Abstract

Purpose

To retrospectively evaluate blood supply to the caudate lobe of the liver from the right inferior phrenic artery (RIPA) using cone-beam computed tomography during arteriography (CBCTA-RIPA).

Methods

CBCTA-RIPA examinations during transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) were collected from 2448 procedures in 787 patients. The exclusion criteria were (1) major artifacts, (2) TACE of hepatic arterial branches before performing CBCTA-RIPA, and (3) repeated CBCTA-RIPA studies in the same patient. Blood supply to three subsegments, the Spiegel lobe (SP), paracaval, and caudate process, was evaluated on CBCTA-RIPA images. The origins and routes of branches supplying the caudate lobe were also evaluated by three-dimensional vessel-tracking software.

Results

Forty-seven CBCTA-RIPA examinations in 47 patients (38 with a history of TACE [repeated TACE group] and nine without it [initial TACE group]) were eligible, including five who had previously undergone hepatectomy. Seven had caudate lobe HCCs. Blood supply to the caudate lobe was demonstrated in 21 (44.7%) patients: in 50% (19/38) and 22.2% (2/9) of the repeated and initial TACE groups, respectively. The caudate arteries had previously been embolized in eight patients, the RIPA branch in three, and both in one. Forty-one proximal branches mainly supplied the dorsal part of the SP. All branches but five reached there through the inferior vena cava (IVC) ligament. The RIPA supplied eight of nine caudate lobe HCCs, totally (n = 7) or partially (n = 1).

Conclusion

The proximal RIPA branches mainly supply the dorsal SP through the IVC ligament, especially in the repeated TACE group.

中文翻译：

---

右下en动脉向肝脏的尾状叶供血：在动脉造影期间通过锥形束计算机断层扫描观察。

摘要

目的

为了回顾性评估在动脉造影期间使用锥束计算机断层扫描从右下en动脉（RIPA）向肝尾状叶的血液供应。

方法

从787例患者的2448例手术中收集经肝动脉化疗栓塞（TACE）期间的CBCTA-RIPA检查，以进行肝细胞癌（HCC）检查。排除标准为（1）主要伪影，（2）在进行CBCTA-RIPA之前进行肝动脉分支的TACE，以及​​（3）在同一患者中重复进行CBCTA-RIPA研究。在CBCTA-RIPA图像上评估了三个子段的血液供应，明镜叶（SP），副腔和尾状突。还通过三维血管追踪软件评估了供应尾状叶的分支的起源和路线。

结果

47例患者的47例CBCTA-RIPA检查（38例具有TACE病史[重复性TACE组]和9例无TACE病史[初始TACE组]）符合条件，包括5例先前接受了肝切除术。七个有尾状肝癌。在21例（44.7％）患者中证实了向尾状叶的血液供应：分别在重复和初始TACE组的50％（19/38）和22.2％（2/9）中。尾动脉先前被栓塞在八名患者中，RIPA分支被栓塞在三名患者中，两者均被栓塞在一处。41个近端分支主要提供SP的背侧部分。除五个分支机构外，所有分支机构都通过下腔静脉韧带（IVC）到达那里。RIPA提供了9个尾状肝癌中的8个，全部（n  = 7）或部分（n  = 1）。

结论

RIPA近端分支主要通过IVC韧带供应背侧SP，尤其是在重复的TACE组中。