Abdominal Aorta Anatomik Varyasyonları

Yıl 2017, Cilt: 2 Sayı: 2, 53 - 58, 28.08.2018

Özlem Güngör Ömer Faruk Güler Cansu Öztürk , Selma Uysal Ramadan

Öz

Giriş:

Çalışmamızın amacı, abdominal çok kesitli bilgisayarlı tomografi (ÇKBT) incelemesi yapılan hasta popülasyonunda çölyak arter(ÇA), süperior mezenterik arter(SMA) ve renal arter (RA) anatomisindeki varyasyonları saptamaktır.

Gereç ve Yöntem:

Çeşitli nedenlerle abdominal ÇKBT incelemesi yapılan toplam 100 hasta geriye dönük olarak değerlendirilerek ÇA, SMA ve RA varyasyonlarının sıklığı araştırılmıştır.

Bulgular:

100 vakanın 80’inde (%80) normal ÇA anatomisi izlenmiştir. En sık rastlanan ÇA varyasyonu gastro-splenik trunkus (%12) olarak saptanmıştır. Normal SMA, 100 olgunun 83’ünde gözlendi. SMA'nın en sık varyasyonu 12 olgu (%12) ile SMA'dan orjin alan replase sağ hepatik arterdir. İki yüz böbrekten

177 böbrekte (%84) tek ana RA normal dallanma paterni varken, bunlardan 9 (%4.5) böbrekte erken dallanma gözlendi. Ekstrarenal RA ise 23 (%11.5) böbrekte gözlendi. Bu 21 böbrekte aksesuar (%10.5) hiler arter mevcutken, 2 tanesinde superior polar arter (%1) izlendi.

Sonuç:

ÇKBT anjiyografi abdominal vasküler anatomi ve varyasyonların değerlendirilmesinde kullanılacak oldukça güvenilir, invaziv olmayan ve günümüzde rahat ulaşılabilir bir görüntüleme metodudur.

Anahtar Kelimeler

ÇKBT, varyant anatomi, abdominal aorta

Anatomic Variations of Abdominal Aorta

Öz

Aim:

The aim of this study was to determine the ratio of variations observed in the anatomy of the celiac artery( CA), superior mesenteric artery(SMA), and renal artery (RA) by screening a patient population who underwent abdominal multi-detector computed tomography angiography.

Materials and Methods:

A total of 100 patients who underwent abdominal multi-detector computed tomography angiography

for various reasons were analyzed retrospectively and the prevalence of the variations observed in the CA, SMA, and RA were determined.

Results:

A normal anatomy of the celiac artery was determined in 80 of the 100 cases (80%).The most common CA variation was gastro-splenic trunk (12%). We determined normal SMA anatomy in 83 of the total 100 cases (83%). The most common variation of SMA was a replaced right hepatic artery originating from the SMA in 12 cases (12%). While a single RA with normal branching pattern was observed in 177 kidneys (% 84) in 200 kidneys, early branching of RA was observed in 9 (4.5%) kidneys. Extrarenal RA was observed in 23 (11.5%) kidney. Twenty-one of extrarenal RA (10.5%) were a hilar artery and 2(%1) of these were superior polar artery.

Conclusion:

Multi-detector computed tomography angiography is a highly reliable, noninvasive imaging method for the evaluation of abdominal vascular anatomy and its variations.

Anahtar Kelimeler

Multi-detector computed tomography, variant anatomy, abdominal aorta

Kaynakça

• 1. Prokop M. Multislice CT angiography. Eur J Radiol 2000;36:86-96.
• 2. Duddalwar VA. Multislice CT angiography in vascular imaging and intervention. Br J Radiol 2004;77:S27-38.
• 3. Catalano OA, Singh AH, Uppot RN, et al. Vascular and biliary variants in the liver: implications for liver surgery. Radiographics 2008;28:359-78.
• 4. Winston CB, Lee NA, Jarnagin WR, et al. CT angiography for delineation of celiac axis and superior mesenteric artery variants in patients undergoing hepatobiliary and pancreatic surgery. AJR Am J Roentgenol 2007;189:W13-9.
• 5. Williams PL, Warwick R, Dyson M, et al: Gray's Anatomy, 37th Ed, Edinburgh, Churchill Livingstone; 1989.
• 6. Moore M.K. Çeviri Editörleri: Yıldırım M., Okar İ., Dalçık H.: İnsan Embriyolojisi Klinik Yönleri ile,1. baskı, İstanbul; 2002: 380-394.
• 7. Chen H, Yano R, Emura S, et al. Anatomic Variation of The Celiac Trunk with Special Reference to Hepatic Artery Patterns. Ann Anat. 2009; 191.399–407.
• 8. Vandamme JPJ, Bonte J. The Branches of The Celiac Trunk. Acta anat. 1985; 122:110–4.
• 9. Göktay AY, Seçil M. Çölyak Trunkus ve Hepatik Arterlerin Normal Dallanma Varyasyonları: Anjiografik Bulgular. Tanısal ve Girişimsel Radyoloji. 2001; 7: 226–31.
• 10. Yang Y, Jiang N, Lu MQ, et al. Anatomical Variation of The Donor Hepatic Arteries:Analysis of 843 Cases. Nan Fang Yi Ke Da Xue Xue Bao. 2007; 27:1164-6.
• 11. Uzun A, Ulcay T, Kosif R, Baş O, Emirzeoğlu M. Anomalies of number and orıgın of the renal artery: case report and review of the literature. J. Urol. 2002;28:452-7.
• 12. Özkan U, Oğuzkurt L, Tercan F, Kızılkılıç O, Koç Z, Koca N. Renal artery origins and variations: Angiographic Evaluation of 855 Consecutive Patients. Diagn Interv Radiol. 2006;12:183-18.
• 13. Satyapal K.S,Haffejee A.A,Singh B, Ramsaroop L, Robbs J.V,Kalidden I.M. Additional renal arteries. Surg Radiol Anat. 2001;23:33-8.
• 14. Benedetti E, Troppmann C, Gillingham K, David E.R, Sutherland, William D, Payne, Dunn L.D, Matas J.A, Najarian S.J, Gruessner G.W.R. Short- and Long-Term Outcomes Kidney transplants with multiple renal arteries. Ann. of Surgery. 1995; 221:406-14.
• 15. Cuxart M, Picazo M, Matas M, Canalias J, Nadal C, Falcó J. Arterial hypertension and stenosis of the accessory renal artery. Nefrologia 2007;27:509-10. 16. Ferrari R, De Cecco CN, Lafrate F, et al. Anatomical variations of coeliac trunk and the mesenteric arteries evaluated with 64-row CT angiography: Radiol Med 2007;112:988-98. 17. Song SY, Chung JW, Yin YH, et al. Celiac axis and common hepatic artery variations in 5002 patients: Systemic Analysis with Spiral CT and DSA. Radiology 2010;255:278-88.
• 18. Sampaio F.J.B, Passos M. Renal arteries: anatomic study for surgical and radological practise. Surg radiol anat. 1992;14:113-7.
• 19. Bordei P,Şapte E, Iliescu D, Double Renal arteries originating from the aorta. Surg Radiol Anat. 2004;26:474–9.