Surgical and Radiologic Anatomy最新文献

{"title":"Morphometric and signal intensity benchmarks of 3D CRANI MR neurography sequence for extraforaminal cranial and occipital nerves visualization: a pilot study.","authors":"Iraj Ahmadzai, Frederic Van der Cruyssen, Sohaib Shujaat, Jan W Casselman, Constantinus Politis, Reinhilde Jacobs","doi":"10.1007/s00276-025-03726-5","DOIUrl":"10.1007/s00276-025-03726-5","url":null,"abstract":"<p><strong>Purpose: </strong>Lack of evidence exists related to the reporting of benchmark values of MR neurography sequences required for extraforaminal cranial and occipital nerve visualization. This study aimed to establish benchmarks of morphometric and signal intensity values of 3D CRANI MR neurography sequence in healthy subjects.</p><p><strong>Methods: </strong>A total of 10 healthy participants (5 males, 5 females; age range:14-83 years) were recruited. Imaging was conducted using a 3.0 Tesla MRI system fitted with a 32-channel head coil. The assessed extraforaminal cranial and occipital nerves included auriculotemporal, buccal, facial, greater occipital, hypoglossal, inferior alveolar, lingual, mandibular, masseteric, and maxillary. These nerves were semi-automatically segmented and divided into five segments: proximal, mid-proximal, middle, mid-distal, and distal. Measurements were performed for per nerve and segment diameter, signal intensity, apparent signal-to-noise (aSNR) and apparent nerve-muscle contrast-to-noise ratios (aNMCNR).</p><p><strong>Results: </strong>All nerves exhibited a decreasing trend in diameter and signal intensity from the proximal to the distal end, except for the facial, maxillary, and auriculotemporal nerves. The mid-proximal section of the nerves under examination showed notably higher values for diameter (p < 0.01), signal intensity (p < 0.0001), and aNMCNR (p < 0.05). On the other hand, the distal segment recorded the lowest values across all parameters. The aSNR and aNMCNR values confirmed good discrimination of each observed nerve.</p><p><strong>Conclusions: </strong>The proposed benchmark for 3D CRANI MR neurography enhances the neuroradiological understanding of cranial and occipital nerves. It could act as a reference guide in various head and neck scenarios, particularly when distinguishing between healthy and pathological conditions.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"216"},"PeriodicalIF":1.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193720","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":"Text to image generators for anatomical illustrations: potential and limitations.","authors":"Bahattin Paslı, Helin Yücedağ Gündoğdu","doi":"10.1007/s00276-025-03699-5","DOIUrl":"https://doi.org/10.1007/s00276-025-03699-5","url":null,"abstract":"<p><strong>Purpose: </strong>In recent years, artificial intelligence has made significant advances in medical illustration, paralleling progress in many other fields. These tools provide an efficient and cost-effective approach to creating custom illustrations and rapidly visualizing medical and anatomical contents. The aim of this study is to investigate the strengths and limitations of artificial intelligence in generating such illustrations, with a focus on its potential application in anatomy education.</p><p><strong>Methods: </strong>The present study assessed the ability of ChatGPT, Microsoft Designer, Craiyon and Image FX to create illustrations of the liver, spleen, kidney, their cadaveric forms, and genital organs. Each illustration was independently evaluated by two researchers using a five-point Likert scale based on nine criteria assessing anatomical features, educational utility, and visual quality.</p><p><strong>Results: </strong>Image FX, ChatGPT, and Microsoft Designer achieved overall scores (3.46; 3.40; and 3.24, respectively), while Craiyon received the lowest score (1.86). Despite the aesthetic appeal, and visual quality of the generated images, a notable lack of anatomical features was observed. Microsoft Designer was restricted by policy from generating both cadaveric organ and genital system images, whereas Image FX, ChatGPT, and Craiyon produced such images despite their limited accuracy.</p><p><strong>Conclusions: </strong>This study highlights both the capabilities and limitations of artificial intelligence powered text-to-image generators in anatomical illustrations. Future advancements in artificial intelligence models, particularly through the integration of anatomically accurate databases and standardized anatomical terminology, have the potential to significantly increase the accuracy and applicability of these tools in medical education.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"215"},"PeriodicalIF":1.