MORPHOLOGICAL CHARACTERISTICS AND ANATOMICAL VARIATIONS OF THE CELIAC TRUNK ON MULTI-DETECTOR COMPUTED TOMOGRAPHY

Ngoc Tuong Vy Pham1, , Abdul Hamid Hamzaini2, Thi Giao Ha Nguyen3, Anh Quan To3, Dung Tien Doan3, Thuy Nga Doan3, Thi Thao Trang Nguyen1, Trong Nguyen Vo1
1 Can Tho University of Medicine and Pharmacy Hospital
2 Gleneagles Hospital Kuala Lumpur, Malaysia
3 Can Tho University of Medicine and Pharmacy

Main Article Content

Abstract

Background: The morphological characteristics and anatomical variations of the celiac trunk hold particularly important clinical significance, providing safe guidance for upper gastrointestinal surgery and endovascular interventions. Objectives: To describe the origin and branching patterns of the celiac trunk using multi-detector computed tomography (MDCT). Materials and methods:  A cross-sectional descriptive study was conducted on 1070 patients who underwent abdominal MDCT scans at Can Tho Central General Hospital from July 2024 to February 2026. Results: The mean age of the study sample was 55.76 ± 15.43 years, with a comparable male-to-female ratio (50.9% male and 49.1% female). The site of origin of the celiac trunk was primarily at the level of the T12 vertebral body (40.2%) and the T12/L1 intervertebral disc (39.0%). Regarding branching characteristics, 87.3% of cases exhibited typical anatomy (Uflacker Type I), while anatomical variations accounted for 12.7%. These included Types II, III, IV, V, VI, and VIII, along with several rare variants not included in this classification system (12 cases, 1.1%). Among the variations, Types II (4.9%) and V (4.4%) were the most prevalent. Conclusion: In a study of 1070 patients, the celiac trunk exhibited diverse anatomy with a 12.7% variation rate, predominantly originating at the T12 vertebral and T12/L1 intervertebral levels (79.2%); Types II and V were the most common variants, and rare forms outside the Uflacker classification were recorded in 1.1% of cases. 

Article Details

References

1. White R.D., Weir-McCall J.R., Sullivan C.M., Mustafa S.A.R., Yeap P.M., et al. The Celiac Axis Revisited: Anatomic Variants, Pathologic Features, and Implications for Modern Endovascular Management. RadioGraphics. 2015. 35(3), 879-898, https://doi.org/10.1148/rg.2015140243.
2. Zhang Z., Wang S., Ye M., Tao F., Guo D. Rare variation: the absence of both the celiac trunk artery and the common hepatic artery. World Journal of Surgical Oncology. 2022. 20(1), 388, https://doi.org/10.1186/s12957-022-02858-x.
3. Trần Quang Lộc, Lê Mạnh Thường, Phan Nhật Anh, Lê Thanh Dũng. Nghiên cứu đặc điểm giải phẫu động mạch thân tạng trên cắt lớp vi tính 256 dãy. Tạp chí Y học Việt Nam. 2023. 523(1), https://doi.org/10.51298/vmj.v523i1.4434.
4. Brown A.M., Kassab I., Massani M., Townsend W., Singal A.G., et al. TACE versus TARE for patients with hepatocellular carcinoma: Overall and individual patient level meta-analysis. Cancer Medicine. 2023. 12(3), 2590-2599, https://doi.org/10.1002/cam4.5125.
5. Araujo Neto S.A., Franca H.A., de Mello Júnior C.F., Silva Neto E.J., Negromonte G.R., et al. Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography. Radiologia Brasileira. 2015. 48(6), 358-362, https://doi.org/10.1590/0100-3984.2014.0100.
6. Uflacker A., Guimaraes M. Uflacker's Atlas of Vascular Anatomy: An Angiographic Approach. 3rd ed. Philadelphia: Wolters Kluwer. 2021.
7. Osman A.M., Abdrabou A. Celiac trunk and hepatic artery variants: A retrospective preliminary MSCT report among Egyptian patients. The Egyptian Journal of Radiology and Nuclear Medicine. 2016. 47(4), 1451-1458, https://doi.org/10.1016/j.ejrnm.2016.09.011.
8. Panagouli E., Venieratos D., Lolis E., Skandalakis P. Variations in the anatomy of the celiac trunk: A systematic review and clinical implications. Annals of Anatomy. 2013. 195(6), 501511, https://doi.org/10.1016/j.aanat.2013.06.003.
9. Song S.Y., Chung J.W., Yin Y.H., Jae H.J., Kim H.C., et al. Celiac axis and common hepatic artery variations in 5002 patients: systematic analysis with spiral CT and DSA. Radiology. 2010. 255(1), 278-288, https://doi.org/10.1148/radiol.09090389.
10. Mrowiec S., Król R., Jabłońska B. Absence of the celiac trunk and anomalous very low origin of the common hepatic artery arising independently from the abdominal aorta just above aortic bifurcation in patient undergoing radical pancreaticoduodenectomy. Surgical and Radiologic Anatomy. 2021. 43, 585-588, https://doi.org/10.1007/s00276-020-02666-6.
11. Namba Y., Oishi K., Okimoto S., Moriuchi T., Bekki T., et al. Imaging diagnosis of aberrant proper hepatic and gastroduodenal arteries prior to pancreaticoduodenectomy: A case report. Radiology Case Reports. 2021. 16(7), 1650-1654, https://doi.org/10.1016/j.radcr.2021.03.062.