Pak Neda, Patel Shilpan G, Hashemi Taheri Amir P, Hashemi Fariba, Eftekhari Vaghefi Raana, Naybandi Atashi Sara, Mirjalili S Ali
Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Anatomy with Radiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Clin Anat. 2016 Mar;29(2):191-6. doi: 10.1002/ca.22669. Epub 2015 Dec 10.
Surface anatomy is a core component of human anatomy in clinical practice. It allows clinicians to assess patients accurately and quickly; however, recent studies have revealed variability among individuals and ethnicities. The aim of this study is to investigate possible variations in adult thoracic and abdominal surface anatomy landmarks in an Iranian population. This study used 100 thoracoabdominal CT scans (mean age: 47 ± 17 years, age range: 20-77 years, 47% females), noted the most common locations of clinically relevant surface markings, and analyzed correlations between these variables and age or gender. While many common surface markings in Iranians were consistent with the evidence-based literature, there were some differences. In relation to the corresponding segments of the vertebral column, the superior vena cava formation and the lower border of the pleura adjacent to the vertebral column and right kidney tended to be at higher levels in adult Iranians than a Caucasian population. There were also discrepancies between the Iranian population and commonly-referenced medical textbooks and recent evidence-based literature concerning the vertebral levels of the diaphragmatic openings of the esophagus, aorta, and inferior vena cava. This study emphasizes the need to consider evidence-based reappraisals of surface anatomy to guide clinical practice. Much of our current knowledge of surface anatomy is based on older studies of cadavers rather than living people, and does not take ethnic and individual variations into consideration.
表面解剖学是临床实践中人体解剖学的核心组成部分。它使临床医生能够准确、快速地评估患者；然而，最近的研究揭示了个体和种族之间的差异。本研究的目的是调查伊朗人群中成人胸部和腹部表面解剖标志的可能差异。本研究使用了100例胸腹部CT扫描（平均年龄：47±17岁，年龄范围：20 - 77岁，47%为女性），记录了临床相关表面标志的最常见位置，并分析了这些变量与年龄或性别的相关性。虽然伊朗人的许多常见表面标志与循证文献一致，但也存在一些差异。与脊柱的相应节段相比，伊朗成年人的上腔静脉形成部位以及与脊柱和右肾相邻的胸膜下缘往往比白种人群更高。在伊朗人群与常用医学教科书以及最近的循证文献之间，关于食管、主动脉和下腔静脉膈肌裂孔的椎体水平也存在差异。本研究强调需要考虑对表面解剖学进行循证重新评估以指导临床实践。我们目前对表面解剖学的许多认识是基于对尸体的较旧研究而非活人，并且没有考虑种族和个体差异。
