Background. The evaluation of arteries originating from the abdominal aorta and aortic arch using CT−angiogra− phy plays a major role in the diagnostics and treatment of many conditions. The method is particularly meaning− ful in diagnostics before potential stentgraft implantation or angiosurgery, follow−up evaluation of patients after endovascular or angiosurgical procedures, management before hepatic transplantation and liver resection, patients with renal hypertension caused by renal artery stenosis, and patients with intermittent claudication or postprandial abdominal angina. Objectives. The goals of the study were to assess the prevalence of anatomical variants of arteries arising from the abdominal aorta and aortic arch and their clinical aspects and to evaluate the diagnostic potential and available techniques of modern CT−angiography in visualizing the selected arterial system. Material and Methods. CT−angiographies were performed in 240 consecutive patients enrolled between January 2004 and May 2007. The examinations were carried out using a 10−row CT unit with 3−mm slice thickness (pri− mary reconstruction by means of thin slices with slice thickness of 1 mm). Contrast medium was injected with flow rate 4 ml/sec in a volume of 2 ml/kg patient body weight. Initially raw axial images of CT−angiographies were eval− uated and then the following secondary two−dimensional and three−dimensional reconstructions were employed: coronal and sagittal reformations, multiplanar reformation, curved planar reformation, maximum intensity projec− tion, and the volume rendering technique. Results. A common prevalence of anatomical variants of arteries arising from the abdominal aorta was demon− strated and their frequencies were estimated. The analyzed material revealed the following kinds of anomalies: renal arteries: early division of the renal artery and the presence of unilateral or bilateral additional renal arteries; hepatic arteries: different variants of hepatic arterial supply; celiac trunk: different anomalies of the origins from the abdominal aorta; aortic arch: rare presence of anatomical variants of large arteries arising from the aortic arch. Conclusions. CT−angiography enables rapid and accurate imaging of the abdominal arteries and the arteries com− mencing at the aortic arch, including detection of vascular anatomical variants, which is of great value before planned surgery and interventional radiological procedures as well as in the diagnostics of internal conditions. Various techniques of reconstruction are helpful in the visualization of arterial branches, which makes evaluation of the abdominal arterial system easier (Adv Clin Exp Med 2007, 16, 6, 751–760).

The Usefulness of CT−angiography in Detecting Anatomical Variants of Arteries Arising from the Abdominal Aorta and Aortic Arch

A 74-year-old female underwent surgical treatment for adenocarcinoma of the pancreatic head. Preoperative multi-detector row computed tomography (MD-CT) demonstrated tumor invasion into the accessory right colic vein and the branch of the middle colic artery (MCA), which was not detected by digital subtraction angiography. MD-CT showed anatomical variants in the left hepatic artery arising from the left gastric artery, and the right posterior hepatic artery arising from the superior mesenteric artery. Three-dimensional reconstruction CT generated a clear picture of the anatomy of the region concerned, which is essential for a safe operation. The MD-CT findings were highly consistent with the intra-operative findings. We have demonstrated that MD-CT is an important and highly accurate modality for pancreatic surgery.

Un sujet du sexe feminin âgee de 74 ans avait subi un traitement chirurgical pour adenocarcinome et la tete pancreatique la tomographie par ordinateur et rangee multi-detecteur Preoperatoire (TO-MD) a indique invasion de la tumeur dans la veine du coli accessoire de la droite et la branche du colique artere du centre (CAC) qui n'etait pas detecte par l'angiographie subtraction digitale. Le TO-MD avait indique une variante anatomique dans I'artere hepatique du gauche resulte d'artere gastrique du gauche et l'artere hepatique posterieur de la droite resulte de l'artere mesenterique superieure. Une reconstruction d'une trio dimension TO a provoque une image claire de l'atomie de la region concernee, ce qui est essentiel pour une operation sans danger. Les resultats TO-MD etaient surtout constants avec des resultats intraoperatoire. Nous avons montre que le TO-MD est une modalite tres correcte et importante pour la chirurgie pancreatique.


 Keywords : Preoperative assessment, Multi-detector row Computed tomography (MD-CT), Pancreatic carcinoma, Tumor invasion. West African Journal of Medicine Vol. 25 (3) 2006: pp. 242-245

https://www.ajol.info/index.php/wajm/article/download/28287/5054

Usefulness of multi-detector row computed tomography for accurate preoperative assessment of pancreatic adenocarcinoma: report of a case.

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Usefulness of multi-detector row computed tomography for accurate preoperative assessment of pancreatic adenocarcinoma: report of a case.