Abstract
Objective
The purpose of this retrospective investigation is to characterize and illustrate the appearances of celiomesenteric trunk (CMT) and hepatosplenomesenteric trunk (HSMT) using CT with three-dimensional volume-rendering with attention to the proximal branching patterns. We also correlate our results with an embryologic model and assess the accuracy of radiologists in recognizing these entities.
Methods
CT studies on 36 adult subjects with CMT and 10 with HSMT were analyzed to determine the proximal branching patterns and lengths of the common vascular trunks. The official reports in appropriately selected cases were reviewed to ascertain if the interpreting radiologists recognized the anomalies.
Results
Two types of CMT were found. In 29 of 36 cases (81%), the CMT bifurcated into the celiac trunk and superior mesenteric artery (Type A CMT), while in 7 cases the left gastric artery (LGA) arose from the CMT proximal to the hepatosplenic trunk and superior mesenteric artery (Type B CMT). Type A trunks (mean length = 10.4 mm) were significantly shorter (p = 0.007) than Type B trunks (mean length = 17.8 mm). Short common trunks (less than 1.0 cm) were only seen with Type A CMT. Branching patterns in all 10 cases of HSMT were identical with no short common trunks. The CMT was not mentioned in the radiology reports in 88% of the cases assessed.
Conclusion
The location of the LGA origin distinguishes the two variants of CMT and differentiates CMT from HSMT. These anomalies are easily overlooked during evaluation of routine clinical cases.
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References
Panagouli E, Venieratos D, Lolis E, Skandalakis (2013) Variations in the anatomy of the celiac trunk: a systematic review and clinical implications. Ann Anat 195:501–511
Bhatnagar S, Rajesh S, Jain VK, et al. (2013) Celiacomesenteric trunk: a short report. Surg Radiol Anat 35:979–981
Ishigami K, Zhang Y, Rayhill S, Katz D, Stolpen A (2004) Does variant hepatic artery anatomy in a liver transplant recipient increase the risk of hepatic artery complications after transplantation? AJR 183:1577–1584
Liu DM, Salem R, Bui JT, et al. (2005) Angiographic considerations in patients undergoing liver-directed therapy. J Vasc Interv Radiol 16:911–935
Tandler J (1904) Über die Varietäten der Arteria coeliaca undderen Entwicklung. Anat HFT 25:472–500 (in German)
Morita M (1935) Reports and conception of three anomalous cases in the area of the celiac and the superior mesenteric arteries. Acta Med 9:159–172 (in Japanese)
Yi SQ, Terayama H, Naito M, et al. (2007) A common celiacomesenteric trunk, and a brief review of the literature. Ann Anat 189:482–488
Cavdar S, Sehirli U, Pekin B (1997) Celiacomesenteric Trunk. Clin Anat 10:231–234
Song SY, Chung JW, Yin YH, et al. (2010) Celiac axis and common hepatic artery variations in 5002 patients: systematic analysis with spiral CT and DSA. Radiology 255:278–288
Higashi N, Sone C (1987) A case of celiaco-mesenteric trunk. Kaibogaku Zasshi 62:550–556 (in Japanese)
Katagiri H, Ichimura K, Sakai T (2007) A case of celiacomesenteric trunk with some other arterial anomalies in a Japanese woman. Anat Sci Int 82:53–58
Rountas C, Fanariotis M, Vlychou M, et al. (2013) Celiomesenteric trunk demonstrated by multi-detector computed tomography angiography: two cases of a rare vascular variation. Folia Morphol 72:171–175
Petscavage JM, Maldjian P (2007) Celiomesenteric trunk: two variants of a rare anomaly. Australas Radiol 51:B306–B309
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Maldjian, P.D., Chorney, M.A. Celiomesenteric and hepatosplenomesenteric trunks: characterization of two rare vascular anomalies with CT. Abdom Imaging 40, 1800–1807 (2015). https://doi.org/10.1007/s00261-014-0312-9
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DOI: https://doi.org/10.1007/s00261-014-0312-9