{"title":"Segmental agenesis of the internal carotid artery without proximal regression: an embryological clue for a new segment of the internal carotid artery?","authors":"Marialuisa Zedde, Rosario Pascarella","doi":"10.1007/s00276-025-03630-y","DOIUrl":"https://doi.org/10.1007/s00276-025-03630-y","url":null,"abstract":"<p><strong>Purpose: </strong>The paper aims to explore the complexities of the internal carotid artery (ICA) segmentation, particularly in the context of segmental agenesis, by presenting a unique case of ICA segmental agenesis without proximal regression. This case prompts a reevaluation of existing embryological classifications and suggests the need for an updated segmentation model.</p><p><strong>Methods: </strong>A 63-year-old woman underwent brain Magnetic Resonance Imaging (MRI) and MR Angiography due to hypoacusis, revealing incidental findings of vascular anomalies, including a focal absence of contrast in the left ICA. Subsequent imaging techniques, including Computed Tomography Angiography (CTA) and Digital Subtraction Angiography (DSA), confirmed the segmental agenesis while also identifying associated vascular anomalies, such as a triplicated anterior communicating artery and a saccular aneurysm. The study employs a detailed analysis of embryological development and existing ICA classification systems to contextualize these findings.</p><p><strong>Conclusions: </strong>The case highlights a previously unreported segmental agenesis of the ICA between the posterior communicating artery and the anterior choroidal artery, suggesting the existence of a new segment. The findings indicate that collateralization through a hyperplastic anterior choroidal artery and a complex anterior communicating system may offer compensation. This case advocates for an update in the ICA segmentation framework to accommodate emerging embryological insights and improve understanding of vascular anomalies.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"121"},"PeriodicalIF":1.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051466","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":"Association of the pituitary gland height with variant sella morphology in children.","authors":"Göktuğ Ülkü, Çağrı Elbir, Bilal Abbasoğlu, Caghan Tonge, Oğuz Kağan Demirtaş, Habibullah Dolgun, Erdal Reşit Yılmaz, Serkan Civlan, Fatma Sevmez, Orhan Beger","doi":"10.1007/s00276-025-03632-w","DOIUrl":"https://doi.org/10.1007/s00276-025-03632-w","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the relationship of the height of the pituitary gland (HPG) with the heights of the dorsum sellae (HDS) and tuberculum sellae (HTS) on pediatric magnetic resonance imaging (MRI) views.</p><p><strong>Methods: </strong>MRI slices of 180 healthy children (100 males and 80 females) aged 1-18 years were included in the study.</p><p><strong>Results: </strong>Average HPG, HTS and HDS values were determined as 6.66 ± 1.58 mm, 10.97 ± 1.99 mm, 13.62 ± 2.67 mm, respectively. No statistically significant difference was determined between the measurements in term of sex. All parameters correlated with pediatric ages. HPG increased up to the prepubescent period, and decreased after this period (p < 0.001). HDS and HTS increased with an irregular pattern (p < 0.001). There were six children (3.33%) with HPG > 10 mm. There was no child with HPG/HDS > 1 or HPG/HTS > 1.</p><p><strong>Conclusion: </strong>This work provided three substantial additions to the literature as follows: (a) all pediatric HPGs were distinctly smaller than HDSs and HTSs, (b) some children (3.33%) at puberty (age range: 10-14 years), regardless of sex, might have a HPG > 10 mm, even though there was no pathology at the pituitary gland, and (c) to our knowledge, this retrospective MRI examination evaluated the relation of HPG with variant sella morphology in normal children for the first time in the literature.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"120"},"PeriodicalIF":1.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022465","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}
Gonul Kotil, Eren Ogut, Gizem Serpil Balyemez, Serdar Bagci, Pedram Turkoglu, Medine Isik, Çağatay Barut
