Surgical and Radiologic Anatomy最新文献

{"title":"A cautionary tale of anatomical variations of the extrahepatic biliary system and their implications for surgical procedures: a systematic literature review.","authors":"Andrew Chiagozie Ekwesianya, Boluwatife Oladapo Ayantunde, Abraham Abiodun Ayantunde","doi":"10.1007/s00276-025-03660-6","DOIUrl":"https://doi.org/10.1007/s00276-025-03660-6","url":null,"abstract":"<p><strong>Background: </strong>The hepatobiliary system has the most associated anatomical variations in the body and they are a direct reflection of the complexity of its embryological development. The anatomical pattern commonly described as 'normal' occurs only in 57-72% of the population. The objective of the study is to review the English Language published literature on the prevalence of the anatomical extra-hepatic biliary system variations and their potential implications for surgical and endoscopic procedures. This will assist both practicing and trainee surgeons in preventing biliary tract injuries while operating in this area.</p><p><strong>Methodology: </strong>A comprehensive literature search was conducted using the PICO framework across SCOPUS, PubMed, MEDLINE, and Cochrane databases. Study characteristics and relevant data were collated. The prevalence of the most clinically important anatomical variations is presented.</p><p><strong>Results: </strong>Seventy studies, encompassing 17,207 subjects, were included: 27 studies (9,738 subjects) on cystic duct variations, 17 studies (2,633 subjects) on gallbladder variations, and 26 studies (4,836 subjects) on cystic artery variations. Notable findings include low insertion (11.2%), medial insertion (9.8%), and parallel course (7.4%) of the cystic duct, Hartmann's pouch in 12.2% of gallbladders, and the cystic artery originating from the right hepatic artery in 83.6% or other sources in 16.4%. Moynihan's hump of the right hepatic artery was found in 1.8%.</p><p><strong>Conclusion: </strong>These variations are frequent and surgically relevant. Understanding them is critical to avoiding complications. Employing the critical view of safety in laparoscopic cholecystectomy ensures proper visualization of anatomical structures, reducing the risk of injury.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"145"},"PeriodicalIF":1.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136509","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":"Duplicate origin of the middle cerebral artery: a rare variant.","authors":"George Triantafyllou, Panagiotis Papadopoulos-Manolarakis, Panagiotis Papanagiotou, George Tsakotos, Maria Piagkou","doi":"10.1007/s00276-025-03654-4","DOIUrl":"10.1007/s00276-025-03654-4","url":null,"abstract":"<p><p>The cerebral arterial circle exhibits considerable morphological variability. Variations in the middle cerebral artery (MCA) are infrequent occurrences that can be readily identified via imaging techniques. The current imaging report describes a rare variant of the MCA consisting of a duplicate origin, which was incidentally discovered in a 42-year-old female patient through computed tomography angiography. The duplicated origin of the MCA was identified on the left side of the cerebral arterial circle, forming an arterial ring with the temporopolar branch of the MCA originating from one of its limbs. The remainder of the arterial circle demonstrated no variants. It is essential to distinguish variants of the MCA without conflating them. The present variant is accurately characterized as a 'duplicate origin\", it should not be confused with fenestrations, and has a reported prevalence of 0.1%. Comprehending such arterial variations is vital prior to undertaking endovascular or neurosurgical procedures in the region.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"140"},"PeriodicalIF":1.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103011","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":"Common origin of the right vertebral artery and the right costocervical trunk diagnosed by magnetic resonance angiography.","authors":"Akira Uchino, Kenzo Minamimura","doi":"10.1007/s00276-025-03652-6","DOIUrl":"https://doi.org/10.1007/s00276-025-03652-6","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a case of common origin of the right vertebral artery (VA) and the right costocervical trunk (CCT) diagnosed by magnetic resonance angiography (MRA).</p><p><strong>Methods: </strong>A 74-year-old woman with cerebral infarctions underwent cranial magnetic resonance imaging (MRI) and head and neck MRA using a 3-Tesla scanner. MRA was performed using a standard 3-dimensional time-of-flight technique.</p><p><strong>Results: </strong>Cranial MRI showed an acute infarction of the posterior limb of the right internal capsule. MRA of the intracranial region revealed no significant pathological lesions. MRA from the aortic arch (AA) to the craniovertebral junction level also showed no pathological lesions; however, there was a common origin of the right VA and CCT. The right VA normally enters the C6 transverse foramen (TF).