Surgical and Radiologic Anatomy最新文献

{"title":"Comprehensive review of the cervical ligamenta flava.","authors":"Tatjana Mortell, Ali Mortezaei, Rarinthorn Samrid, Sassan Keshavarzi, Seiichi Inoue, Keishiro Kikuchi, Joe Iwanaga, Aaron S Dumont, R Shane Tubbs","doi":"10.1007/s00276-025-03615-x","DOIUrl":"https://doi.org/10.1007/s00276-025-03615-x","url":null,"abstract":"<p><strong>Purpose: </strong>The current literature contains many data associated with the cervical ligamentum flavum (CLF). The present study is to overview knowledge of CLF.</p><p><strong>Methods: </strong>Comprehensive literature review was performed.</p><p><strong>Results: </strong>Topics include anatomy, embryology, histology, radiology, clinical relevance, and pathological manifestations of the CLF, including ossification, calcification, and hypertrophy. Spine procedures always require extreme precision; spine surgeons and neurosurgeons encounter challenges that put patients' lives at risk.</p><p><strong>Conclusion: </strong>This study can assist clinicians in performing spinal interventions with the fewest possible complications. Because there have been few studies of the CLF, further investigation is suggested.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"109"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the topography of the splenic artery: a comprehensive analysis.","authors":"Jakub Wilk, Jan Koszewski, Anna Gwóźdź, Jakub Gliwa, Julia Toppich, Patryk Ostrowski, Wadim Wojciechowski, Jerzy Walocha, Mateusz Koziej, Michał Bonczar","doi":"10.1007/s00276-025-03622-y","DOIUrl":"https://doi.org/10.1007/s00276-025-03622-y","url":null,"abstract":"<p><strong>Introduction: </strong>Comprehensive knowledge of the complete anatomy of the splenic artery (SA) is of utmost importance in various abdominal surgical procedures. The present study aims to present a novel arterial map of the SA, showcasing its origin and course in the abdominal cavity. We hope that our results can be of great value to physicians performing the aforementioned procedures.</p><p><strong>Methods: </strong>The research involved the analysis of records from 75 consecutive patients who underwent abdomen and pelvis computed tomography angiography. Morphometric characteristics of the SA and/or its associated anatomical area were evaluated across 42 categories.</p><p><strong>Results: </strong>The SA was identified to originate from the celiac trunk in 73 cases (98.6%) and in one case from the aorta (1.4%). The most common branching pattern was the left gastric artery, followed by the common trunk of SA and the common hepatic artery occurring in 51 cases (69.9%). The median SA length (in a straight line) was determined to be 74.18 mm (LQ = 64.50; HQ = 87.22). Moreover, the median length of SA (over the surface) was 149.28 mm (LQ = 119.28, HQ = 177.50).</p><p><strong>Conclusion: </strong>The present study demonstrated the high complexity of the arterial blood supply of the spleen. The SA exhibited a significant degree of variability regarding its course, branching pattern, and spatial relationship to the pancreas. By creating a novel arterial heat map, we provided a detailed visualization of the SA's course. These findings aim to improve the pre- and intraoperative identification of the SA, potentially reducing costs and the risk of complications associated with iatrogenic vessel injury during various surgical and endovascular procedures.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"108"},"PeriodicalIF":1.4,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and morphology of the gastrocnemius tertius: anatomical study and literature review.","authors":"George Triantafyllou, Nicol Zielinska, Maria Piagkou, Krzysztof Koptas, Andrzej Węgiel, Łukasz Olewnik","doi":"10.1007/s00276-025-03625-9","DOIUrl":"https://doi.org/10.1007/s00276-025-03625-9","url":null,"abstract":"<p><strong>Background: </strong>The gastrocnemius muscle (GM) third head or gastrocnemius tertius (GT) is a well-described GM variant. The purpose of the current study was to investigate the GT prevalence and morphology (including the proximal and distal attachments, and relationship with the neurovascular structures) in a cadaveric Central European population.</p><p><strong>Methods: </strong>A total of seventy-three lower limbs were dissected and investigated for GT presence; when the variant was identified, morphometric measurements were obtained.</p><p><strong>Results: </strong>The GM third head was observed in 10.96% (8/73 cases) under the form of two different morphological variants. The commonest variant type (6 cases) with proximal attachment from the femur posterior surface and fused with the GM lateral head. The second variant type (2 cases) proximal attachment was from the femur posterior surface and fused with the GM medial head. To understand this variation, we performed a brief literature review with meta-analysis. The GT variant has been identified with a pooled prevalence of 4.34%, under great morphological variability.