Bilgisayarlı Tomografi Görüntülerinde Çölyak Mezenterik Trunkusun Morfometrik Analizi ve Literatürün Gözden Geçirilmesi

Amaç: Bilgisayarlı tomografi (BT) görüntüleri kullanılarak Tekirdağ ilindeki nadir görülen Çölyak mezenterik trunus (CMT) varyasyon sıklığının ve morfometrik bulgularının değerlendirilmesidir. Gereç ve Yöntem: Herhangi bir indikasyon ile BT anjiyografik incelemesi yapılan 1.919 hastayı (1.313 erkek, 606 kadın; ortalama yaş 60,47±14,88) içeren bir çalışma popülasyonu, retrospektif olarak incelendi. Uzunluk, çap, dikey ve yatay açılar ve oryantasyon (yukarı, aşağı, sağ taraflı, sol taraflı), abdominal aortadan köken aldığı düzey ve CMT tipleri analiz edildi. Bulgular: Toplamda 23 (%1,19) CMT hastası saptandı. Dikey açı değerlendirmesinde 20 (%87) olguda aşağı, üç (%13) olguda yukarı doğru oryantasyon mevcuttu. Yatay açı değerlendirmesinde 11 olguda (%47,8) sağ taraflı, 12 olguda (%52,2) sol taraflı oryantasyon vardı. Tip 1 CMT olgularının %60’ı sağ taraflı oryantasyonlu iken, tip 2 olguların %75’inin sol taraflı oryantasyonu vardı ve her iki tipte de çoğunluğun, aşağıya doğru oryantasyonu vardı. On beş (%65,22) olgu tip 1 ve 8 (%34,78) olgu tip 2 olarak saptandı. CMT’nin uzunluğu ve çapı arasında negatif zayıf bir korelasyon vardı (p=0,048, r=-0,417). CMT’nin aortadan en yaygın orijin seviyesi L1-L2 düzeyi idi (%30,4). Tip 1’de en yaygın seviye L1-L2 (%40, n=6) iken, tip 2’de (%37,5) aynı dağılım ile L1 ve L1-alt end-plate düzeyi idi. Sonuç: CMT’de özellikle cerrahi planlama ve arteriyel girişimsel prosedürler açısından morfometrik değerlendirme son derece önemlidir. Bu çalışmada, CMT’lerin çoğunlukla tip 1, aşağı (17 derece±14,28) ve sol taraflı (73 derece±6,88) oryantasyon olduğu bulunmuştur.

Morphometric Analysis of Celiac Mesenteric Trunk in Computed Tomography Images and a Review of the Literature

Aim: Evaluation of the frequency of variation and morphometric findings of the rare Celiac mesenteric trunk (CMT) in Tekirdağ province using computed tomography (CT) images. Materials and Methods: A study population containing 1,919 patients (1,313 males, 606 females; mean age 60.47±14.88 years) with any indication of CT angiographic examination was reviewed retrospectively. The length, diameter, vertical and horizontal angles and orientations (upward, downward, right-sided, left-sided), the level of origin from abdominal aorta and their types were analyzed. Results: Twenty-three (1.19%) CMT patients were detected. In vertical angle evaluation 20 (87%) cases had downward and three (13%) had upward orientations. In horizontal angle assessment 11 (47.8%) cases had right-sided and 12 (52.2%) had left-sided orientations. 60% of type 1 CMT cases had right-sided orientation, while 75% of type 2 cases had left-sided orientation and in both of types, the majority part had downward orientation. Fifteen (65.22%) cases were type 1 and 8 (34.78%) cases were type 2. There was a negative weak correlation between the length and diameter of CMT (p=0.048, r=-0.417). The most common level of origin of CMT was in L1-L2 level (30.4%). The most common level in type 1 was L1-L2 (40%, n=6), while L1 and L1-inferior-end-plate with the same distribution were in type 2 (37.5%). Conclusion: In CMT, especially in terms of prior to surgical planning and arterial interventional procedures morphometric assessment is highly important. In this study, CMTs were found to be mostly type 1, as well as downward (17 degrees±14.28) and left-sided (73 degrees±6.88) orientation.

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