Hepatic Arterial Anatomy Variations Evaluated by the Computed Tomography Angiography in the Patients with Hepatocellular Carcinoma: A Case-Control Study

Abstract

Background: Hepatic arterial anatomy is of major importance in performing many surgical and endovascular procedures on the liver. Hepatic artery anatomical variations are a common finding. Aim: The aim of our study was to estimate the prevalence of various hepatic arterial variants in HCC patients and compare it with that in individuals with no abdominal abnormality. Patients and methods: Total of 78 patients was included in the study. They were categorized into following groups: 1) Patients with HCC (n=46); 2) Control group (n=32). Prevalence of variant arterial anatomy in each group and subgroup was determined and compared to the values in Control Group. Results: Compared to the control group HCC group showed higher incidence of hepatic arterial anatomy variations (54.5% vs. 31.2%). The difference was statistically significant (p<0.05). Among the patients with HCC lesions larger than 10 cm the percentage of arterial variations was 81.25% which was very statistically significantly different from that of the control group (p<0.01). This subgroup of patients also showed higher incidence of SMA type RHA p<0.05). Among the patients with single HCC lesion the percentage of arterial variations was 76.92% which was very statistically significantly different from that of the control group (p<0.01). Among the patients with two HCC lesions the percentage of arterial variations was 62.5% which was not statistically significantly different from that of the control group. Groups of patients with HCC lesions less than 10 cm as well as the group with multiple HCC lesions did not show statistically significant difference of the hepatic arterial anatomy variation incidence compared to the control group either. Our study implies that there may be a difference in the incidence of hepatic arterial anatomical variations between HCC patients and healthy individuals. This issue is worth of conducting further research on large series.