{"title":"The subclavian artery branching patterns with emphasis on the unilateral thyrovertebral trunk: a cadaver case report.","authors":"Gonul Kotil, Eren Ogut, Gizem Serpil Balyemez, Serdar Bagci, Pedram Turkoglu, Medine Isik, Çağatay Barut","doi":"10.1007/s00276-025-03629-5","DOIUrl":"https://doi.org/10.1007/s00276-025-03629-5","url":null,"abstract":"<p><strong>Purpose: </strong>The subclavian artery is a major vessel supplying the neck and upper limbs, and significant anatomical variations are often observed in its branches. This study investigated bilateral variations in the branching of the subclavian arteries, including rare deviations such as the presence of a thyrovertebral trunk and altered origins of several branches of the subclavian arteries. The goal of this study was to contribute to the limited literature on these anomalies, which have implications for clinical practice and surgical procedures.</p><p><strong>Case presentation: </strong>During routine dissection of an 87-year-old male donor, notable bilateral variations in the subclavian artery branching were identified. On the right side, the thyrovertebral trunk originated from the subclavian artery, from which the vertebral and inferior thyroid arteries originated. Additionally, a common trunk gave rise to the internal thoracic, transverse cervical, and ascending cervical arteries. On the left side, the subclavian artery gave rise to the vertebral artery, inferior thyroid artery, and costocervical trunk, as well as the common trunk for the internal thoracic, transverse cervical, and suprascapular arteries.</p><p><strong>Conclusions: </strong>The findings highlight significant anatomical variations in the subclavian artery branching patterns, including the presence of a thyrovertebral trunk and the absence of a thyrocervical trunk bilaterally. These variations are clinically relevant, particularly in surgeries involving the neck and upper limbs, and should be considered to avoid complications during surgery. This study proposes the term \"thoracocervical trunk\" for the common root of the transverse cervical and internal thoracic arteries, which may aid in the identification of similar anomalies in future clinical practice.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"119"},"PeriodicalIF":1.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995250","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}
Leo Gulan, Miljenko Kovačević, Gordana Žauhar, Hari Jurdana, Gordan Gulan
{"title":"The forgotten third: understanding the ACL femoral insertion and lateral intercondylar ridge extension onto the notch roof.","authors":"Leo Gulan, Miljenko Kovačević, Gordana Žauhar, Hari Jurdana, Gordan Gulan","doi":"10.1007/s00276-025-03628-6","DOIUrl":"https://doi.org/10.1007/s00276-025-03628-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study assesses the positioning of the lateral intercondylar ridge (LIR) and the anterior cruciate ligament (ACL) femoral insertion area (FIA) in relation to the femoral notch roof and the lateral notch wall and examines its correlation with the width of the posterior notch outlet.</p><p><strong>Method: </strong>45 dried femurs underwent 3D scanning. A cutting plane was established to divide the intercondylar roof from the condylar wall based on three points. The length of the LIR on the roof and wall were measured, along with the distances from key landmarks. The total ACL-FIA and the areas on the roof and wall of the intercondylar notch were measured.</p><p><strong>Results: </strong>A significant correlation was found between the LIR position on the roof and the width of the notch. LIR averaged 16.18 mm, with 30.86% on the roof, while ACL-FIA averaged 134.19 mm², with 31.55% on the roof. The width of the posterior notch outlet was averaged at 24.34 mm. The distance between the most proximal part of the LIR and the posterior intercondylar line averaged 4.87 mm and 12.46 mm to the most proximal and deepest point of the cartilage border of the lateral femoral condyle.</p><p><strong>Conclusion: </strong>This study confirms that approximately 30% of the LIR and ACL-FIA extend to the intercondylar notch roof, with a significant moderate positive correlation with the width of the posterior notch outlet. These findings highlight the need to consider the notch roof in the placement of the femoral tunnel for improved anatomical reconstruction of the ACL.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"118"},"PeriodicalIF":1.