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182522","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 and morphometric study of variations of the clivus in dried human skulls from the northeastern Thai population.","authors":"Laphatrada Yurasakpong, Athikhun Suwannakhan, Somluk Asuvapongpatana, R Shane Tubbs, Joe Iwanaga, Sitthichai Iamsaard, Rarinthorn Samrid, Thewarid Berkban, Arada Chaiyamoon","doi":"10.1007/s00276-025-03732-7","DOIUrl":"https://doi.org/10.1007/s00276-025-03732-7","url":null,"abstract":"<p><strong>Purpose: </strong>Anatomical variations of the clivus may have clinical and embryological relevance but remain underexplored in specific populations. This study investigated the prevalence and morphometric characteristics of clival anatomical variants in dried human skulls from the Northeastern Thai population.</p><p><strong>Methods: </strong>Three hundred four dried human skulls (282 males, 22 females) were examined macroscopically. Variations of the clivus were identified and recorded by two independent observers, with discrepancies resolved by consensus. Descriptive statistics were used to report prevalence. Morphometric measurements (height and breadth) were taken for applicable variants using a digital caliper. Chi-square tests assessed sex differences.</p><p><strong>Results: </strong>Fossa navicularis magna and tubercle at the anterior margin of the foramen magnum were the most prevalent variants, each observed in 38 skulls (12.5%). The basilar processes were found in 12 skulls (3.9%), condylus tertius in 5 skulls (1.6%), and prebasioccipital arch in 1 skull (0.3%). These variations showed variable morphometry. Fossa navicularis magna averaged 5.1 mm in height and 4.1 mm in breadth; tubercle at the anterior margin of the foramen magnum, 2.7 mm in breadth; basilar processes, 3.9 mm in height; condylus tertius, 6.3 mm in height and 6.9 mm in breadth; and prebasioccipital arch, 10.5 mm in height and 15.5 mm in breadth. No significant sex differences were found for fossa navicularis magna (p = 0.40), tubercle at the anterior margin of foramen magnum (p = 0.61) or basilar process (p = 0.67).</p><p><strong>Conclusion: </strong>Clival variants, especially fossa navicularis magna and anterior tubercles, were found in 12.5% of skulls in this first study on Northeastern Thais. These may impact imaging interpretation and skull base surgery, reiterating the need for anatomical awareness in clinical contexts.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"214"},"PeriodicalIF":1.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139272","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":"Identification of elbow joint structures on cadaver sectioned images in various planes for radiologic analysis.","authors":"Minji Kim, Hyeonguk Choi, Beom Sun Chung","doi":"10.1007/s00276-025-03727-4","DOIUrl":"https://doi.org/10.1007/s00276-025-03727-4","url":null,"abstract":"<p><strong>Purpose: </strong>Conventional imaging modalities, including MRI and ultrasonography, often fail to depict the intricate anatomy of the elbow in sufficient detail. This study presents high-resolution sectional and surface anatomical images to enhance understanding of elbow morphology and aid interpretation of MRI and ultrasound in clinical practice.</p><p><strong>Methods: </strong>Sectioned images of a male cadaver from the Visible Korean dataset were analyzed. The cadaver was sectioned horizontally at 0.2-mm intervals and photographed to produce high-resolution (3040 × 2008 pixels), true-color images. Coronal and sagittal reconstructions were generated to visualize elbow structures. Bones, muscles, blood vessels, and nerves were identified and traced across multiple planes, and the resulting images were compared with corresponding ultrasound views to confirm spatial correlations.</p><p><strong>Results: </strong>The images revealed various elbow structures in great detail. Horizontal images displayed muscle origins and insertions, and ligament orientations, while coronal images highlighted the relationships between tendons and ligaments. Sagittal images distinctly showed the articulation of the humeroulnar and humeroradial joints. Additionally, illustrations of surface anatomy facilitated the correlation with clinical ultrasound images. No significant anatomical variations were observed compared to established literature.</p><p><strong>Conclusion: </strong>The high-resolution anatomical images presented in this study enhance understanding of elbow anatomy and facilitate MRI and ultrasound interpretation. These resources can support more accurate diagnosis and treatment of elbow disorders and serve as effective educational tools for medical trainees.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"213"},"PeriodicalIF":1.