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Erschienen in: Surgical and Radiologic Anatomy 11/2023

28.08.2023 | Original Article

MDCT evaluation of Dorsal Pancreatic Artery and Intrapancreatic arcade anatomy

verfasst von: Shaurya Sharma, Binit Sureka, Vaibhav Varshney, Subhash Soni, Taruna Yadav, Pawan Kumar Garg, Pushpinder Singh Khera

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 11/2023

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Abstract

Objective

The purpose of the study was to analyze the anatomy and variations in the origin of the dorsal pancreatic artery, greater pancreatic artery and to study the various types of arterial arcades supplying the pancreas on multidetector CT (MDCT).

Methods

A retrospective analysis of 747 MDCT scans was performed in patients who underwent triple phase or dual phase CT abdomen between December 2020 and October 2022. Variations in origin of Dorsal pancreatic artery (DPA), greater pancreatic artery (GPA), uncinate process branch were studied. Intrapancreatic arcade anatomy was classified according to Roman Ramos et al. into 4 types—small arcades (type I), small and large arcades (type II), large arcades (type III) and straight branches (type IV).

Results

The DPA was visualized in 65.3% (n = 488) of cases. The most common origin was from the splenic artery in 58.2% (n = 284) cases. The mean calibre of DPA was 2.05 mm (1.0–4.8 mm). The uncinate branch was seen in 21.7% (n = 106) with an average diameter of 1.3 mm. The greater pancreatic artery was seen in 57.3% (n = 428) predominantly seen arising from the splenic artery. The most common arcade anatomy was of Type II in 52.1% (n = 63) cases.