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804603","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 features of mandibular second molar C-shaped root canals in a Chinese population: a CBCT analysis.","authors":"Wenwei Hong, Jinzan Zhu, Liuhui Liu, Limin Zhang, Haifeng Tang","doi":"10.1007/s00276-025-03626-8","DOIUrl":"10.1007/s00276-025-03626-8","url":null,"abstract":"<p><strong>Purpose: </strong>C-shaped root morphology features narrow canals, root concavity, and thin dentinal walls, necessitating careful treatment planning and clinical expertise for effective cleaning and shaping.</p><p><strong>Methods: </strong>This study included 401 total CBCT images of mandibular second molars with C-shaped root canals. Root morphology, root length, dentin thickness, and the location, length, width, and depth of the radicular groove were all analyzed with the Planmeca Romexis 3.1.0.R software. Fan Bing's C-shaped root canal classification method was used to classify all data, and SPSS was used for statistical analyses.</p><p><strong>Results: </strong>These analyses revealed significant differences in radicular groove for mandibular second molars with C-shaped root canals across different root canal cross-sections. The mean respective root and radicular groove lengths for the analyzed molars were 11.64 ± 1.42 mm, and 9.34 ± 1.42 mm, and coronal, middle, and apical radicular groove incidence rates were 94.51%, 100%, and 98.75% respectively. The observed radicular grooves were widest at the coronal level and deepest at the middle level, while dentin was thinnest at the apical level.</p><p><strong>Conclusions: </strong>This study offers an overview of the radicular groove characteristics in mandibular second molars with C-shaped root canals, providing anatomical data to assist clinicians in root canal treatment.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"117"},"PeriodicalIF":1.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789301","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}
Derya Karatas, Ahmet Dagtekin, Saygi Uygur, Irmak Tekeli Barut, Engin Kara, Kaan Esen, Emel Avci, Mustafa Kemal Baskaya
{"title":"Influence of variations of craniovertebral junction anatomy on safe C1 lateral mass and C2 pedicle screw insertion: a cadaveric and radiologic study.","authors":"Derya Karatas, Ahmet Dagtekin, Saygi Uygur, Irmak Tekeli Barut, Engin Kara, Kaan Esen, Emel Avci, Mustafa Kemal Baskaya","doi":"10.1007/s00276-025-03599-8","DOIUrl":"10.1007/s00276-025-03599-8","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the present study is to analyze the feasibility of a new optimized C1 lateral mass and C2 pedicle screw method that has a suitable trajectory for a range of anatomical variations to decrease the risk of vertebral artery injury.</p><p><strong>Methods: </strong>The craniovertebral junction of 17 cadavers (34 sides) were dissected after performing thin-cut computed tomography. The screw entry points, targets, angles, and lengths of the trajectories were performed for C1 lateral mass and C2 pedicle. We particularly focused on the morphometric features and the safety of trajectories in cadavers with vascular and bony variations.</p><p><strong>Results: </strong>For the C1 lateral mass, the ideal medial and cranial angles were 13.4° ± 1.0° and 14.7° ± 1.1°, respectively. For the C2 pedicle screw, the cranial and medial angles were 27.7° ± 1.4° and 20.4° ± 1.5°, respectively. High-riding vertebral arteries (HRVA) were observed in 35.3% of all cadavers. The incidence of an arcuate foramen was 47% among all sides and its coexistence with an HRVA among all cadavers was 23.5%.</p><p><strong>Conclusion: </strong>Preoperative pedicle-oriented radiological evaluation is crucial before C1 lateral mass and C2 pedicle screw placement because of the high incidence of bony and vascular variations. Using our safe C2 pedicle trajectory, a longer and safer screw course that preserves the vertebral artery can be achieved with a more feasible cranial angle, even with HRVAs, with the exception of narrow pedicle anatomy.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"112"},"PeriodicalIF":1.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774599","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":"Determination of the prevalence of complete type retrotransverse and arcuate foramen of the atlas using three-dimensional computed tomography images.","authors":"Kaan Çimen, Enes Gül","doi":"10.1007/s00276-025-03619-7","DOIUrl":"10.1007/s00276-025-03619-7","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the prevalence of complete type retrotransverse (RTF) and arcuate foramen (AF)'s in a large cohort using three-dimensional (3D) computed images (CT) and explore their correlation with each other.