</p><p><strong>Conclusion: </strong>Using MRA, we diagnosed a case of a common origin of the right VA and CCT, an extremely rare arterial variation. This type of right VA is considered to result from the same embryonic developmental variation as the left VA arising from the AA distal to the left subclavian artery. Usually, this type of right VA enters the 7th TF, however, the right VA of our patient entered the normal 6th TF. We cannot explain why the right VA of our patient did not enter the 7th TF. The image quality of MRA is not excellent; however, the creation of both partial VR images and reformatted images is useful and important for the identification of rare arterial variations.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"139"},"PeriodicalIF":1.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103006","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":"Bilateral variations in the branching of the external carotid artery: a case report.","authors":"Robert Abbott, Sarah Ward, Maya Jodidio, George Holan, Jeremy J Grachan","doi":"10.1007/s00276-025-03653-5","DOIUrl":"10.1007/s00276-025-03653-5","url":null,"abstract":"<p><strong>Purpose: </strong>Various anatomical variations in the branching pattern of the external carotid arteries are known to occur with significant frequency and have been documented in published literature. The purpose of this case report is to document and discuss variations in the branching patterns of the external carotid artery as seen in an anatomical donor and determine the clinical relevance of these variations.</p><p><strong>Case presentation: </strong>A routine dissection of an 89-year-old female anatomical donor, whose cause of death was reported as acute myocardial infarction and atherosclerotic heart disease, revealed variations in the branching patterns of both external carotid arteries. Bilaterally, the common carotid arteries bifurcated at the C4 vertebral level. On the left side, an occipitoauricular trunk originated 0.5 mm superior to the common carotid artery's bifurcation, whereas, on the right side, an occipitoauriculopharyngeal trunk branching 0.8 mm superior to the bifurcation of the common carotid artery was observed before branching into an occipitoauricular trunk and ascending pharyngeal artery.</p><p><strong>Conclusion: </strong>This case report reinforces previous publications on arterial branching patterns and the importance of imaging prior to procedures. Clinically, these variations may impact surgical approaches, endovascular procedures within the neck, and vascular pathology management.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"141"},"PeriodicalIF":1.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103004","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":"Dual fenestration of the A1 and azygos A2 segments of the anterior cerebral artery illustrated by Magnetic Resonance Imaging.","authors":"Marialuisa Zedde, Rosario Pascarella","doi":"10.1007/s00276-025-03645-5","DOIUrl":"https://doi.org/10.1007/s00276-025-03645-5","url":null,"abstract":"<p><strong>Purpose: </strong>Fenestrations are probably the most common among the anomalies of intracranial arteries. They are known for their association with other vascular conditions, such as aneurysms and arterio-venous malformations. Anterior cerebral artery (ACA) in both A1 and A2 segments is subjected to many anomalies, including fenestrations, but they are rarer than hypoplasia and aplasia. The association of more than one anomaly has been described, but the presence of a dual fenestration in a single arterial segment has been anecdotally reported.</p><p><strong>Methods: </strong>A case of an incidentally discovered association of two ACA anomalies, i.e. dual fenestration in the A1 segment and azygos pattern in the A2 segment, is presented. Both anomalies were identified in a brain Magnetic Resonance Imaging (MRI) study with MR Angiography. The clinical indication for MRI was tinnitus. The other intracranial arteries were unremarkable (apart from duplicated posterior communicating arteries) and the brain parenchyma did not show abnormalities. No aneurysms were found.</p><p><strong>Conclusions: </strong>The reported anomalies (the dual fenestration and the azygos A2 ACA) are located in the same arterial territory and potentially have a long-term effect on the local hemodynamics of the ACA facilitating the formation of aneurysms. Then, an imaging follow-up may be adviced.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"137"},"PeriodicalIF":1.