Conclusion

Pancreatic arterial variations are not very uncommon in daily practice. Knowledge of these variations before pancreatic surgery and endovascular intervention procedure is important for surgeons and interventional radiologist.
Literatur
1.
Zurück zum Zitat Baranski AG, Lam HD, Braat AE, Schaapherder AF (2016) The dorsal pancreatic artery in pancreas procurement and transplantation: anatomical considerations and potential implications. Clin Transplant 30:1360–1364 CrossRefPubMed Baranski AG, Lam HD, Braat AE, Schaapherder AF (2016) The dorsal pancreatic artery in pancreas procurement and transplantation: anatomical considerations and potential implications. Clin Transplant 30:1360–1364 CrossRefPubMed
2.
Zurück zum Zitat Boscà-Ramon A, Ratnam L, Cavenagh T, Chun JY, Morgan R, Gonsalves M, Das R, Ameli-Renani S, Pavlidis V, Hawthorn B, Ntagiantas N, Mailli L (2022) Impact of site of occlusion in proximal splenic artery embolisation for blunt splenic trauma. CVIR Endovasc 5:43 CrossRefPubMedPubMedCentral Boscà-Ramon A, Ratnam L, Cavenagh T, Chun JY, Morgan R, Gonsalves M, Das R, Ameli-Renani S, Pavlidis V, Hawthorn B, Ntagiantas N, Mailli L (2022) Impact of site of occlusion in proximal splenic artery embolisation for blunt splenic trauma. CVIR Endovasc 5:43 CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Chong M, Freeny PC, Schmiedl UP (1998) Pancreatic arterial anatomy: depiction with dual-phase helical CT. Radiology 208:537–542 CrossRefPubMed Chong M, Freeny PC, Schmiedl UP (1998) Pancreatic arterial anatomy: depiction with dual-phase helical CT. Radiology 208:537–542 CrossRefPubMed
4.
Zurück zum Zitat Covantev S, Mazuruc N, Belic O (2019) The arterial supply of the distal part of the pancreas. Surg Res Pract 2019:5804047 PubMedPubMedCentral Covantev S, Mazuruc N, Belic O (2019) The arterial supply of the distal part of the pancreas. Surg Res Pract 2019:5804047 PubMedPubMedCentral
6.
Zurück zum Zitat Henry BM, Skinningsrud B, Saganiak K, Pękala PA, Walocha JA, Tomaszewski KA (2019) Development of the human pancreas and its vasculature—an integrated review covering anatomical, embryological, histological, and molecular aspects. Ann Anat 221:115–124 CrossRefPubMed Henry BM, Skinningsrud B, Saganiak K, Pękala PA, Walocha JA, Tomaszewski KA (2019) Development of the human pancreas and its vasculature—an integrated review covering anatomical, embryological, histological, and molecular aspects. Ann Anat 221:115–124 CrossRefPubMed
8.
Zurück zum Zitat Hong KC, Freeny PC (1999) Pancreaticoduodenal arcades and dorsal pancreatic artery: comparison of CT angiography with three-dimensional volume rendering, maximum intensity projection, and shaded-surface display. AJR Am J Roentgenol 172:925–931 CrossRefPubMed Hong KC, Freeny PC (1999) Pancreaticoduodenal arcades and dorsal pancreatic artery: comparison of CT angiography with three-dimensional volume rendering, maximum intensity projection, and shaded-surface display. AJR Am J Roentgenol 172:925–931 CrossRefPubMed
9.
Zurück zum Zitat Horiguchi A, Ishihara S, Ito M, Asano Y, Yamamoto T, Miyakawa S (2010) Three-dimensional models of arteries constructed using multidetector-row CT images to performpancreatoduodenectomy safely following dissection of the inferior pancreaticoduodenal artery. J Hepatobiliary Pancreat Sci 17:523–526 CrossRefPubMed Horiguchi A, Ishihara S, Ito M, Asano Y, Yamamoto T, Miyakawa S (2010) Three-dimensional models of arteries constructed using multidetector-row CT images to performpancreatoduodenectomy safely following dissection of the inferior pancreaticoduodenal artery. J Hepatobiliary Pancreat Sci 17:523–526 CrossRefPubMed
10.
Zurück zum Zitat Iede K, Nakao A, Oshima K, Suzuki R, Yamada H, Oshima Y, Kobayashi H, Kimura Y (2018) Early ligation of the dorsal pancreatic artery with a mesenteric approach reduces intraoperative blood loss during pancreatoduodenectomy. J Hepatobiliary Pancreat Sci 25:329–334 CrossRefPubMed Iede K, Nakao A, Oshima K, Suzuki R, Yamada H, Oshima Y, Kobayashi H, Kimura Y (2018) Early ligation of the dorsal pancreatic artery with a mesenteric approach reduces intraoperative blood loss during pancreatoduodenectomy. J Hepatobiliary Pancreat Sci 25:329–334 CrossRefPubMed
11.
Zurück zum Zitat Kanazawa A, Tanaka H, Hirohashi K, Shuto T, Takemura S, Tanaka S, Hamuro M, Kinoshita H, Kubo S (2005) Pseudoaneurysm of the dorsal pancreatic artery with obstruction of the celiac axis after pancreatoduodenectomy: report of a case. Surg Today 35:332–335 CrossRefPubMed Kanazawa A, Tanaka H, Hirohashi K, Shuto T, Takemura S, Tanaka S, Hamuro M, Kinoshita H, Kubo S (2005) Pseudoaneurysm of the dorsal pancreatic artery with obstruction of the celiac axis after pancreatoduodenectomy: report of a case. Surg Today 35:332–335 CrossRefPubMed
12.
