Evaluation of Inferior Phrenic Artery Variations of 1029 Patients Using MDCT Angiography

Background: 128-Multi-detector computerized tomography (128-MDCT) technologies make the detection of inferior phrenic arteries (IPAs) originations and traces possible. Knowing their originating and variations is very important for planning interventional and surgical procedures. Objective: To evaluate the IPAs variations in a large patient group, using 128-MDCTA. Methods: The origin, trace and branching pattern of IPAs were evaluated using128- MDCTA in 1029 patients. The study population included 53.3% males and 46.7% females with a mean age of 59±15.7 years. We used abdominal aortic CTA and hepatic arterial phase images of triphasic abdominal CT which were obtained for various reasons. Results: Right and left IPA (RIPA and LIPA) arose from the celiac trunk (35,6% and 46,6%), abdominal aorta (27,2% and 23,4%), right and left renal artery (8,6% and 0,9%), and left gastric artery (1,1% and 0,9 %). Respectively IPAs rarely originate from accessory or polar renal artery, main hepatic artery, superior mesenteric artery (SMA), splenic artery, dorsal pancreatic artery and accessory left hepatic artery. In 74% of the patients RIPA and LIPA originated from a separate branch, whereas in 26% of the patients RIPA and LIPA originated from a common trunk. The localization of common trunk was celiac trunk in 13,6%, abdominal aorta in 11,4%, left gastric and right renal artery in 0,3%, left renal artery in 0,2% and splenic artery in 0,1% of the patients. Conclusion: This study is the first to detect 9 new origin sites and 4 new common root types of IPAs.