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Fetal median sacral artery anatomy study by micro-CT imaging

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Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Purpose

The median sacral artery (MSA) is the termination of the dorsal aorta, which undergoes a complex regression and remodeling process during embryo and fetal development. The MSA contributes to the pelvic vascularization and may be injured during pelvic surgery. The embryological steps of MSA development, anastomosis formation and anatomical variations are linked, but not fully understood.

Methods

The pelvic vascularization and more precisely the MSA of a human fetus at 22 weeks of gestation (GW) were studied using micro-CT imaging. Image treatment included arterial segmentations and 3D visualization.

Results

At 22 GW, the MSA was a well-developed straight artery in front of the sacrum and was longer than the abdominal aorta. Anastomoses between the MSA and the internal pudendal arteries and the superior rectal artery were detected. No evidence was found for the existence of a coccygeal glomus with arteriovenous anastomosis.

Conclusions

Micro-CT imaging and 3D visualization helped us understand the MSA central role in pelvic vascularization through the ilio-aortic anastomotic system. It is essential to know this anastomotic network to treat pathological conditions, such as sacrococcygeal teratomas and parasitic ischiopagus twins (for instance, fetus in fetu and twin-reversed arterial perfusion sequence).

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Acknowledgements

We would like to thank Gérard Subsol for review of the Methods section. Data used in this study were partly produced thanks to the equipment of the MRI facility and the labEx CeMEB.

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Authors and Affiliations

  1. Service de chirurgie pédiatrique viscérale, urologique, plastique et brûlés, CHRU Tours, Tours, France

    P. Meignan, A. Binet, A. R. Cook & H. Lardy

  2. EA2415, Aide à la décision médicale personnalisée, Université Montpellier, Montpellier, France

    G. Captier

  3. Laboratoire d’anatomie de Montpellier, UFR médecine, Université Montpellier, Montpellier, France

    G. Captier

Authors
  1. P. Meignan
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  2. A. Binet
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  3. A. R. Cook
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  4. H. Lardy
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  5. G. Captier
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Contributions

P.M. data management, data analysis, manuscript writing, A.B. data analysis, A.R.C manuscript writing, H.L. data analysis, G.C. project development, data collection, data analysis, manuscript writing.

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Correspondence to P. Meignan.

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All the authors declare that they have no conflict of interest.

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Meignan, P., Binet, A., Cook, A.R. et al. Fetal median sacral artery anatomy study by micro-CT imaging. Surg Radiol Anat 40, 735–741 (2018). https://doi.org/10.1007/s00276-018-2032-2

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  • DOI: https://doi.org/10.1007/s00276-018-2032-2

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