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054127","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":"Concomitance of persistent primitive olfactory artery, accessory middle cerebral, and early bifurcated anterior cerebral arteries.","authors":"George Triantafyllou, Panagiotis Papadopoulos-Manolarakis, Fabrice Duparc, George Tsakotos, Maria Piagkou","doi":"10.1007/s00276-025-03647-3","DOIUrl":"https://doi.org/10.1007/s00276-025-03647-3","url":null,"abstract":"<p><p>The cerebral arterial circle is susceptible to various developmental anomalies that may persist in adulthood. Notably, the persistent primitive olfactory artery (PPOA) is a rare variation, with a reported prevalence of 0.14%, and it is infrequently paired with other vascular anomalies. This imaging report details a unique instance involving a 65-year-old male patient presenting a rare combination of a left-sided PPOA, a left-sided accessory middle cerebral artery (AMCA), and an early bifurcation of the anterior cerebral artery (ACA). The arterial variations were identified utilizing computed tomography angiography (CTA). The PPOA, characterized by its distinctive hairpin turn and nasal branch, runs parallel to the A2 segments, while the AMCA emerges as an anomalous branch from the ACA. Comprehending such configurations is essential for preoperative planning in anterior skull base surgeries due to the associated risks of aneurysm formation and potential intraoperative complications. This case underscores the significance of recognizing rare vascular anomalies to mitigate surgical risks and enhance patient outcomes.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"138"},"PeriodicalIF":1.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004444","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":"Diagnosis of C5 segmental vertebral artery using magnetic resonance angiography.","authors":"Kenji Takata, Midori Ueda, Kiyotaka Takeuchi, Hideaki Komiya, Daisuke Yoshikawa, Satomi Kanai, Tasuku Wakabayashi, Ayaki Kitano, Mariko Toyooka, Toyohiko Sakai, Tetsuya Tsujikawa","doi":"10.1007/s00276-025-03640-w","DOIUrl":"https://doi.org/10.1007/s00276-025-03640-w","url":null,"abstract":"<p><strong>Purpose: </strong>The vertebral artery (VA) typically enters the subarachnoid space at the atlanto-occipital region. However, segmental variations can occur, with the VA entering the spinal canal at atypical levels. While a C3 segmental VA has been reported, no prior studies describe a C5 segmental VA. This case represents the first documented occurrence of this anomaly.</p><p><strong>Methods: </strong>An 8-year-old girl underwent brain magnetic resonance imaging for headache screening, which incidentally revealed an abnormal VA course.</p><p><strong>Results: </strong>Imaging revealed the absence of the left VA at the proximal V2 segment. Instead, a radiculomedullary artery at C4/5 entered the spinal canal and contributed to the formation of the anterior spinal artery (ASA), which ascended along the spinal cord. The right VA appeared normal; however, a radiculomedullary artery at the C3/4 level was identified, joining the contralateral radiculomedullary artery at the C1 level to form the ASA. Additionally, bilateral accessory middle cerebral arteries were observed. No clear association was found between this anomaly and the patient's headache, and she remained under observation.</p><p><strong>Conclusion: </strong>This anomaly may result from persistence of the fifth intersegmental artery. The vascular course resembled collateral circulation observed in acquired VA occlusion. Given its proximity to the spinal cord, potential risks include ischemic complications and spinal cord compression. This case highlights the importance of accurate imaging and careful surgical planning. Further studies on these rare vascular anomalies will enhance our understanding of VA variations and their clinical significance.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"132"},"PeriodicalIF":1.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024892","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":"Accessory anterior cerebral artery of duplicate origin associated with accessory middle cerebral artery and anterior cerebral artery fenestration.","authors":"Hideki Endo, Hidetoshi Ono, Yohei Yamaguchi, Hirohiko Nakamura","doi":"10.1007/s00276-025-03649-1","DOIUrl":"https://doi.org/10.1007/s00276-025-03649-1","url":null,"abstract":"<p><strong>Purpose: </strong>There are few reports of an accessory anterior cerebral artery (ACA) of duplicate origin. The combination of accessory middle cerebral artery (MCA) and ACA fenestration is also rare.</p><p><strong>Methods: </strong>We report a case of accessory ACA of duplicate origin associated with accessory MCA and ACA fenestration diagnosed by magnetic resonance angiography (MRA).</p><p><strong>Results: </strong>A 25-year-old woman visited our hospital because of headaches. She underwent 3-Tesla magnetic resonance imaging and MRA, including partial maximum intensity projection and volume rendering images, which showed an accessory ACA originating from the anterior communicating artery. The accessory ACA had two limbs in its proximal portion. Careful assessment revealed a duplicate origin of the accessory ACA. MRA also showed a left accessory MCA arising from the left ACA proximal A1 segment and fenestration of the left ACA distal A1 segment.</p><p><strong>Conclusion: </strong>Identification of these rare anatomical variants requires careful imaging assessment. In our case, MRA partial maximum intensity projection and volume rendering images were useful and provided a better understanding of the three-dimensional vascular architecture. Although no aneurysms were observed in our case, patients with such anatomical variations should be carefully assessed for associated aneurysms.