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In comparison with the left and right hepatic arteries, there is a relative lack of information on the middle hepatic artery (MHA). In this study, data obtained by multidetector computed tomography from 145 patients were studied to evaluate anatomical variations of the MHA, a hilar artery that primarily supplies hepatic segment 4. An MHA was present in 103 (71%) of the subjects. In livers that had a replaced left hepatic artery, the MHA originated from the right hepatic artery; in livers that had a replaced right hepatic artery, it originated from the left hepatic artery. It always arose directly or indirectly from the common hepatic artery, from which the gastroduodenal artery also arose. We classified MHAs into 5 types according to the anatomical variations of the origin. This classification may have major relevance to modern surgical practice related to living donor liver transplantation (LDLT). The new classification of hepatic arterial anatomy may enhance the acquisition of further knowledge on arterial development, and its application may favorably influence the outcome of LDLT. Liver Transpl 16:736-741,

There is no significant correlation between MVD and perfusion. Neovascularizaton and perfusion are highly presented in early colorectal carcinoma. CT perfusion imaging may be more suited for assessing tumorigenesis in colorectal carcinoma than histological MVD technique.

Background and Aims Emerging evidence points to a link between creeping fat and pathogenesis of Crohn’s disease (CD). Non-invasive assessment of the severity of creeping fat on cross-sectional imaging modality has seldom been investigated. This study aimed to develop and characterize a novel mesenteric creeping fat index (MCFI) based on CT in CD patients. Methods MCFI was developed based on vascular findings on CT in retrospective cohort (n=91) and validated in prospective cohort (n=30). The severity of creeping fat was graded based on the extent to which mesenteric fat extended around the intestinal circumference using the vessels in the fat as a marker. The accuracy of MCFI was assessed by comparing it with the degree of creeping fat observed in surgical specimens. The relationship between MCFI and fibrostenosis was characterized by determining if these correlated. The accuracy of MCFI was compared with other radiographic indices (i.e. visceral to subcutaneous fat area ratio and fibrofatty proliferation score). Results In retrospective cohort, MCFI had moderate accuracy in differentiating moderate-severe from mild fibrostenosis (AUC=0.799; P=0.000). ROC analysis in retrospective cohort identified a threshold MCFI of >3 which accurately differentiated fibrostenosis severity in prospective cohort (AUC=0.756; P=0.018). Excellent correlation was shown between MCFI and the extent of fat wrapping in specimens in prospective cohort (r=0.840, P=0.000). Neither visceral to subcutaneous fat area ratio nor fibrofatty proliferation score correlated well with intestinal fibrosis degree. Conclusions MCFI can accurately characterize the extent of mesenteric fat wrapping in surgical specimens. It may become another non-invasive measure of CD fibrostenosis.

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