The hepatic capsular arteries: imaging features and clinical significance

BackgroundAlthough the anatomical features of the hepatic capsular arteries have been previously reported, the radiological and clinical importance of these arteries has not been well documented.Imaging findingsWe injected barium sulfate into the intra- and extra-hepatic arteries in cadavers to investigate the hepatic capsular arteries. The web-like hepatic capsular arteries derived from the capsular branch of the peripheral hepatic arteries are called isolated arteries. There were anastomoses between the intra- and extra-hepatic arteries (inferior phrenic artery, superior falciform ligament artery, and cystic artery) through the hepatic capsular arteries.Clinical significanceWe reviewed the radiology database and assessed clinical cases. When the hepatic artery is occluded, the collateral vessels, such as the inferior phrenic artery and the superior falciform ligament artery, develop via the hepatic capsular arteries at the right triangular ligament and falciform ligament, respectively. Bleeding from capsular arteries causes extensions of the subcapsular hematoma.ConclusionThe hepatic capsular arteries spread along the hepatic surface and constitute the vascular network throughout the liver. These arteries play an important role in collateral circulation in various clinical situations, as well as subcapsular hematoma.