术前三维CT血管成像评估肠系膜下动脉解剖特征

doi:10.13418/j.issn.1001-165x.2022.5.06

Abstract

Abstract: Objective To evaluate and analyze the classification and anatomical characteristics of the inferior mesenteric artery (IMA) of patients with rectal cancer by three-dimensional CT angiography (CTA) in order to provide reference for the surgical management of rectal cancer. Methods A retrospective analysis was performed on the clinical and image data of rectal cancer patients received IMA CTA examinations in Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from January 2018 to December 2019. IMA images were reconstructed by three-dimensional CT angiography. Branch types of IMA were classified, and anatomical parameters of the inferior mesenteric vessel were measured and analyzed. Results Among the 266 cases, 187 were males and 79 were females. The left colon artery (LCA) arose independently from the common trunk in 111 cases (accounting for 41.7%). In 112 cases (accounting for 42.1%), the LCA and sigmoid colon artery (SA) had a common trunk, and in 33 cases (accounting for 12.4%), LCA, SA and superior rectal artery (SRA) forked at same point, whereas LCA disappeared in 10 cases (accounting for 3.8%). The length of the IMA (LIMA) was (39.1±10.1) mm, and the distance between the IMA root and iliac aortic bifurcation (DIMA) was (44.1±7.4) mm. The distance from the IMA root to the inferior mesenteric vein (IMV) and the IMA branch point to the IMV were (24.6±8.9) mm, (13.0±5.3) mm, respectively. In 122 cases (accounting for 47.6%), LCA ascended medial to the lateral border of left kidney, while in 46 patients (accounting for 18.0%), LCA arranged below the inferior border of left kidney. LCA located medial to IMV at the level of IMA root in 65 cases (accounting for 25.4%), just lateral to IMV in 136 cases (accounting for 53.1%), and lateral away from IMV in 55 cases (accounting for 21.5%). Conclusions Three-dimensional CT angiography before surgery can accurately assess the IMA branch types and anatomical parameters of the inferior mesenteric vessel, which can provide reference for vascular management in rectal cancer surgery.

Key words: Rectal cancer, Inferior mesenteric artery, , , Three-dimensional CT angiography, , , Vascular variation

CLC Number:

R816.5

Zhang Peng, Chen Xin, Zhang Lan, Lin Yao, Lv Jianbo, Zeng Xinyu, Wang Zheng, Li Xin, Jin Yao, Tao Kaixiong. Anatomy of the inferior mesenteric artery evaluated by three-dimensional CT angiography before radical resection of rectal cancer[J]. Chinese Journal of Clinical Anatomy, 2022, 40(5): 530-535.

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Anatomy of the inferior mesenteric artery evaluated by three-dimensional CT angiography before radical resection of rectal cancer

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