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DOI:10.2214/AJR.09.2417
AJR 2009; 193:W288-W294
© American Roentgen Ray Society

Clinical Observations

Left Inferior Phrenic Artery Feeding Hepatocellular Carcinoma: Angiographic Anatomy Using C-Arm CT

Hyo-Cheol Kim1, Jin Wook Chung1, Sangbu An1, Nak Jong Seong1, Hwan Jun Jae1, Baik Hwan Cho2 and Jae Hyung Park1

1 Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, and Clinical Research Institute, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea.
2 Department of Surgery and Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonbuk Cancer Center, Chonbuk National University Hospital, Jeonju, Korea.

OBJECTIVE. The left inferior phrenic artery (LIPA) is one of the common extrahepatic collateral arteries that supply hepatocellular carcinomas (HCCs). The purpose of this study is to describe the anatomy of the LIPA that supplies HCCs using C-arm CT in 23 patients.

CONCLUSION. The anteromedial limb of the ascending branch was present in 14 patients and accessory gastric branches were noted in 11 patients. The use of angiography and C-arm CT of the LIPA showed 26 tumor feeders in 23 patients. The feeders were seen in the anteromedial limb (n = 12), lateral limb (n = 9), anterior limb (n = 3), and descending branch (n = 2). The anteromedial limb of the ascending branch is a common tumor feeder of the LIPA and can supply HCCs located in the right liver dome. Gastric staining is also frequently depicted on LIPA angiography and should not be confused with tumor staining.

Keywords: C-arm CT • chemoembolization • hepatocellular carcinoma • left inferior phrenic artery


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