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"134"},"PeriodicalIF":1.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042669","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":"Anatomical study of the lateral plantar ligament of the population in the southwest of Shandong Province.","authors":"Zhuan Gao, Yue Li, Yu-Jie Yang, Li-Ying Guo, Shuang-Fei Yu, Jing Wang, Jing Li","doi":"10.1007/s00276-025-03651-7","DOIUrl":"https://doi.org/10.1007/s00276-025-03651-7","url":null,"abstract":"<p><strong>Purpose: </strong>To clarify the anatomical characteristics of the lateral plantar ligament (LPL) of the transverse metatarsal arch (TMA) in the population of southwest Shandong Province, so as to complement the anatomical structures of the midfoot and Lisfranc joint complexes.</p><p><strong>Methods: </strong>A total of 100 adult lower limbs were dissected and the types of LPL were divided according to their insertions, among them, 63 were (63%) and 37 were female (37%); 50 were on the left side (50%) and 50 were on the right side (50%). The fiber bundle length, origin width, insertion width, and thickness of the LPL were measured.</p><p><strong>Results: </strong>(1) According to the insertions of the LPL, they were divided into: ① Type I, the LPL was inserted at the base of the second metatarsal (M2) in 47 cases; ② Type II, the LPL was inserted at the base of M2 and fused with tibialis posterior tendon (TPT) in 16 cases; ③ Type III, the LPL was absent in 16 cases; ④ Type IV, the LPL was inserted at TPT in 6 cases; ⑤ Type V, the LPL was inserted at the intermediate cuneiform (IC) in 1 case; ⑥ Type VI, bifid LPL with one bundle inserted at the base of M2, and the other bundle inserted at the medial cuneiform (MC) in 4 cases; ⑦ Type VII, two bundles of LPL inserted at the base of M2 in 8 cases; ⑧ Type VIII, the LPL consisted of 3 bundles; the distal, middle and proximal bundles was inserted at the base of M2, the TPT and the lateral side of navicular bone in 2 cases, respectively. (2) There was a statistical significance in the length of LPL between male (31.62 ± 3.83) mm and female (28.07 ± 3.46) mm (t=-3.050, P = 0.003). There was no statistical significance in the types of LPL between male and female (Z=-1.721, P > 0.05), and no statistical significance in the types between left and right sides (Z=-0.026, P > 0.05).</p><p><strong>Conclusion: </strong>According to our research, LPL originates from M5 and is divided into 8 types according to its insertion location, of which insertion at the base of M2 is the most common. In addition, we found that LPL has fibrous fusion with the long plantar ligament and the TPT, which may be involved in maintaining arch stability. The classification of LPL in this study is a supplement to the anatomical structure of the middle foot and Lisfranc joint complex, providing a new direction for the diagnosis and treatment of middle foot and arch injury in the future.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"133"},"PeriodicalIF":1.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995236","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":"Aberrant courses of the occipital artery.","authors":"Mugurel Constantin Rusu, Cătălin Constantin Dumitru, Răzvan Costin Tudose","doi":"10.1007/s00276-025-03650-8","DOIUrl":"https://doi.org/10.1007/s00276-025-03650-8","url":null,"abstract":"<p><strong>Purpose: </strong>The occipital artery (OA), typically arising from the external carotid artery (ECA), usually courses deep to the posterior belly of the digastric muscle as it ascends toward the skull base. While variations in the height of origin from the ECA are known, aberrant courses of the OA have not been previously documented.</p><p><strong>Methods: </strong>This study presents a four-case series identified through retrospective analysis of archived CT angiograms involving three female and one male patient, aged between 57 and 66.</p><p><strong>Results: </strong>In two cases, the OA was observed to pass deep to the internal jugular vein instead of its usual superficial trajectory; these variants were located on the left side. In the remaining two cases, the OA demonstrated aberrant retromandibular courses deep within the parotid glands. One of these cases revealed bilateral retromandibular segments of the OA, while the other exhibited a common occipitoauricular trunk originating from the right superficial temporal artery within the parotid space, which subsequently divided into the posterior auricular artery and the OA.</p><p><strong>Conclusion: </strong>These previously unreported anatomical variations are clinically significant and should be considered during surgical or interventional procedures involving the parotid region.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"135"},"PeriodicalIF":1.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045665","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}