</p><p><strong>Conclusion: </strong>Clinicians, especially orthopaedics, should be aware of this variant, as it has been proven to cause popliteal neurovascular compression.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"107"},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRA, CTA and three-dimensional rotational angiography of incidentally detected bilateral accessory middle cerebral arteries.","authors":"Yuta Oka, Yoshinobu Horio, Jota Tega, Koichiro Suzuki, Rina Shibayama, Ryuhei Takeyama, Koichiro Takemoto, Hiroshi Abe","doi":"10.1007/s00276-025-03620-0","DOIUrl":"https://doi.org/10.1007/s00276-025-03620-0","url":null,"abstract":"<p><strong>Purpose: </strong>The accessory middle cerebral artery and duplicated middle cerebral artery are anomalous, extremely rare and detected incidentally. While almost all cases where they are detected are unilateral, bilateral cases are extremely rare with only a few case reports.</p><p><strong>Methods: </strong>We report a case of incidentally detected bilateral accessory middle cerebral arteries (AMCAs) on imaging findings at our hospital with a review of previous reports.</p><p><strong>Case report and results: </strong>A sixty-year-old woman was brought to our hospital with right upper and lower extremity paralysis and dysarthria. Magnetic resonance imaging scan of the head showed cerebral infarction from the left putamen to the corona radiata and bilateral AMCAs on magnetic resonance angiography. We performed cerebral angiography and CT angiography to evaluate the vessels and obtained detailed imaging findings. The bilateral AMCAs were symmetrically located, both branching from the distal part of A1, and were type 3 according to Manelfe's classification. We reviewed the literature on bilateral AMCAs and found seven similar cases. The age, gender, and pathology varied widely, and the location of the bifurcation was symmetrical in six of the seven cases.</p><p><strong>Conclusion: </strong>We found bilateral AMCAs incidentally in a cerebral infarction that occurred in a sixty-year-old woman. We should consider the presence of abnormal vessels when treating cerebrovascular diseases.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"103"},"PeriodicalIF":1.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teaching abdominal aorta anatomy applied to clinical practice through active methodology and 3D printing.","authors":"Julia Fernandes de Oliveira, Gleison Carlos Arantes Filho, Luiz Eduardo Sousa","doi":"10.1007/s00276-025-03623-x","DOIUrl":"https://doi.org/10.1007/s00276-025-03623-x","url":null,"abstract":"<p><strong>Purpose: </strong>3D printing of anatomical structures from computed tomography (CT) or magnetic resonance imaging (MRI) scans enables new didactic strategies in the teaching anatomy applied clinical medicine, allowing the reproduction of organs affected by diseases or traumas. This approach brings students closer to real clinical cases, promoting the development of critical thinking through a practical and immersive experience. The present study aimed to analyse the performance of medical students in identifying vascular structures of the abdominal aorta associated with an aneurysm and horseshoe kidney using a 3D printed model. We also analysed the costs related to the 3D printing of the models.</p><p><strong>Methods: </strong>This is a randomized study with a quantitative approach. The performance of medical students regarding anatomical and clinical knowledge of aorta artery associated with an aneurysm and a horseshoe kidney was analysed. Active methodology and 3D printed models of the abdominal aorta were used in the project.</p><p><strong>Results: </strong>The results show that the methodologies used were effective in improving students' performance regarding anatomical and clinical knowledge of aorta artery, specially in the group that used 3D models associated with 2D images.</p><p><strong>Conclusion: </strong>The use of an integrated and interactive approach, which places the student as the protagonist of the learning process, improves performance and knowledge in anatomy. 3D printing, capable of producing high-quality and low-cost anatomical models, can become an additional tool in the teaching- learning process.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"104"},"PeriodicalIF":1.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphometric, morphologic and topographic evaluation of diaphyseal nutrient foramina of the femur.","authors":"Bahattin Paslı, Mehmet Ülkir, Ceren Günenç Beşer","doi":"10.1007/s00276-025-03611-1","DOIUrl":"https://doi.org/10.1007/s00276-025-03611-1","url":null,"abstract":"<p><strong>Purpose: </strong>Vascularization of bones is crucial for bone growth and repair. The nutrient artery, passing through the nutrient foramen, is key to bone blood supply, but its impact on fracture healing and complications is not fully understood. The study aims to investigate the morphology and location of the nutrient foramen in the femoral diaphysis and to understand its clinical implications for fractures.