Mallard Alexandre, Bonjour Maxime, Milot Laurent, Viste Anthony, Stacoffe Nicolas, Cotton François
Radiology Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, Pierre Benite Cedex, 69495, France.
Biostatistics & Bioinformatics Department, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.
Surg Radiol Anat. 2024 Dec 16;47(1):32. doi: 10.1007/s00276-024-03535-2.
The aim was to find bony landmarks of the pelvis for the origins and routes of uterine arteries, hoping to improve speed and safety of embolization procedures (leiomyoma, post-partum bleedings…).
We carried out a study based on the analysis of CT-angiographies in arterial phases of whole-body scans. Two measurements were done per artery, one from the origin of uterine arteries to a first perpendicular line passing through the lowest part of the sacroiliac joint, another one from the beginning of the parametrial segment from a second parallel line passing by the acetabular roof. Mean distances across all these measurements were calculated, as were potential associations with known variables such as anatomical variants, age, parity and any pelvic surgical history.
Two hundred uterine arteries were analyzed. Concerning the origin, 83.5% of uterine arteries were located approximately one centimeter around the first line defined above, with a mean distance of + 4.8 mm. Concerning parametrial segment beginning, 88% were located approximately one centimeter around the second line defined, with a mean distance of only + 3.9 mm above the acetabular roof. Some significant differences were observed in subgroups, notably with a small trend to higher arising of uterine arteries in patients who had at least one childbirth, and expectedly lower arising in distal anatomical variants.
Clear pelvic anatomic landmarks exist and could help the guidance of arteries catheterization, and therefore indirectly lead to faster embolization and optimize procedures safety.
旨在寻找骨盆中子宫动脉起源和走行的骨性标志，以期提高栓塞手术（子宫肌瘤、产后出血等）的速度和安全性。
我们开展了一项基于全身扫描动脉期CT血管造影分析的研究。每条动脉进行两次测量，一次是从子宫动脉起源至穿过骶髂关节最低点的第一条垂线，另一次是从子宫旁段起始处至经过髋臼顶的第二条平行线。计算所有这些测量值的平均距离，以及与解剖变异、年龄、产次和任何盆腔手术史等已知变量的潜在关联。
分析了200条子宫动脉。关于起源，83.5%的子宫动脉位于上述第一条线周围约1厘米处，平均距离为+4.8毫米。关于子宫旁段起始处，88%位于所定义的第二条线周围约1厘米处，在髋臼顶上方的平均距离仅为+3.9毫米。在亚组中观察到一些显著差异，特别是至少有一次分娩的患者中子宫动脉起源位置有稍高的趋势，而在远端解剖变异中起源位置预期较低。
存在清晰的骨盆解剖标志，可有助于动脉插管的引导，从而间接实现更快的栓塞并优化手术安全性。
