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Left hepatic artery

The left hepatic artery (LHA) is one of the terminal branches of the proper hepatic artery, itself derived from the common hepatic artery (a branch of the celiac trunk). It usually arises at the porta hepatis after the proper hepatic artery bifurcates into the left and right hepatic arteries.

The LHA courses to the left within the hepatoduodenal ligament and enters the left lobe of the liver, where it further divides into medial and lateral segmental branches. These branches supply segments II–IV of the liver, according to Couinaud’s classification.

The LHA provides a significant portion of the arterial blood supply to the left hepatic lobe and bile ducts, in addition to the portal venous contribution. It exhibits frequent anatomical variations; in some cases, it may arise from the left gastric artery (“replaced LHA”), an important consideration in gastrectomy, liver transplantation, and interventional procedures.

Synonyms

  • LHA

  • Arteria hepatica sinistra

  • Left branch of proper hepatic artery

Function

  • Supplies oxygenated blood to the left lobe of the liver (segments II–IV)

  • Provides essential arterial supply to the bile ducts, particularly the left hepatic duct

  • Forms part of the dual blood supply of the liver along with the portal vein

  • Critical for hepatic resection, transplantation, and interventional radiology planning

Branches

  • Medial segmental branch → supplies segment IV

  • Lateral segmental branch → supplies segments II and III

  • Smaller branches may also contribute to biliary perfusion

MRI Appearance

T1-weighted images:

  • Blood flow appears as a signal void (black lumen)

  • Vessel wall appears hypointense; surrounding hepatic parenchyma aids localization

T2-weighted images:

  • Lumen remains a signal void

  • Adjacent edema, tumor infiltration, or inflammation appears hyperintense

STIR (Short Tau Inversion Recovery):

  • Fat suppression enhances visibility of perivascular structures

  • Pathology (e.g., edema, inflammatory changes, tumor invasion) appears bright hyperintense near the artery

T1 Post-Contrast (Gadolinium-enhanced):

  • LHA enhances brightly and homogeneously

  • Clearly demonstrates course, stenosis, aneurysm, dissection, or collateral vessels

  • Improves visualization of intrahepatic segmental branching

MRA (Magnetic Resonance Angiography):

  • Contrast-enhanced MRA provides detailed mapping of the origin, course, intrahepatic branches, and anatomical variants of the LHA

  • Essential for surgical planning (hepatic resection, transplant) and interventional radiology

  • Identifies stenosis, aneurysm, pseudoaneurysm, or tumor encasement

  • 3D reconstruction allows precise vascular mapping

CT Appearance

Non-contrast CT:

  • Appears as a tubular soft tissue density in the porta hepatis

  • Not well visualized unless calcified

CT Angiography (CTA):

  • Provides excellent delineation of the origin, intrahepatic course, and branching pattern

  • Identifies anatomical variants, stenosis, aneurysm, pseudoaneurysm, or neoplastic encasement

  • Crucial for transplantation, hepatic resection, and embolization procedures

  • Multiplanar and 3D reconstructions give precise mapping of hepatic arterial anatomy

MRI image

Left hepatic artery MRI axial image -img-00000-00000

CT images

Left hepatic artery anatomy ct axial image -img-00000-00000

CT images

Left hepatic artery ct axial image 1

CT images

Left hepatic artery ct axial image