperative detection of hepatic arterial anomalies in patients undergoing pancreaticoduodenectomy

Objective To assess the preoperative detection of hepatic arterial anomalies in patients undergoing pancreaticoduodenectomy using multi-slice computed tomographic angiography (MSCTA). Methods Between January 2014 and December 2017, 60 patients who underwent pancreaticoduodenectomy were included in this retrospective study. The clinical and imaging data were analyzed. The types of hepatic artery found by preoperative MSCTA based on the Michels classification were compared with the actual hepatic arterial anatomy detected during surgery. Results Hepatic arterial anomalies were detected by MSCTA in 12 of 60 patients (20.0%). Using the Michels classification, there were 3 patients with type Ⅱ (25.0%), 6 patients with type Ⅲ (50.0%), 1 patient with type Ⅵ (8.3%), and 1 patient with type Ⅸ (8.3%). One patient (8.3%, 1/12) had an anomaly which was not included in the Michels typing. All the hepatic arterial anomalies detected by MSCTA corresponded to those found in surgery (12 patients). The rates of accuracy, sensitivity, and specificity of MSCTA were all 100%. Conclusions MSCTA provided a high accuracy in diagnosing hepatic arterial anomalies. MSCTA should be routinely used before pancreaticoduodenectomy. Key words: Mography, X-ray computed; Pancreatoduodenectomy; Aberrant hepatic artery