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Three-dimensional computed tomography angiography reconstruction of the origin of the uterine artery and its clinical significance

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Abstract

Purpose

In women, the uterine artery is the main branch of the internal iliac artery, vascularizing most of the uterus. Knowledge of its origin and variations is essential during extensive gynaecological surgery and interventional radiological procedures. We aimed to investigate its origin and explore its anatomical variations by three-dimensional (3D) reconstructed computed tomography (CT) angiography.

Methods

This was a retrospective, monocentric observational study involving CT scans of the abdomen and lower limbs of women < 50 years old with 3D reconstructed CT images of the internal and external iliac arterial axes.

Results

Between 01 January 2014 and 31 December 2015, among 986 cases of CT scans performed in women, for all indications, 3D reconstructed images for 43 women could be analysed. The uterine artery originated from a common trunk with the umbilical artery in 62.7% of cases, from a direct branch of the internal iliac artery in 25.6% of cases, directly from the superior gluteal artery in 9.3% of cases and from the internal pudendal artery in 2.3%.

Conclusions

Three-dimensional(3D) reconstructed CT angiography can detect the point of origin of the uterine artery. Therefore, it can be used as a mapping tool of the pelvic arterial tree. Our study corroborates data from the literature that the uterine artery most often originates from a common trunk with the umbilical artery. However, surgeons and intervention radiologists must be aware of the variability of its origin to facilitate the safety of the patients during procedures.

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Reproductive Medicine, Hôpital Intercommunal de Créteil, Université Paris Est, Paris XII, 40 avenue de Verdun, 94000, Créteil, France

    Alexandra Arfi & Cyril Touboul

  2. UMR INSERM U965: Angiogenèse et Recherche translationnelle, Hôpital Lariboisière, 49 bd de la chapelle, 75010, Paris, France

    Alexandra Arfi & Cyril Touboul

  3. Department of Radiology, Institut Gustave Roussy, Université Paris-Sud XI, 114 rue Édouard-Vaillant, 94805, Villejuif, France

    Julia Arfi-Rouche

  4. Department of Radiology, Centre cardiologique du Nord, 32-36 Rue des Moulins Gémeaux, 93200, Saint-Denis, France

    Vincent Barrau

  5. Department of Obstetrics, Gynecology and Reproductive Medicine, Centre Hospitalier Universitaire de Rennes, Hopital Sud, 16 boulevard de Bulgarie, 35203, Rennes, France

    Krystel Nyangoh Timoh

Authors
  1. Alexandra Arfi
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  2. Julia Arfi-Rouche
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  3. Vincent Barrau
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  4. Krystel Nyangoh Timoh
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  5. Cyril Touboul
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Corresponding author

Correspondence to Alexandra Arfi.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this retrospective study, formal consent is not required.

Conflict of interest

The authors declare that they have no conflict of interest.

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Arfi, A., Arfi-Rouche, J., Barrau, V. et al. Three-dimensional computed tomography angiography reconstruction of the origin of the uterine artery and its clinical significance. Surg Radiol Anat 40, 85–90 (2018). https://doi.org/10.1007/s00276-017-1941-9

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  • DOI: https://doi.org/10.1007/s00276-017-1941-9

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