The role of 3d-ct angiography in preoperative analysis of vascular anatomy of the splenic angle of the colon
DOI:
https://doi.org/10.11603/2414-4533.2021.4.12724Keywords:
3D-CT angiography, colorectal cancer, splenic flexureAbstract
The aim of the work: to analyze anatomical variants of blood supply to the splenic angle of the colon in patients with left colon cancer, which usually need to be discussed before surgery by a multi-disciplinary team.
Materials and Methods. In this study, we included 103 patients (56 men and 47 women; mean age (64.2±11.6) for colorectal cancer who underwent preoperative 3D-CT angiography at Ternopil University Hospital between 2016 and 2021. In this study, we set the following objectives: to investigate various arterial variations in the blood supply to the splenic angle of the colon using 3D-CT angiography and to assess the possibility of ligation or preservation of certain structures to prevent the development of anastomotic failure.
Results and Discussion. There are 4 types of blood supply to the splenic angle of the colon: type 1 was found in 83 (80.6 %) patients, type 2 – in 9 (8.7%) patients, type 3 – in 10 (9.7 %) patients and type 4 – in 1 (1 %) patient. There are several arcades in the arterial structure of the splenic angle of the colon: the marginal artery of Drummond (found in all 103 (100 %) patients), the arc of Riolan (found in 47 (45.6 %) patients) and the Moskowitz artery (found in only 1 (1) %) of the patient). Contrast-enhanced computed tomography (CT) is the gold standard for diagnosing and staging patients with colon cancer and for assessing vascular anatomy of the colon. The disadvantage of 3D-CT angiography is that the caliber of the branches of VBA and NBA is usually small and they can not always be well visualized. In case of poor visualization of such structures as the marginal artery of Drummond, the arc of Riolan and to a lesser extent Moskowitz artery of the above-mentioned structures on 3D-CT angiography, the analysis should be performed in normal 2D mode.
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