</p><p><strong>Methods: </strong>Between January 2023 and August 2024, all neck and cervical vertebrae CTs taken in our hospital were scanned retrospectively. It is noted the presence or absence of complete RTF and AF, laterality, gender, and age of those included in the study.</p><p><strong>Results: </strong>A total of 2000 patients were included in the study, with an equal distribution of females and males. The prevalence of complete AF was 6.4%, 10%, and 16.3% bilaterally, unilaterally, and in total. The prevalence of complete AF was 12% in females and 20.6% in males. The gender prevalence differences of bilateral AF were statistically significant (p < 0.001). The prevalence of complete RTF was 1.8%, 8.9%, and 10.6% bilaterally, unilaterally, and in total. The prevalence of complete RTF was 9.7% in females, and 11.6% in males. The prevalence differences between genders were insignificant (p = 0.173). The ipsilateral prevalence of complete AF and RTF was 0.2%, 0.2%, and 0.4%, respectively, bilateral, unilateral right, and unilateral left.</p><p><strong>Conclusions: </strong>The complete AF and RTF prevalences in the study group were not uncommon. The prevalence of complete AF and RTF together is quite rare. Complete RTF is more common in elderly patients and on the left side, while complete AF does not show any difference in laterality and age, and is more common in males than in females.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"113"},"PeriodicalIF":1.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774598","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":"Radiological anatomy of sella turcica in children: a retrospective study with CT.","authors":"Zehra Ağolday, Emek Öykü Yıldızoğlu, Erdal Özdemir, Rıdvan Çetin, Orhan Beger","doi":"10.1007/s00276-025-03624-w","DOIUrl":"10.1007/s00276-025-03624-w","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the sella turcica (ST) morphology on pediatric computed tomography views.</p><p><strong>Methods: </strong>Radiologic images of 113 children (47 females / 66 males, mean age: 9.24 ± 6.07 years) were included in the study. The diameter (STD), width (STW), length (STL), anterior height (STA), middle height (STM), and posterior height (STP) of ST were measured. ST shape was noted.</p><p><strong>Results: </strong>STL, STD, STA, STM, STP and STW were measured as 6.81 ± 1.57 mm, 8.52 ± 2.05 mm, 5.30 ± 1.57 mm, 6.06 ± 1.49 mm, 5.71 ± 1.64 mm, and 6.38 ± 1.91 mm, respectively. STL (p = 0.012) and STD (p < 0.001) did not show significant change after the late childhood period, while STA, STM, STP and STW did not display significant change after the early childhood period (p < 0.001). According to Axelsson classification, ST shape was identified as Type 1 (normal ST) in 34 cases (30.10%), Type 2 (oblique anterior wall) in 17 cases (15%), Type 3 (double contour of the floor) in four cases (3.60%), Type 4 (irregularity) in eight cases (7.10%), and Type 5 (pyramidal shape of the dorsum sellae) in 50 cases (44.20%). According to Camp classification, ST shape was identified as oval in 39 cases (34.50%), round in 62 cases (54.90%), and flattened in 12 cases (10.60%). Dispersion ratios of ST shape types in in the first and second decades showed that Axelsson (p < 0.001) and Camp (p = 0.043) classifications correlated with age.</p><p><strong>Conclusion: </strong>ST size does not show significant change after the late childhood period. Its shape correlates with age, but not gender.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"116"},"PeriodicalIF":1.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781883","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}
Rodica Narcisa Calotă, Mugurel Constantin Rusu, Cătălin Constantin Dumitru, Liliana Moraru, Răzvan Costin Tudose
