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Anatomical variations of the coeliac trunk and the mesenteric arteries evaluated with 64-row CT angiography

Studio sulla variabilità anatomica del tripode celiaco e delle arterie mesenteriche mediante angiografia con TC spirale multistrato a 64 strati

  • Abdominal Radiology Radiologia Addominale
  • Published:
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Abstract

Purpose

This study was undertaken to evaluate the accuracy of 64-row computed tomography angiography (CTA) in the study of vascular anatomy by assessing the incidence of anatomical variations of the origin of the coeliac trunk, mesenteric arteries and collateral branches.

Materials and methods

Sixty patients were evaluated with 64-row CTA (VCT, General Electric Healthcare, Milwaukee, WI, USA) with a collimation of 0.625 mm after the injection of iodinated nonionic contrast material (4 ml/s). Exclusion criteria were the presence of any pathological condition likely to affect normal vascular anatomy.

Results

The coeliac trunk had a normal trifurcation in 56.7% of cases. The common hepatic artery was normal in 60% of patients. The inferior pancreaticoduodenal arteries were either absent or not assessable in 8.3% of cases and there was a double trunk in 5%, a common trunk in 83.3% and a single vessel in 3.3%. The number of jejunal and ileal arteries ranged from a minimum of six to a maximum of 13 (mean value 8.7 ± 1.34). The Riolan arcade was assessable in 31.7% and developed in 68.4% of these.

Conclusions

The 64-row CTA enables visualisation of small vessels and accessory arteries that are difficult to identify with other techniques. The technique’s high sensitivity allowed us to observe that the prevalence of vascular abnormalities is higher than that reported in the literature.

Riassunto

Obiettivo

Valutare l’adeguatezza dell’angio-TC a 64 strati nello studio dell’anatomia vascolare, studiando l’incidenza delle varianti anatomiche di origine del tripode celiaco, delle arterie mesenteriche superiori ed inferiori, e dei loro rami collaterali dall’aorta.

Materiali e metodi

Sono stati valutati 60 pazienti sottoposti a studio con angio-TC a 64 strati, utilizzando una collimazione submillimetrica (0,625) e previa somministrazione di mezzo di contrasto iodato non ionico ad alto flusso (4 ml/s). I criteri di esclusione riguardavano tutte quelle condizioni che potevano modificare normale anatomia vascolare.

Risultati

Il tripode celiaco presentava una normale triforcazione nel 56,7% dei casi. L’arteria epatica comune è risultata normale nel 60% dei casi. Le arterie pancreatico-duodenali inferiori risultavano assenti o non valutabili nel 8,3%, era presente un doppio tronco nel 5%, un tronco comune nel 83,3%, ed un unico vaso nel 3,3%. Il numero delle arterie digiuno-ileali variava da un minimo di 6 ad un massimo di 13 con una media di 8,7±1,34. L’arcata di Riolano è risultata valutabile nel 31,7% dei casi, e di questi era sviluppata nel 68,4%.

Conclusioni

L’angio-TC a 64 strati permette di visualizzare piccoli vasi ed arterie accessorie, difficilmente identificabili con altre metodiche. Questa elevata sensibilità ha permesso di rilevare come il numero di anomalie vascolari risulti più elevato di quello riportato in letteratura.

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Correspondence to C. N. De Cecco.

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Ferrari, R., De Cecco, C.N., Iafrate, F. et al. Anatomical variations of the coeliac trunk and the mesenteric arteries evaluated with 64-row CT angiography. Radiol med 112, 988–998 (2007). https://doi.org/10.1007/s11547-007-0200-2

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  • DOI: https://doi.org/10.1007/s11547-007-0200-2

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