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139205","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":"Scaphoid bone morphometry and nutrient foramina: anatomical study and clinical implications.","authors":"Bahar Selenay Bulut, Niymet Pelin Çavdar Yılmaz, Mehmet Yılmaz, Murat Doğuş Günel, George Triantafyllou, Trifon Totlis, Aysun Uz","doi":"10.1007/s00276-025-03722-9","DOIUrl":"https://doi.org/10.1007/s00276-025-03722-9","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the current study is to reveal the morphological features and nutrient foramina distribution of scaphoid bone in a Turkish population, which may be helpful to diagnosis and surgical treatment of scaphoid fractures.</p><p><strong>Methods: </strong>One hundred and two (51 right, 51 left) dry scaphoid bone were measured. The following measurements were performed: length, width, area of articular surfaces, mid-peripheral width, number of posterior grooves, width and length of the grooves, length of the scaphoid tubercle and number of nutrient foramina, proximal or distal location of these foramina, and distance to the transverse midline were measured. Circumferential measurements were made using a surgical tape measure, morphometric measurements using a digital caliper and area measurements using the ImageJ program (LOCI, University of Wisconsin, Madison, USA).</p><p><strong>Results: </strong>The length and width of the scaphoid bone are 25.57 ± 2.17 mm and 10.07 ± 1.25 mm, and the midline circumference is 34.85 ± 3.92 mm. In 41 bones a second posterior groove (sulcus) was found. Length and width of the main posterior groove was 19.43 ± 3.14 mm and 2.17 ± 0.67 mm respectively, number of nutrient foramen was 6 ± 2, length of scaphoid tubercle was 12.03 ± 1.78 mm. Overall, 341 nutrient foramen (215 dorsal, 126 palmar) were identified. The distance of the proximal nutrient foramen to the midline was 3.41 ± 2.37 mm and the corresponding distance of the distal nutrient foramen was 4.63 ± 2.72 mm.</p><p><strong>Conclusion: </strong>This study revealed the scaphoid bone morphology, morphometry and nutrient foramina number and location in the Turkish population. These findings are important for orthopaedic surgeons during scaphoid bone surgery for fractures or pseudarthrosis.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"210"},"PeriodicalIF":1.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126479","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":"Study of superficial variations of ulnar nerve beyond the flexor retinaculum: a comprehensive review for surgical practice.","authors":"Nandini Prashanth Bhat, Pihu Toshniwal, Ashwath Acharya, Ashwija Shetty, Lydia Shobha Andrade","doi":"10.1007/s00276-025-03719-4","DOIUrl":"https://doi.org/10.1007/s00276-025-03719-4","url":null,"abstract":"<p><strong>Purpose: </strong>The ulnar nerve in the palm exhibits significant anatomical variations, including branching patterns and interconnections. Understanding these variations is crucial for the management of neuropathies. This study aimed to analyze the branching of the superficial branch of the ulnar nerve, the presence of communications between it and the median nerve, and the morphometric characteristics of these connections in cadaveric specimens and clinical cases.</p><p><strong>Methods: </strong>Fifty hands were dissected to examine the different patterns, morphometric variations between the ulnar and median nerves. Variations in Berrettini's anastomosis were classified according to established criteria. Clinical cases related to surgical complications, nerve injuries related to these anatomical variations were also evaluated and correlated.</p><p><strong>Results: </strong>In the wrist, the branching pattern of the ulnar nerve showed bifurcation in 90% and trifurcation in 10% of specimens. Communicating branches were observed, between the superficial branch of ulnar nerve and the median nerve, and showed variations in trunk length, angle, and distance of origin. Berrettini's anastomosis (Type I and Type III) was identified in 36% of specimens. Double communications and fiber networking between nerves were documented. Patient cases of unexpected claw hand, iatrogenic injuries and altered sensory nerve choice of transfer were correlated to these variations.</p><p><strong>Conclusion: </strong>The study stresses the irregularity in the branching patterns of the ulnar nerve and the interconnections between the ulnar and median nerves, providing analytical insights into their developmental and clinical inferences. These findings highlight the value of identifying anatomical variations to reduce iatrogenic injuries and improve diagnostic and surgical results.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"212"},"PeriodicalIF":1.