Distance measurements and origin levels of the coeliac trunk, superior mesenteric artery, and inferior mesenteric artery by multiple-detector computed tomography angiography

The branching of the inferior mesenteric artery and vein varies among individuals. Three-dimensional CT angiography is a less invasive modality than traditional angiographic examination to assess the artery and vein.

To demonstrate the clinical applicability of 3-dimensional CT angiography (3D-CTA) in evaluating the anatomic variations of inferior mesenteric artery (IMA) and left colic artery (LCA), to help make pre-operative strategies of rectal cancer surgery.

To evaluate the ability of MDCT reformations in describing the celiac trunk vascular anatomy and variations. A total of 555 MDCT angiographies of the abdominal aorta performed between January 2002 and July 2005 were retrospectively reviewed to assess the celiac trunk vascular anatomy and variations. All the patients with pathological condition likely to affect normal vascular anatomy as well as CT exams technically inadequate were excluded from our study. A total of 524 MDCT angiographies of abdominal aorta were included in our study. The classical configuration of the celiac trunk was detected in 72.1%. The hepato-splenic trunk was detected in 50.4% of cases; the hepato-gastro-splenic trunk was detected in 19.4% of cases; the gastro-splenic trunk was detected in 2.3% of cases. The hepato-spleno-gastric trunk associated with hepatic arteries variants were found in 15.4%. The hepato-splenic trunk, the hepato-gastric trunk, the hepato-splenic-mesenteric trunk, and the spleno-gastric trunk were found in 2.7, 5, 0.4, and 3.6%, respectively. In 0.6%, we found an absent celiac trunk. The knowledge of the type of anatomical variants and their subtypes is fundamental for a correct pre-operative vascular planning in surgical or radiological abdominal procedures. Multidetector-row CT (MDCT) provides high-quality 3D-reconstructed images and allows non-invasive assessment of normal anatomy and anatomic variants of celiac trunk.