Anatomical Variations of the Celiac Trunk and Hepatic Arteries with a New Classification, Based on CT Angiography

Objectives: To analyse the distribution of anatomical variations in both celiac trunk (CeT) and hepatic artery (HA) branching patterns on computed tomography (CT) angiography images; as well as to propose a new classification by unifying the already reported classifications of the CeT and HA vascular anatomy. Study Design: Observational study. Place and Duration of Study: Department of Radiology, Faculty of Medicine, Selçuk University, Konya, Turkey, from February 2019 to March 2020. Methodology: CT angiography-based evaluation of the CeT and HA branching patterns was performed in patient undergoing routine contrast-enhauced CT of abdomen. Types of variation were determined and classified into five types (1-5) and ten subtypes. Distribution was also sorted by age and gender. Results: Type 1 (classic CeT and HA branching pattern) was detected in 240 (70.6%) out of 340 cases (126 females, 214 males). Sixty-five (19.12%) had Type 2 subtypes, in which HA branching pattern coexists with normal CeT configuration; whereas, Type 3a and 3d, Type 4 and 5 having anomalous CeT variants, with typical HA pattern, were observed in 5.87% (20/340) of the cases. The frequency of the concurrent variations (Type 3b and 3c) was 4.41% (15/340). The least frequent subtypes, Type 4 and 5, were observed in one (0.29%) and three (0.88%) cases, respectively. There was no significant differences in branching types frequency by gender and age (p>0.05). Conclusion: Awareness of the range of anatomical variation in both the CeT and HA branching patterns, especially concurrent variations, is vital when planning surgical and radiological interventions to prevent possible iatrogenic injury and complications.