Al-Hajri Mohammed, Abduwani Ali, Al-Saadi Ilyas, Sidairi Nasser Al, Riyami Mahmood Salim Nasser Al, Baawain Saleh, Das Srijit
Department of Human & Clinical Anatomy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat 123, Oman.
Radiology Program, Oman Medical Specialty Board, Muscat 132, Oman.
Diagnostics (Basel). 2025 Aug 26;15(17):2167. doi: 10.3390/diagnostics15172167.
The abdominal aorta (AA) bifurcates at the level of the L4 vertebra, giving origin to the right and left common iliac arteries (CIA). The CIA then bifurcates into external iliac arteries (EIA) and internal iliac arteries (IIA). The present radiological study aimed to (i) measure the diameter of the right and left CIA, (ii) measure the distance between the AA bifurcation and the point where the ureter crossed the ipsilateral iliac vessels, (iii) examine the angle of AA bifurcation, and (iv) observe the vertebral level at which the AA bifurcated. The retrospective cross-sectional study included contrast-enhanced CT angiograms of 200 patients ( = 144 males and 56 females) who attended the radiology department from 1 January 2022 to 31 December 2023. Two independent radiologists interpreted the angiograms. The results were interpreted using parametric and non-parametric statistical tests. The mean angle of the AA bifurcation was 40.46° and 44.68° in males and females, respectively ( = 0.013). The mean diameter of the right and left CIA was wider in males than in females, but no statistical significance was found. The average distance between the AA bifurcation and the point where the right and left ureter crossed the ipsilateral iliac arteries was longer in females (60.99 and 60.29 mm, respectively) than in males (59.05 and 59.95 mm, respectively), but no statistical difference was found ( > 0.05). The most common vertebral level for AA bifurcation was the L4 vertebra, which was found in 137 (68.50%) patients. The AA bifurcated at the level of L3 and L5 in 52 (26.00%) and 11 (5.50%) patients, respectively. Understanding the radiological anatomy of the CIA and AA bifurcation and its relation to the ureter is crucial for surgeons performing aortic and pelvic surgeries.
腹主动脉（AA）在第4腰椎水平处分为左右髂总动脉（CIA）。然后，髂总动脉再分为髂外动脉（EIA）和髂内动脉（IIA）。本放射学研究旨在：（i）测量左右髂总动脉的直径；（ii）测量腹主动脉分叉处与输尿管跨过同侧髂血管处之间的距离；（iii）检查腹主动脉分叉角度；（iv）观察腹主动脉分叉的椎体水平。这项回顾性横断面研究纳入了200例患者（144例男性和56例女性）的增强CT血管造影图像，这些患者于2022年1月1日至2023年12月31日在放射科就诊。两名独立的放射科医生对血管造影图像进行解读。结果采用参数和非参数统计检验进行分析。男性和女性腹主动脉分叉的平均角度分别为40.46°和44.68°（P = 0.013）。男性左右髂总动脉的平均直径比女性宽，但未发现统计学意义。女性腹主动脉分叉处与左右输尿管跨过同侧髂动脉处之间的平均距离（分别为60.99和60.29毫米）比男性（分别为59.05和59.95毫米）长，但未发现统计学差异（P>0.05）。腹主动脉分叉最常见的椎体水平是第4腰椎，137例（68.50%）患者为此水平。分别有52例（26.00%）和11例（5.50%）患者腹主动脉在第3腰椎和第5腰椎水平处分叉。了解髂总动脉和腹主动脉分叉的放射学解剖结构及其与输尿管的关系，对外科医生进行主动脉和盆腔手术至关重要。