{"title":"Retropharyngeal course of the superior thyroid artery - a novel finding.","authors":"Rodica Narcisa Calotă, Mugurel Constantin Rusu, Cătălin Constantin Dumitru, Liliana Moraru, Răzvan Costin Tudose","doi":"10.1007/s00276-025-03627-7","DOIUrl":"10.1007/s00276-025-03627-7","url":null,"abstract":"<p><strong>Purpose: </strong>The anatomical variables of the superior thyroid artery (STA) are well-studied. It typically leaves the external carotid artery (ECA) and descends on the inferior pharyngeal constrictor muscle to reach the thyroid lobe. We serendipitously found a novel possibility: the bilateral retropharyngeal course of the STA, which we report here.</p><p><strong>Method: </strong>The case was found while studying the archived angioCT file of a 56-year-old male.</p><p><strong>Results: </strong>The right carotid bifurcation (CB) was in the coronal plane at 3.3 mm inferior to the greater horn of the hyoid bone (GHHB). The initial segment of the ECA was medial to the GHHB. The origin of the right STA was at 2.7 cm medial to the GHHB greater hyoid horn from the anterior side of the ECA. The left CB was at 2.5 mm posterior to the left hyoid tubercle. It was oriented sagittally oblique, with the left ECA antero-medially to the left ICA. The left STA arose from the medial side of the ECA at 5.6 mm postero-superior to the hyoid tubercle. Each STA descended medially to the GHHB and, further, the superior horn of the thyroid cartilage on that side. At the root of the superior horn of the thyroid cartilage, each STA turned laterally between the common carotid artery and the posterior margin of the lamina of the thyroid cartilage and continued to the thyroid lobe on that side. Thus, both STAs coursed posteriorly to the pyriform recess of the hypopharynx on that side.</p><p><strong>Conclusion: </strong>Finding bilateral STAs is extraordinary but possible. Such extremely rare variants can be accurately identified during preoperative angioCT scans.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"115"},"PeriodicalIF":1.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774606","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}
Ann Rizkallah, Ashley Deer, Mitchell Katkic, Jonathan A Millard
{"title":"Landmark based morphometric analysis of the pulmonary valve.","authors":"Ann Rizkallah, Ashley Deer, Mitchell Katkic, Jonathan A Millard","doi":"10.1007/s00276-025-03617-9","DOIUrl":"10.1007/s00276-025-03617-9","url":null,"abstract":"<p><strong>Purpose: </strong>The pulmonary valve comprises three leaflets which attach to the wall of the right ventricle via the annulus. The purpose of this study is to describe the leaflet attachment pattern of the pulmonary valve using landmark-based geometric morphometric techniques and explore the relationship between shape variables and size.</p><p><strong>Methods: </strong>A total of 28 pulmonary valves were harvested from anatomical donors. The valves were opened and photographed in a standardized manner. A geometric morphometric landmark protocol was digitally applied to each photograph. Generalized Procrustes superimposition and an ordination analysis were used to assess valve shape. The relationship between major components of valve shape and centroid size were investigated. Ten valves were repinned and photographed by another researcher to evaluate the role of error in the results.</p><p><strong>Results: </strong>The principal component analysis (PCA) revealed several patterns in pulmonary valve leaflet attachment. Principal component 1 (PC1) accounted for 40.6% of the variation in the sample; its major axis of variation reflects a curvature in the ends of the open outflow tract which corresponds with natural variability in the circumference of the tract between the level of the annulus and sinotubular junction. Principal component 2 accounted for 19.2% of the variation in the sample and was associated with asymmetry in peak leaflet attachment. Uniform variation in sinus depth was seen along PC3 (12.7%). Principal component 4 was associated with non-uniform asymmetric variation in sinus depth and accounted for 7.5% of the variation in the sample. No association was found between the size and shape of the valve. Error study results demonstrated the process of pinning and photographing had a marginal effect shape outcomes.</p><p><strong>Conclusion: </strong>Our results show notable variability in pulmonary valve leaflet attachment pattern. Shape variables had no relationship with valve centroid size. More nuanced morphologic analyses may stimulate physiologic questions aimed at assessing the relationship between valve morphology and performance.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"114"},"PeriodicalIF":1.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774601","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}