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126166","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":"Evaluation of the performance of different large language models on head and neck anatomy questions in the dentistry specialization exam in Turkey.","authors":"Busra Nur Gokkurt Yilmaz, Furkan Ozbey, Birkan Eyup Yilmaz","doi":"10.1007/s00276-025-03723-8","DOIUrl":"https://doi.org/10.1007/s00276-025-03723-8","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to assess the performance of various Large Language Models (LLMs) in addressing head and neck anatomy questions from the Dental Specialization Exam (DUS), conducted between 2012 and 2021.</p><p><strong>Methods: </strong>A total of 103 multiple-choice questions were selected from DUS examinations over a decade. These questions covered major topics: Musculoskeletal System, Nervous System and Sensory Organs, Dental Anatomy, and Veins, Arteries, Lymphatic System and the Glandular System. Eight of the LLMs Gemini 1.5, Gemini 2, Copilot, Deepseek, Claude, ChatGPT 4o, ChatGPT 4, and ChatGPT o1 were employed using their most updated versions. Each model's accuracy was calculated by comparing the number of correct and incorrect responses.</p><p><strong>Results: </strong>The ChatGPT o1 demonstrated the highest accuracy rate among all tested models, while Gemini 1.5 showed the lowest accuracy. These differences were found to be statistically significant (p = 0.027). Post-hoc analysis revealed that the only statistically significant difference among the LLMs was between ChatGPT o1 and Gemini 1.5 (p < 0.0031). When questions were analyzed by topic, no significant accuracy differences emerged in the Musculoskeletal System section. However, the ChatGPT o1 performed best in the Nervous System and Sensory Organs category. For Dental Anatomy questions, both ChatGPT o1 and Copilot achieved top results, and for Veins, Arteries, Lymphatic System and Glandular System section, ChatGPT o1 again excelled.</p><p><strong>Conclusion: </strong>Overall, the findings show that LLMs effectively answer DUS head and neck anatomy questions with comparable performance. These insights support future exam-related model development and suggest that LLMs can serve as valuable educational tools.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"211"},"PeriodicalIF":1.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126516","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":"Topography, prevalence, and diameter of the parietal emissary foramen in the pediatric population.","authors":"Mert Çetin, Abidin Murat Geyik, Melih Akşamoğlu, Necati Üçler, Ali Nehir, Yiğit Aksoğan, Muhammet Enes Gurses, Murat Gölpınar, Ömer Faruk Cihan, Orhan Beger","doi":"10.1007/s00276-025-03725-6","DOIUrl":"https://doi.org/10.1007/s00276-025-03725-6","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to see changes in the topography, prevalence, and diameter of the parietal emissary foramen (PEF) in children with advancing age.</p><p><strong>Methods: </strong>The 360 normal pediatric subjects aged 1-18 years, who underwent cranial computed tomography scans were included in the study. The diameter of PEF (PEFD), if present, was measured. Distances from PEF to sagittal (PEF-SS), lambdoid (PEF-LS), and coronal (PEF-CS) sutures were measured.</p><p><strong>Results: </strong>Of 360 children, 269 subjects had PEF (74.7%) and three had multiple PEFs (0.8%). Bilateral, unilateral right-side, and unilateral left-side PEF incidences were determined as 44.2%, 20.3% and 10.3%, respectively. PEFD was determined to be 3.16 ± 1.02 mm, and it remained unchanged after the early childhood period. PEFD > 5 mm was identified in six children (1.7%). PEF-SS, PEF-LS, and PEF-CS were measured as 5.44 ± 2.74 mm, 35.50 ± 6.44 mm, and 81.90 ± 7.33 mm, respectively. According to age groups, PEF-LS and PEF-CS did not change after the early childhood period. PEF-SS did not correlate with pediatric age groups. Linear function was calculated as y = 2.531 + 0.065 × age for PEFD, and y = 76.918 + 0.515 × age for PEF-CS.</p><p><strong>Conclusions: </strong>Approximately three in four children have a PEF. Its diameter remains unchanged after the early childhood period. A pediatric PEF is located approximately 5 mm lateral to the sagittal suture, 35 mm anterior to the lambdoid suture, and 80 mm posterior to the coronal sutures.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"208"},"PeriodicalIF":1.