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Intra-mural distribution of the blood vessels in the stomach demonstrated by contrast medium injection: a cadaver study

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Abstract

Purpose

With advances in diagnostic imaging techniques of gastric cancer screening with X-ray fluoroscopy, it has been suggested that mucosal projections induced by the vessels distributed in the submucosal layer of the stomach may be mistaken for abnormal mucosal folds. In this study, we aimed to describe the distribution of blood vessels in the submucosal layer of the stomach to improve the diagnostic accuracy of screening of gastric cancer.

Methods

Twenty-four stomachs from Japanese cadavers were used in this study. Uncolored or colored contrast agents were injected into arteries and/or veins for macroscopic analyses, X-ray imaging, and methyl salicylate clearing. In addition, histological analysis was performed to examine blood vessels distributed inside the stomach wall.

Results

Following contrast agent injection, thick blood vessels were distributed perpendicular to both curvature sides, and branches parallel to both curvature sides flowed from these thick blood vessels, and a vascular network was formed throughout the stomach wall. This vascular network had intra-mural anastomoses connecting both curvature sides. Moreover, in histological analyses, blood vessels depicted by injection were mainly distributed in the submucosal layer.

Conclusion

This study strongly suggests that the mucosal projections induced by arteries and veins in the submucosal layer could be mistaken for abnormal mucosal folds. Therefore, a better understanding of the vascular distribution in the submucosal layer is important to improve diagnostic accuracy from imaging studies of the stomach. The information provided by this research may facilitate better accuracy in diagnosis and reduce the number of unnecessary invasive procedures.

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Acknowledgements

We thank Editage (www.editage.com) for English language editing

Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Clinical Anatomy, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Haruka Eishi, Kumiko Yamaguchi & Keiichi Akita

  2. Department of Radiology, Tachikawa Kitaguchi Kenshinkan, Tokyo, Japan

    Yoshihiro Hiramatsu

Authors
  1. Haruka Eishi
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  2. Kumiko Yamaguchi
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  3. Yoshihiro Hiramatsu
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  4. Keiichi Akita
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Contributions

HE: protocol/project development, data collection/management, manuscript writing. KY: protocol/project development, data collection/management, manuscript editing. YH: project development, manuscript editing. KA: project development, data management, manuscript editing.

Corresponding author

Correspondence to Keiichi Akita.

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Conflicts of interest

The authors have no conflict of interest to declare regarding the materials or methods used in this study or the findings presented in this paper.

Ethics approval

All procedures were approved by the institutional review board of Tokyo Medical and Dental University (Approval No. M2018-233).

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Eishi, H., Yamaguchi, K., Hiramatsu, Y. et al. Intra-mural distribution of the blood vessels in the stomach demonstrated by contrast medium injection: a cadaver study. Surg Radiol Anat 43, 389–396 (2021). https://doi.org/10.1007/s00276-020-02613-5

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  • DOI: https://doi.org/10.1007/s00276-020-02613-5

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