He Hao, Chen Peng, Chen Xiaofeng, Wang Pei Yuan, Liu Shuo Yan, Wang Feng
Department of Thoracic Surgery, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China.
J Thorac Dis. 2021 Aug;13(8):5035-5041. doi: 10.21037/jtd-21-1141.
Thoracic surgeons must be familiar with the anatomy of the pulmonary artery during segmentectomy and segmentectomy. But pulmonary arteries have numerous variations and aberrant branching patterns. The purpose of the present study was to analyze the anatomical variations and frequencies of the lingular artery of the left upper lobe (LUL) using 3D computed tomography angiography and bronchography (3D-CTAB).
We retrospectively studied 166 patients having undergone lobectomy or segmentectomy from January to December 2020 at Fujian Medical University Cancer Hospital's Department of Thoracic Surgery. All patients underwent 3D reconstruction using 3D-CTAB before surgery.
The lingular segment was supplied by 1 artery in 45.18% of cases, 2 arteries in 46.39% of cases, and 3 arteries in 8.43% of cases. The branching patterns of the lingular artery included 119 (71.68%) cases with interlobar origin, 35 (21.08%) cases with interlobar and mediastinal origin, and 13 (7.83%) cases with mediastinal origin. The interlobar lingular artery include superior lingular artery (A4) and inferior lingular artery (A5). The interlobar lingular artery type was A4a, A4b, A5 in 7.23% of cases; A4 and A4b+5 in 3.01% of cases; and A4b and A4a+5 in 4.82% of cases. The mediastinal lingular artery was divided into the following 5 types: 'A4', 'A4b', 'A4b+5', 'A4b+5a', and 'A4+5'. The most common type was A4 (12.05%, 20/166) in 166 patients. The interlobar lingular artery had the following 5 patterns of variation: 'A4+5', 'A4, A5', 'A4a, A4b, A5', 'A4a, A4b+5', and 'A4b, A4a+5'. The single interlobar lingular artery (A4+5) was the most common type in 38.55% of cases. In 24.10% of cases, A5 came from A8 or A8+9. Besides In 8.43% of cases, the origin of A5 was close to A8 or A8+9.
We identified the left various lingular artery branching patterns with 3D-CTAB in patients and defined the frequency of anatomic variations. 3D-CTAB is useful for finding these variations.
胸外科医生在进行肺段切除术和肺叶切除术时必须熟悉肺动脉的解剖结构。但肺动脉存在众多变异和异常分支模式。本研究的目的是使用三维计算机断层扫描血管造影和支气管造影（3D-CTAB）分析左上叶（LUL）舌叶动脉的解剖变异及频率。
我们回顾性研究了2020年1月至12月在福建医科大学附属肿瘤医院胸外科接受肺叶切除术或肺段切除术的166例患者。所有患者术前均使用3D-CTAB进行三维重建。
45.18%的病例中舌叶段由1支动脉供血，46.39%的病例由2支动脉供血，8.43%的病例由3支动脉供血。舌叶动脉的分支模式包括119例（71.68%）为叶间起源，35例（21.08%）为叶间和纵隔起源，13例（7.83%）为纵隔起源。叶间舌叶动脉包括上舌叶动脉（A4）和下舌叶动脉（A5）。叶间舌叶动脉类型为A4a、A4b、A5的占7.23%；A4和A4b+5的占3.01%；A4b和A4a+5的占4.82%。纵隔舌叶动脉分为以下5种类型：“A4”、“A4b”、“A4b+5”、“A4b+5a”和“A4+5”。166例患者中最常见的类型是A4（12.05%，20/166）。叶间舌叶动脉有以下5种变异模式：“A4+5”、“A4，A5”、“A4a，A4b，A5”、“A4a，A4b+5”和“A4b，A4a+5”。单一叶间舌叶动脉（A4+5）是最常见的类型，占38.55%。在24.10%的病例中，A5来自A8或A8+9。此外，在8.43%的病例中，A5的起源靠近A8或A8+9。
我们通过3D-CTAB确定了患者左侧舌叶动脉的各种分支模式，并明确了解剖变异的频率。3D-CTAB有助于发现这些变异。