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126253","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":"Predominant role of the left gastroomental artery in distal pancreatectomy with preservation of the spleen and splenic vessels resection (Warshaw technique): an anatomoradioclinical study.","authors":"Gaétan Pasinato, Quentin Laferté, Matys Pannet, Johann Peltier, Eric Havet, Jean-Marc Regimbeau","doi":"10.1007/s00276-025-03700-1","DOIUrl":"https://doi.org/10.1007/s00276-025-03700-1","url":null,"abstract":"<p><strong>Introduction: </strong>Left pancreatectomy with conservation of the spleen but not of the splenic vessels, also known as the Warshaw technique (WT), is a rapidly developing procedure in pancreatic surgery. The left gastro-omental artery has been little studied and could play a key role in spleen viability during the WT. The objectives of this study were to perform an anatomical study of the topography of this artery, establish a simple anatomical classification of the left gastroomental artery, and to determine the feasibility of its conservation during WT.</p><p><strong>Materials and methods: </strong>We studied the topography of the left gastroomental artery and the feasibility of its preservation during the WT using data obtained by three methods: cadaveric dissection/analysis of splenic arteriograms/3D reconstructions of CT scans with contrast injection during the arterial phase in patients undergoing splenic embolization.</p><p><strong>Results: </strong>Dissection data showed that preservation of the left gastroomental artery during the WT is possible in 75% of anatomical configurations. Data for arteriography and CT scans with contrast injection showed that the left gastroomental artery played a major role in spleen vascularization in patients who had undergone embolization of the splenic artery.</p><p><strong>Conclusion: </strong>It is often possible to preserve the left gastroomental artery during a WT, with potentially beneficial consequences for spleen vascularization.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"209"},"PeriodicalIF":1.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126499","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":"Preservation of parathyroid vascularization in thyroid surgery: morphological study and surgical implications.","authors":"Catarina Melo, António Bernardes, Luis Cardoso, António Miguéis","doi":"10.1007/s00276-025-03720-x","DOIUrl":"10.1007/s00276-025-03720-x","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this work was to study the vascularization of parathyroid glands (PTG) and determine the features that may influence its preservation. Based on those findings we propose surgical strategies to preserve the parathyroid vascular supply in thyroid surgery.</p><p><strong>Methods: </strong>A study of the vascular supply of 110 PTG was performed in 30 cadaver specimens. The thyroid arteries were cannulated and injected with an isoprene polymer. Data collection included: number and location of PTG and information about their vascular supply: origin, number of arteries, length, course, relation with recurrent laryngeal nerve (RLN) and thyroid lobe. There were determined the most variable features and the most consistent features about PTG arteries.</p><p><strong>Results: </strong>The vascular supply of PTG was provided by a terminal artery. The PTG's hilum was related to the thyroid surface. The PTG received 1 vessel in most cases, with no significant difference between the superior and inferior PTG (P = 0.111). The superior PTG received a vessel from the posterior branch of inferior thyroid artery (ITA) in 49 cases (87.5%) and the inferior PTG received a vessel from the anterior branch of ITA in all 54 cases (100%). The length of the arteries was on average 7 mm and the arteries to inferior PTG were smaller (P = 0.004). The artery to superior PTG described a cranial course in 40 cases (71.4%) and the artery to the inferior PTG described a caudal course in 31 cases (57.4%) (P < 0.001). The parathyroid arteries were located anterior to the RLN in most cases. The arteries to superior PTG were all posterior to the thyroid lobe and the arteries for inferior PTG were posterior to the thyroid lobe in 48 cases (88.9%) and course through the thyroid parenchyma in 6 cases (11,1%). All PTG arteries were located lateral to the attachment of the pretracheal layer of the deep cervical fascia to the trachea.</p><p><strong>Conclusions: </strong>The origin, number, course and length of the parathyroid arteries are variable, which influence its preservation. There are some consistent features that can guide thyroidectomy. The PTG should be retracted from medial-to-lateral direction from the thyroid surface to protect their hilum. The PTG located anterior to the thyroid lobe may need to be re-implanted, once their artery crosses thyroid parenchyma. The area posterior to the thyroid lobe, anterior to the recurrent laryngeal nerve and lateral to the pretracheal layer of the deep cervical fascia should be spared from dissection and vessel ligation, once is the main territory for PTG arteries.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"207"},"PeriodicalIF":1.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087750","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}