ANATOMY OF THE ARTERIAL SUPPLY TO THE LIVER DEMONSTRATED BY MRI

The aim of this study was to establish the accuracy of dynamic contras t-enhanced magnetic resonance imaging (DCEMRI) in assessing the site o f origin and the patency of the hepatic arteries. Sixty-one were exami ned 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 coron al oblique plane before and at 10, 40 and 70s after a bolus of gadolin ium-DTPA. The hepatic, left gastric, gastroduodenal, splenic and super ior mesenteric arteries were examined. The main portal vein, its right and left intrahepatic divisions, and the splenic and superior mesente ric veins were also assessed. The common hepatic artery was occluded i n 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 su rgery in 38 and 39 cases and with X-ray angiography in 21 and 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 oc cluded in 1 patient. The main portal vein was patent in 56 patients, o ccluded in 2 and narrowed in 2. Thirty-two patients had upper abdomina l varices. It is concluded that DCEMRI with sequential imaging provide s a non-invasive demonstration of hepatic arterial and venous structur es.