Department of Radiology, St Marianna University School of Medicine, Yokohama City Seibu Hospital, 1197-1, Yasashicho, Asahi-Ward, Yokohama, 241-0811, Kanagawa, Japan.
Department of Gastrointestinal Surgery, St Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Kanagawa, Japan.
Jpn J Radiol. 2018 Dec;36(12):698-705. doi: 10.1007/s11604-018-0775-7. Epub 2018 Sep 14.
To prospectively correlate the preoperative vessel anatomy in three-dimensional computed tomographic angiography with computed tomographic colonography (3D-CTA with CTC) with that in laparoscopic surgery for colorectal cancer.
The study protocol was approved by our institutional review board. The study population consisted of 101 patients with colon cancer who underwent 3D-CTA with CTC between June 2016 and January 2018. Two radiologists assessed the branching patterns of sigmoid arteries (SAs) and right colonic artery (RCA), the position between the ileocolic artery (ICA) and superior mesenteric vein (SMV), and the existence of an accessory middle colonic artery (aMCA). The vessel anatomy on 3D-CTA with CTC was correlated with that of intraoperative findings.
Ninety-eight examinations (97.0%) were technically successful. Between preoperative and intraoperative vessel anatomy, the branching patterns of SAs were concordant in all 29 cases with rectosigmoid and descending colon cancer. The branching patterns of RCA and the position between the ICA and SMV were completely concordant in 32 cases of cecal and ascending colon cancer. No aMCA was identified either intraoperatively or by imaging analysis.
3D-CTA with CTC guided the surgeons to determine the resection margin of the relevant vessels for laparoscopic colorectal surgery.
前瞻性地将三维计算机断层血管造影术（3D-CTA）与 CT 结肠成像（CTC）的术前血管解剖与腹腔镜结直肠癌手术的血管解剖进行相关性研究。
本研究方案经我院伦理审查委员会批准。研究人群为 2016 年 6 月至 2018 年 1 月期间接受 3D-CTA 与 CTC 的 101 例结肠癌患者。两位放射科医生评估了乙状结肠动脉（SAs）和右结肠动脉（RCA）的分支模式、回结肠动脉（ICA）和肠系膜上静脉（SMV）之间的位置以及中间结肠副动脉（aMCA）的存在。将 3D-CTA 与 CTC 的血管解剖与术中发现进行相关性分析。
98 例检查（97.0%）技术上成功。在术前和术中的血管解剖之间，在 29 例直肠乙状结肠癌中，SAs 的分支模式完全一致。在 32 例盲肠和升结肠癌中，RCA 的分支模式和 ICA 与 SMV 之间的位置完全一致。术中或影像学分析均未发现 aMCA。
3D-CTA 与 CTC 可指导外科医生确定腹腔镜结直肠手术中相关血管的切除范围。
