Anatomy of the arterial supply to the liver demonstrated by MRI

The aim of this study was to establish the accuracy of dynamic contrast-enhanced magnetic resonance imaging (DCEMRI) in assessing the site of origin and the patency of the hepatic arteries. Sixty-one patients were examined with serial DCEMRI. MRI was performed at 1.0 T with a rapid multi-section breath-hold fast low-angle shot (FLASH) technique in the coronal oblique plane before and at 10, 40 and 70 s after a bolus of gadolinium-DTPA. The hepatic, left gastric, gastroduodenal, splenic and superior mesenteric arteries were examined. The main portal vein, its right and left intrahepatic divisions, and the splenic and superior mesenteric veins were also assessed. The common hepatic artery was occluded in one patient. The right hepatic artery was seen in 59 patients, left hepatic in 54, left gastric in 43, gastroduodenal in 54, splenic in 60 and superior mesenteric artery in 61. Results were concordant with surgery in 38 of 39 cases and with X-ray angiography in 21 of 22 cases. In the detection of aberrant vessels DCEMRI had a sensitivity of 89 %, a specificity of 100 % and an accuracy of 97 %. All five veins were occluded in 1 patient. The main portal vein was patent in 56 patients, occluded in 2 and narrowed in 2. Thirty-two patients had upper abdominal varices. It is concluded that DCEMRI with sequential imaging provides a non-invasive demonstration of hepatic arterial and venous structures.