Zurück zum Zitat Kumar KH, Garg S, Yadav TD, Sahni D, Singh H, Singh R (2021) Anatomy of peripancreatic arteries and pancreaticoduodenal arterial arcades in the human pancreas: a cadaveric study. Surg Radiol Anat 43:367–375 CrossRefPubMed Kumar KH, Garg S, Yadav TD, Sahni D, Singh H, Singh R (2021) Anatomy of peripancreatic arteries and pancreaticoduodenal arterial arcades in the human pancreas: a cadaveric study. Surg Radiol Anat 43:367–375 CrossRefPubMed
13.
Zurück zum Zitat Lin Y, Yang X, Chen Z, Tan J, Zhong Q, Yang L, Wu Z (2012) Demonstration of the dorsal pancreatic artery by CTA to facilitate superselective arterial infusion of stem cells into the pancreas. Eur J Radiol 81:461–465 CrossRefPubMed Lin Y, Yang X, Chen Z, Tan J, Zhong Q, Yang L, Wu Z (2012) Demonstration of the dorsal pancreatic artery by CTA to facilitate superselective arterial infusion of stem cells into the pancreas. Eur J Radiol 81:461–465 CrossRefPubMed
14.
Zurück zum Zitat Macchi V, Picardi EEE, Porzionato A, Morra A, Bardini R, Loukas M, Tubbs RS, De Caro R (2017) Anatomo-radiological patterns of pancreatic vascularization, with surgical implications: clinical and anatomical study. Clin Anat 30:614–624 CrossRefPubMed Macchi V, Picardi EEE, Porzionato A, Morra A, Bardini R, Loukas M, Tubbs RS, De Caro R (2017) Anatomo-radiological patterns of pancreatic vascularization, with surgical implications: clinical and anatomical study. Clin Anat 30:614–624 CrossRefPubMed
15.
Zurück zum Zitat Michels NA (1942) The variational anatomy of the spleen and splenic artery. Am J Anat 70:21–72 CrossRef Michels NA (1942) The variational anatomy of the spleen and splenic artery. Am J Anat 70:21–72 CrossRef
16.
Zurück zum Zitat Pitzorno M (1920) Morfologia delle arterie del pancreas. Arch Ital Anat Embriol 18:1–48 Pitzorno M (1920) Morfologia delle arterie del pancreas. Arch Ital Anat Embriol 18:1–48
17.
Zurück zum Zitat Ramos RR, Zagorskaia IB, Kulik VP (1977) Participation of splenic vessels in blood supply to the pancreas (experimental-mathematical study). Arkh Anat Gistol Embriol 73:53–59 PubMed Ramos RR, Zagorskaia IB, Kulik VP (1977) Participation of splenic vessels in blood supply to the pancreas (experimental-mathematical study). Arkh Anat Gistol Embriol 73:53–59 PubMed
18.
Zurück zum Zitat Branco R, da Silva P (1912) Essai sur l’anatomie et la medecine operatoire du tronc cæliaque et de ses branches de l’artere hepatique en particulier. Steinheil, Paris, pp 119–122 Branco R, da Silva P (1912) Essai sur l’anatomie et la medecine operatoire du tronc cæliaque et de ses branches de l’artere hepatique en particulier. Steinheil, Paris, pp 119–122
19.
Zurück zum Zitat Sakuhara Y, Kodama Y, Abo D, Hasegawa Y, Shimizu T, Omatsu T, Kamishika T, Onodera Y, Terae S, Shirato H (2008) Evaluation of the vascular supply to regions of the pancreas on CT during arteriography. Abdom Imaging 33:563–570 CrossRefPubMed Sakuhara Y, Kodama Y, Abo D, Hasegawa Y, Shimizu T, Omatsu T, Kamishika T, Onodera Y, Terae S, Shirato H (2008) Evaluation of the vascular supply to regions of the pancreas on CT during arteriography. Abdom Imaging 33:563–570 CrossRefPubMed
20.
Zurück zum Zitat Sangster G, Ramirez S, Previgliano C, Al Asfari A, Hamidian Jahromi A, Simoncini A (2014) Celiacomesenteric trunk: a rare anatomical variation with potential clinical and surgical implications. J La State Med Soc 166:53–55 PubMed Sangster G, Ramirez S, Previgliano C, Al Asfari A, Hamidian Jahromi A, Simoncini A (2014) Celiacomesenteric trunk: a rare anatomical variation with potential clinical and surgical implications. J La State Med Soc 166:53–55 PubMed
21.
Zurück zum Zitat Toni R, Favero L, Mosca S, Ricci S, Roversi R, Vezzadini P (1988) Quantitative clinical anatomy of the pancreatic arteries studied by selective celiac angiography. Surg Radiol Anat 10:53–60 CrossRefPubMed Toni R, Favero L, Mosca S, Ricci S, Roversi R, Vezzadini P (1988) Quantitative clinical anatomy of the pancreatic arteries studied by selective celiac angiography. Surg Radiol Anat 10:53–60 CrossRefPubMed
22.
Zurück zum Zitat Vantyghem MC, de Koning EJP, Pattou F, Rickels MR (2019) Advances in β-cell replacement therapy for the treatment of type 1 diabetes. The Lancet 394:1274–1285 CrossRef Vantyghem MC, de Koning EJP, Pattou F, Rickels MR (2019) Advances in β-cell replacement therapy for the treatment of type 1 diabetes. The Lancet 394:1274–1285 CrossRef
23.
Zurück zum Zitat Vergoz M (1921) Artere pancreatique principale. Bull Mem Soc Anat Paris 18:97–99 Vergoz M (1921) Artere pancreatique principale. Bull Mem Soc Anat Paris 18:97–99
24.
Zurück zum Zitat Von Haller A (1745) Iconum anatomicarum, vol 2. Vandenhoek, Goettingen, pp 1–50 Von Haller A (1745) Iconum anatomicarum, vol 2. Vandenhoek, Goettingen, pp 1–50
Metadaten
Titel
MDCT evaluation of Dorsal Pancreatic Artery and Intrapancreatic arcade anatomy
verfasst von
Shaurya Sharma
Binit Sureka
Vaibhav Varshney
Subhash Soni
Taruna Yadav
Pawan Kumar Garg
Pushpinder Singh Khera
Publikationsdatum
28.08.2023
Verlag
Springer Paris
Erschienen in
Surgical and Radiologic Anatomy / Ausgabe 11/2023
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-023-03235-3

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