Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan.
Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan.
Clin Anat. 2021 Oct;34(7):1035-1042. doi: 10.1002/ca.23716. Epub 2021 Feb 5.
Celiac artery (CA) stenosis (CAS), caused by various factors, is often asymptomatic because collateral blood flow from the superior mesenteric artery supplies the CA outflow region. The purpose of this study was to investigate the usefulness of multidetector computed tomography (MDCT) for diagnosing CAS and associated collateral artery formation, and elucidating the effect of CAS on the numbers and diameters of the arteries within the mesopancreas.
We investigated 106 patients who underwent contrast-enhanced MDCT, before pancreaticoduodenectomy, between January 2015 and September 2019. MDCT was used to determine the percentage stenosis of the CAs; patients were classified into CAS (-) (0-29% stenosis) and CAS (+) (30-100% stenosis) groups. The dissection lines of the mesopancreas were classed as Level I or II, and the numbers and diameters of the arteries along each dissection line were counted and measured.
There were 27 CAS (+) patients and 79 CAS (-) patients. In the CAS (+) group there were more arteries and they had larger diameters than those in the CAS (-) group, at both Levels I and II. There were significantly more arteries when the CA stenosis was ≥30% and they had larger diameters when the stenosis was ≥50%.
MDCT is useful for diagnosing CAS, and CAS is associated with larger numbers and diameters of the arteries within the mesopancreas.
由于多种因素导致的腹腔动脉(CA)狭窄(CAS)通常是无症状的,因为来自肠系膜上动脉的侧支血流供应 CA 流出区域。本研究的目的是探讨多排螺旋 CT(MDCT)在诊断 CAS 及其相关侧支动脉形成中的作用,并阐明 CAS 对胰周动脉数量和直径的影响。
我们调查了 2015 年 1 月至 2019 年 9 月期间,106 例在胰十二指肠切除术前接受增强 MDCT 检查的患者。MDCT 用于确定 CA 的狭窄程度;患者被分为 CAS(-)(狭窄 0-29%)和 CAS(+)(狭窄 30-100%)组。将胰周动脉的解剖线分为 I 级或 II 级,并对每条解剖线的动脉数量和直径进行计数和测量。
27 例患者为 CAS(+),79 例患者为 CAS(-)。在 CAS(+)组中,动脉数量更多,直径也比 CAS(-)组更大,在 I 级和 II 级均如此。当 CA 狭窄≥30%时,动脉数量明显增多,当狭窄≥50%时,动脉直径也明显增大。
MDCT 有助于诊断 CAS,CAS 与胰周动脉数量和直径增大有关。