</p><p><strong>Methods: </strong>In this study, 88 adult dry femurs of unknown age and sex were examined. The characteristics of the nutrient foramina, including number, size, direction, and localization were evaluated. The foraminal index [(distance from foramen to proximal end of femur/total length of femur) × 100], was employed to categorize the regions [Region-I, 0-33.33; Region-II, 33.34-66.66; Region-III 66.67-100].</p><p><strong>Results: </strong>The majority of the femurs had one or two foramina (92.94%). Of the total number of nutrient foramina, 121 (97.58%) were directed towards the proximal end, while three (2.42%) were horizontal. The majority of foramina were detected in sizes 18G (34.67%) and 20G (27.42%). All nutrient foramina were found on the posterior surface of the femur and adjacent to linea aspera. Sixteen nutrient foramina were located (12.90%) in Region-I, 104 (83.87%) in Region-II, and 4 (3.23%) in Region-III.</p><p><strong>Conclusions: </strong>The nutrient foramina were typically located in the middle third of femur, adjacent to linea aspera on the posterior surface of femur. This observation indicates that the anterior surface is safer for surgery, while caution is needed near the linea aspera on the posterior surface.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"102"},"PeriodicalIF":1.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coverage of elbow and forearm soft tissue defects with the posterior ulnar recurrent artery perforator flap (PURAP): an anatomical study.","authors":"Elise Lupon, Hadrien Paoli, Yanis Berkane, Nicolas Bertheuil, Jean Baptiste De Villeneuve Bargemon, Olivier Camuzard, Isabelle Pluvy, Benoît Chaput","doi":"10.1007/s00276-025-03616-w","DOIUrl":"10.1007/s00276-025-03616-w","url":null,"abstract":"<p><strong>Introduction: </strong>Covering soft tissue defects from the elbow and forearm is challenging for the plastic surgeon. The posterior ulnar recurrent artery perforator flap is a fasciocutaneous perforator flap vascularized by the perforators emerging from the posterior ulnar recurrent artery. It has multiple functional and aesthetic advantages but has not yet been well studied. This work aimed to examine the number, caliber, and topography of the posterior ulnar recurrent artery's perforators.</p><p><strong>Methods: </strong>Perforator mapping was performed by blue latex injection on 20 fresh cadavers' upper extremities. Thermal mapping by TIRD was used to identify the \"hot spots\" of these perforators, and the 4D vascular network of the ulnar recurrent artery was scanned. The preoperative design and dissection of the flap were adapted based on the results of this anatomical study. A case study was performed to illustrate the clinical application.</p><p><strong>Results: </strong>On average, we located 7.7 ± 1.7 perforators per upper extremity with an average caliber of 0.77 ± 0.19 mm (3.5 ± 1.2 in the forearm and 4.2 ± 1.5 in the arm). On average, the arm perforators were located 3.2 ± 1.6 cm proximally from the medial epicondyle. Thermal mapping showed three perforator \"hot spots,\" two in the forearm (directly at the artery origin level and one more posteriorly) and one in the arm. The 4D CT reconstructions allowed us to estimate the vascular territory at the level of the medial epicondyle and the distal half of the medial aspect of the arm, as well as the ascending course of the artery.</p><p><strong>Conclusion: </strong>The posterior ulnar recurrent artery perforator flap can be harvested efficiently and reliably, as the posterior ulnar recurrent artery has constant perforators, especially around 3 cm proximal to the medial epicondyle. This reinforces this flap's status as a potential elbow and forearm tissue defect coverage alternative.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"105"},"PeriodicalIF":1.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right vertebral artery arising from the extreme proximal right subclavian artery and entering the C3 transverse foramen diagnosed by magnetic resonance angiography.","authors":"Akira Uchino, Yuki Mukai","doi":"10.1007/s00276-025-03621-z","DOIUrl":"https://doi.org/10.1007/s00276-025-03621-z","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a case of right vertebral artery (VA) arising from the extreme proximal right subclavian artery (SA) and entering the C3 transverse foramen (TF), which was diagnosed by magnetic resonance angiography (MRA).</p><p><strong>Methods: </strong>A 46-year-old woman with acute pontine infarction underwent MRA using a 3-Tesla scanner. MRA was performed using a standard 3-dimensional time-of-flight technique.</p><p><strong>Results: </strong>MRA of the intracranial region revealed no pathological lesions. Fenestrations of the basilar artery were observed. MRA from the aortic arch (AA) to the craniovertebral junction level also showed no pathological lesions; however, there was a right VA arising from the extreme proximal right SA. The distance from the origin of the right SA to the origin of the right VA was 3 mm. The right VA entered the C3 TF.