Hepatic artery classification based on three-dimensional CT

Abstract

Background: Precise classification of the hepatic artery is helpful for preoperative surgical planning in hepatobiliary-pancreatic surgery. However, the anatomy of hepatic arteries is variable. This study investigated anatomical variation using three-dimensional visualization and evaluation (3DVE) to develop a nomenclature system. Methods: The origin and course of the hepatic artery were tracked and analysed by using three-dimensional visualization of CT images acquired between 2013 and 2017. The new classification and nomenclature system, named CRL, was developed based on the origins of the common, right and left hepatic arteries. Results: Scans from 770 adults were evaluated. Preoperative 3DVE correlated better with surgical findings than the original CT images alone. Using the CRL classification system, hepatic arteries were divided into nine subtypes. Only 87⋅4-89⋅2 per cent of the hepatic arteries of 610 living-donor liver transplant donors were depicted in Michels', Hiatt's or Varotti's classification, compared with 100 per cent identified by the CRL classification. The CRL classification was validated against external data sets from previous studies, with 99⋅6-100⋅0 per cent of patients classified by the CRL system. Conclusion: The CRL classification covers hepatic artery variants and may be used for planning liver surgery.

AI-based chest CT semantic segmentation algorithm enables semi-automated lung cancer surgery planning by recognizing anatomical variants of pulmonary vessels

“…A comprehensive understanding of the blood vessel structure, especially the artery structure, is the most crucial task in preoperative planning to minimize the chance of intraoperative bleeding and misresection (26)(27)(28). Given the fact that arteries are more hazardous than veins in surgeries…”

Hepatomesenteric trunk: a rare anatomical variation

“…Later in 2019, Yan et al . published a new classification of hepatic artery variations based on three‐dimensional CT scan 4 …”

“…2,3 Later in 2019, Yan et al published a new classification of hepatic artery variations based on three-dimensional CT scan. 4 Aberrant (replaced or accessory) right hepatic artery (AHA) originating from the SMA is the most frequent variation (13-26%). 5 Anomalous CHA arising from the SMA, known as HMT, is classified as Michels type IX, Hyatt type V or Yan's type 9s.…”

A rare hepatic artery variant reporting and a new classification

“…However, despite the many classifications, more than 10% of hepatic arteries still cannot be classified. In recent years, with the wide application of 3D visualization technology (3DVT) ( 9 – 11 ), Yan et al ( 12 ) presented the CRL classification, which succinctly describes the hepatic artery and its branches and covers a wider range of arterial variants. However, some rare variants still cannot be categorized by the CRL classification, and these variations are more likely to be unidentified and injured.…”