Study On The Anatomy Of The Celiac Artery Trunk And The Superior Mesenteric Artery With Medical Imaging

Objective:①To analyze the anatomy of the celiac artery trunk and thesuperior mesenteteric artery with Multislice spiral CT Scan in order to aidinterventional therapy.②To study the roentgen anatomy of the celiacartery trunk and branches with DSA and CTA, evaluate the twoangiography and their clinical implication.Methods:①150 cases recommended to abdominal enhanced CT wererandomly selected in this investigation. Images were obtained with5.0mm×2.5mm scan project, the raw data was reconstructed with 3.0mmthick section and 1.5mm interval. All data of the arterial phase werereconstructed in the mode of multiple planar reconstruction and volumerendering.②150 patients with routine celiac and superior mesentetericarteriography from March 2006 to February 2007 were selected.Results:①The celiac artery trunk arose at the level between T12 and L1in 85.3％, the superior mesenteteric artery arose at the level betweenT12L1 interspace and L1L2 interspace in 93.3％. The angle between theceliac artery and abdominal aorta was acute in 86.7％, obtuse in 13.3％.The angle between the superior mesenteteric artery and abdominal aortawas acute in 94％, obtuse in 6％. The distance between the celiac trunkand the superior mesenteteric artery was 2.76cm in average in axial view. The angle between proper hepatic and common hepatic arteries wasobtuse in 88.4％and acute in 11.6％. The angle between gastroduodenaland common hepatic arteries was obtuse in 71％and acute in 29％. Thecourse of splenic artery showed many styles, namely concave, convex,horizontal and ascending. The rarer styles were of ripple-style andcirde-style in 12.8％. In 150 cases, 17 celiac arteries had variations.②In200 DSA cases, 4 cases of left gastric artery were absent; In 150 CTAcases, the displaying rate of common hepatic artery, proper hepatic arteryand its right and left branches, splenic artery, left gastric artery andsuperior gastroduodenal artery with VR was 100％, 100％, 94％, 88％,100％, 89.3％, 97.3％, respectively. There was no difference betweenDSA, CTA and Zhang's group in displaying the variation of celiacartery. The difference between DSA, CTA and Michels's group indisplaying the variation of hepatic artery had statistical significance.Compared with 28 cases performed DSA, the accuracy of CTA was89.3％.Conclusion:①The investigation of the anatomy of the celiac arterytrunk and the superior mesenteteric artery with MSCT Scan can play ahelpful role in the interventional theraphies.②MSCT lamellar scanconbining with 3D reconstruction can display the beginning of the celiacartery trunk and its branches clearly, but has some disadvantages indisplaying the distal branches of hepatic artery and some collateral communication. DSA can display more than three grade hepatic arteries,but only reflect the arteries in plane and weak in spatial orientation.Besides, improper angiography may result in misdiagnosis.③By thecomplementation of CTA and DSA preoperative, the study of theroentgen anatomy of the celiac artery trunk and branches can play ahelpful role in the interventional theraphies and surgical operation ofepigastric organs.