</p><p><strong>Conclusion: </strong>The right VA rarely enters C3 TF, with a reported prevalence of approximately 0.1%. The right VA arises from the right SA at two types of points: a normal point of origin and an extremely proximal point of origin. The latter type is considered to result from the same embryonic developmental variation of the left VA arising from AA. Although the image quality of MRA at the level of AA is not as good as that of computed tomography angiography, careful observation of MRA and the creation of reformatted MRA images are important for the correct diagnosis of this rare variation.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"106"},"PeriodicalIF":1.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The morphologic and morphometric features of the pisiform: a radioanatomic study.","authors":"İsmet Demirtas, Ayşegül Ayran, Ural Verimli, Livan Gül Durmuş, Onur Buğdaycı, Gülnaz Nural Bekiroğlu","doi":"10.1007/s00276-025-03613-z","DOIUrl":"https://doi.org/10.1007/s00276-025-03613-z","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to investigate the morphologic and morphometric features of the pisiform using various anatomical landmarks, and to analyze its topographic relationship with surrounding bony structures.</p><p><strong>Methods: </strong>Unilateral CT images of the hand and wrist taken from 208 patients (62 females, 146 males) admitted to Radiology Department of Marmara University Faculty of Medicine between 2014 and 2019 retrospectively analyzed in the study. The mean age of the subjects was 33.4 (range, 14-65) years of age. Eight different measurements were performed using 3D Slicer software and one novel classification was made on the images of 117 (56.25%) right and 91 (43.75%) left hands taken in neutral position. The results were further compared between gender, laterality, and age groups.</p><p><strong>Results: </strong>The mean values of the truncated hand length (THL), longitudinal diameter of pisiform (LDP), transverse diameter of pisiform (TDP), and piso-triquetral distance (PTD) were significantly higher for men than for women. No significant difference was found between the right and left side measurements. A significant difference was also observed in PTD values between the age groups. The novel classification used in the present study revealed that the most common shape of triquetral facet of the pisiform was ellipse type (85.6%), followed by round (10.1%), and cylindrical (4.3%) types, respectively.</p><p><strong>Conclusion: </strong>The results of the study provide comprehensive morphologic and morphometric data for the pisiform and may lend support for better understanding of the region which would be beneficial for the surgical interventions of the hand and wrist.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"101"},"PeriodicalIF":1.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence of the fenestrated left renal vein.","authors":"Nawwaf Sebastian Damen, Adelina Maria Jianu, Mugurel Constantin Rusu","doi":"10.1007/s00276-025-03614-y","DOIUrl":"10.1007/s00276-025-03614-y","url":null,"abstract":"<p><strong>Purpose: </strong>The left renal vein (LRV) is typically a single preaortic vein. The discovery of fenestrated LRVs (FLRVs), a rare occurrence previously reported only twice, has piqued our interest. We aimed to determine the prevalence of such variants using an angioCT batch.</p><p><strong>Methods: </strong>We meticulously studied archived angioCT files of 95 men and 55 women. The morphology of the LRVs was carefully checked on planar sections and by three-dimensional volume renderings, ensuring the accuracy of our findings.</p><p><strong>Results: </strong>In 3.34% of cases, four males and one female were found FLRVs. Their posterior projections on the aorta were variable. The FLRVs were either partly preaortic, immediately to the left side of the aorta, or at a distance to the left side of the aorta. There were three true FLRVs, with a single vein attached at the lateral end and two pseudo-fenestrations, with two veins attached laterally. The left suprarenal and gonadal veins drained, respectively, in the superior and inferior arms of the fenestrations. In 2/5 cases, the second left lumbar vein drained into the inferior arms of the fenestrations. In one case, the FLRV was traversed by the inferior segmental branch of the renal artery.</p><p><strong>Conclusion: </strong>Our findings have significant implications for surgical procedures targeting the left renal pedicle. The FLRV, with its morphological and topographical variability, should be considered among the anatomical variations of the LRV that may impede or endanger such procedures. However, it can be accurately discriminated on angioCT scans, providing a potential solution to this challenge.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"100"},"PeriodicalIF":1.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}