Gamo E, Jiménez C, Pallares E, Simón C, Valderrama F, Sañudo J R, Arrazola J
Department of Human Anatomy and Embryology. School of Medicine, Complutense University of Madrid, Madrid, Spain.
Radiology Department. Hospital Clínico San Carlos, Complutense University of Madrid, Madrid, Spain.
Surg Radiol Anat. 2016 Jul;38(5):519-27. doi: 10.1007/s00276-015-1608-3. Epub 2016 Jan 4.
The superior mesenteric artery (SMA) supplies irrigation to the small intestine, ascending and a variable area of the transverse colon. Although medical imaging and surgical procedures have been widely developed in the last decades, the anatomy of the SMA using advanced imaging technology remains to be elucidated. Previous studies have used small sample sizes of cadaveric or radiological samples to propose a number of classifications for the SMA. In this study, we aimed to provide a more detailed description and useful classification of the SMA and its main branches [middle colic artery (MCA), right colic artery (RCA), and ileocolic artery (ICA)]. Samples (n = 50, 28 males and 22 females) were obtained from the repository of human cadavers located at the Department of Human Anatomy and Embryology, Complutense University of Madrid. This sample was dissected by preclinical medical students and completed by two of the authors (Gamo and Jiménez). A second set of samples was obtained from a bank of computerized tomography (CT) (560 CTs, 399 males and 161 females) collected by the Radiology Department at the Clínico San Carlos Hospital, Spain. Based on the results obtained from these studies, we propose a new classification of four patterns for the SMA anatomy. Pattern I as the independent origin of the three main branches of the SMA (cadaveric 40 %; CT 73.69 %); Pattern II is subdivided in three sub-patterns based on the common trunks of origin: Pattern IIa, common trunk between RCA and MCA (cadaveric 20 %, CT 4.28 %); Pattern IIb, common trunk between RCA and ICA (cadaveric 32 %, CT 15 %); Pattern IIc, common trunk for the three main branches (cadaveric 0 %, CT 0.35 %); Pattern III, as the absence of RCA (cadaveric 8 %; CT 2.32 %) and Pattern IV, based on presence of accessory arteries (not found in any of the samples). Although the independent origin of the three colic arteries have been classically described as the most frequent, the right colic artery is responsible of major variations.
肠系膜上动脉（SMA）为小肠、升结肠及部分横结肠供血。尽管在过去几十年里医学影像和外科手术有了广泛发展，但利用先进成像技术对SMA的解剖结构仍有待阐明。以往研究使用少量尸体或放射学样本对SMA提出了多种分类。在本研究中，我们旨在对SMA及其主要分支[中结肠动脉（MCA）、右结肠动脉（RCA）和回结肠动脉（ICA）]进行更详细的描述和实用的分类。样本（n = 50，男28例，女22例）取自马德里康普顿斯大学人体解剖学与胚胎学系的人体尸体库。该样本由临床前医学生进行解剖，并由两位作者（加莫和希门尼斯）完成。第二组样本来自西班牙圣卡洛斯临床医院放射科收集的计算机断层扫描（CT）库（560例CT，男399例，女161例）。基于这些研究结果，我们提出了SMA解剖结构的四种模式的新分类。模式I为SMA三个主要分支独立起源（尸体样本中占40%；CT样本中占73.69%）；模式II根据共同起源干分为三个子模式：模式IIa，RCA和MCA之间的共同干（尸体样本中占20%，CT样本中占4.28%）；模式IIb，RCA和ICA之间的共同干（尸体样本中占32%，CT样本中占15%）；模式IIc，三个主要分支的共同干（尸体样本中占0%，CT样本中占0.35%）；模式III为无RCA（尸体样本中占8%；CT样本中占2.32%），模式IV基于副动脉的存在（在任何样本中均未发现）。尽管经典描述中三个结肠动脉独立起源最为常见，但右结肠动脉是变异的主要原因。
