ARE THE HEPATIC ARTERIES END ARTERIES

Twenty-five autopsy livers were studied for intrahepatic arterial anastomoses. Under fluoroscopy, barium suspension at various concentrations, with or without latex, was injected into the hepatic artery. One-centimeter axial or coronal liver sections were radiographed with high-resolution mammographic technique. All films were reviewed. Seven interconnecting arterial pathways were demonstrated: subcapsular and peripheral arcades, proximal and intermediate connecting vessels, periportal arterial rete and ring, a fine parenchymal network, and connections with the gallbladder arterial system. In the six cases where a branch artery was occluded, arterial filling of the entire liver was demonstrated. The authors conclude that these interconnecting networks could account for the infrequency of hepatic infarcts, are the anatomic basis for the intrahepatic spread of malignant lesions, the "duplication" and "triplication" patterns on arteriography, and may account for the outer streaks of the arteriographic "thread and streak" sign in portal vein invaded by hepatocellular carcinoma.