Research On The Statistics Of Anatomical Parameters Of The Superior Mesenteric Artery Based On CT Imaging And The Role Of Anatomical Parameters In Superior Mesenteric Artery Diseases

Background:superior mesenteric artery(SMA)is an important branch of the abdominal aorta.Due to the thick lumen,the acute angle relationship between the main trunk and the abdominal aorta,and the consistent blood flow direction,cardiogenic emboli has more possibility to embolize in the main trunk of the superior mesenteric artery.Resulting in ischemia and necrosis of the jejunum,ileum,and colon.In severe cases,it can be lifethreatening.The disease is easy to be misdiagnosed in the early stage,and the fatality rate can be as high as 70%.Clinically,conservative treatment,interventional treatment and open surgery can be used to treat such diseases.Interventional surgery is considered a new direction.However,there is still a lack of anatomical data for superior mesenteric artery of the normal population to provide data for the design of new medical instruments.At the same time,the role of anatomical parameters in superior mesenteric artery diseases is not clear.Objective:Measure and analyze the parameters of CT imaging of the normal population and the population with superior mesenteric artery diseases(embolism,aneurysm,dissection,etc.)to obtain imaging data of the superior mesenteric artery in the normal population in Northeast China.And analyze the relationship between the imaging parameters of the superior mesenteric artery and superior mesenteric artery diseases.Methods:Collected 909 normal SMA cases,36 SMA embolization cases,61 SMA thrombosis cases,34 SMA dissection cases,and 22 SMA aneurysm cases in the First Affiliated Hospital of China Medical University from 2017 to 2020.Using impax imaging workstation curved plannar reconstruction(CPR)technology,measure the angle between the midline of the SMA trunk and the midline of the abdominal aorta;the diameter of the SMA trunk at the opening of the abdominal aorta and the origin of the first,second,and third branches;the SMA trunk Length of the first,second and third branches;SMA trunk diameter at the embolization position,embolization length and the length from the opening to the embolization position;starting position and length of SMA dissection;starting position and size of SMA aneurysm.Use IBM SPSS 25.0 software to calculate the imaging parameters of the superior mesenteric artery in the normal group,and compare the imaging parameters of the normal group and the group with superior mesenteric artery diseases.Results:In the normal control group,the mean angle between the geometric midline of the abdominal aorta and the geometric midline of the superior mesenteric artery was 60.08±24.35 degrees;the diameter of the main superior mesenteric artery at the opening and the first three important branches were 6.98±1.36 mm,6.02±1.19 mm,5.54±1.20 mm,4.89±1.20mm;the lengths from the opening of the mesenteric trunk to the first,second and third branches are 33.78±8.62 mm,49.01±10.12 mm,62.33±12.28 mm,respectively.In the acute embolism group,the diameter of the main embolization site was 7.25±1.89mm;the embolization starting position was 24.42±20.58mm;the embolization length was40.25±23.67 mm.In the thrombosis group,the diameter of the trunk at the beginning of thrombus formation was 6.37±1.45mm;the starting position of thrombus formation was37.09±25.76mm;the embolism length was 33.52±25.13 mm.In the dissection group,the length from the starting position of the dissection to the main trunk opening was 21.91±10.17mm;the length of the dissection involved was 28.25±11.99 mm.The maximum diameter of the aneurysm in the aneurysm group was 10.93±3.06mm;the starting position of the aneurysm was 37.45±15.89mm;the length of the aneurysm involved was 14.45±3.49 mm.In the comparison between the normal control group and the embolization group,there were statistical differences in the diameter of the main opening,the diameter of the first branch,and the included angle.In the comparison between the normal control group and the thrombosis group,the diameter of the main opening and the first branch were There are statistical differences in the diameter of the second branch and the diameter of the second branch.In the comparison between the normal control group and the dissection group and the aneurysm group,there was no significant statistical difference in the results.Conclusions:Indicating that the excessively large angle between the superior mesenteric artery and the abdominal aorta,and the excessively large diameter of the SMA trunk opening may be related to the occurrence of acute superior mesenteric artery embolism,and the excessively large diameter of the SMA trunk may be related to the occurrence of superior mesenteric artery thrombosis.