Evaluation of inferior mesenteric vein drainage patterns in the Turkish population: A multidetector computed tomography study

Hakan Yilmaz
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Abstract

Background/Aim: The inferior mesenteric vein (IMV) plays a crucial role in the venous system as it joins the superior mesenteric vein (SMV) and splenic vein to form the portal vein. The widespread adoption of multidetector computed tomography (MDCT) has greatly enhanced our ability to assess abdominal vascular structures. This study aimed to investigate the IMV drainage patterns in a Turkish population using MDCT. Methods: This descriptive, single-center, retrospective study included patients who had undergone abdominal computed tomography (CT) in the portal phase at our hospital for various clinical indications. Excluded from the study were patients who did not undergo imaging in the portal venous phase, those with incomplete evaluation of all IMV segments, and individuals who had undergone pancreaticoduodenal or intestinal surgery for any reason. We retrospectively analyzed a total of 877 contrast-enhanced MDCT examinations performed at our hospital between March 2022 and March 2023. Patients were classified based on their IMV drainage patterns into the following categories: type 1 (drainage into the splenic vein), type 2 (drainage into the SMV), type 3 (drainage at the junction level), type 4 (drainage into the branches of the SMV), and type 5 (patients in whom IMV assessment was not possible). Results: The mean age of the patients was 48.7 years (range: 24–92 years), with 449 (51.2%) being male and 428 (48.8%) female. The distribution of patients according to IMV drainage patterns was as follows: type 1, n=379 (43.2%); type 2, n=398 (45.4%); type 3, n=71 (8.1%); type 4, n=15 (1.7%); and type 5, n=14 (1.6%). Conclusion: Our study findings indicate that in the Turkish population, the IMV predominantly drains into the SMV before joining the splenic vein. This disparity from certain studies in the literature underscores the variability in IMV drainage patterns, emphasizing the importance of individualized patient evaluation in this regard.
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评价土耳其人群的肠系膜下静脉引流模式:一项多探测器计算机断层扫描研究
背景/目的:肠系膜下静脉(IMV)连接肠系膜上静脉(SMV)和脾静脉形成门静脉,在静脉系统中起着至关重要的作用。多探测器计算机断层扫描(MDCT)的广泛采用大大提高了我们评估腹部血管结构的能力。本研究旨在调查土耳其人群中使用MDCT的IMV引流模式。方法:这项描述性、单中心、回顾性研究纳入了因各种临床适应症在我院行门静脉期腹部计算机断层扫描(CT)的患者。没有在门静脉期进行影像学检查的患者、所有IMV节段评估不完整的患者以及因任何原因接受过胰十二指肠或肠道手术的患者均被排除在研究之外。我们回顾性分析了2022年3月至2023年3月期间在我院进行的877例对比增强MDCT检查。根据患者的IMV引流方式将患者分为以下几类:1型(引流至脾静脉)、2型(引流至SMV)、3型(连接水平引流)、4型(引流至SMV分支)和5型(无法进行IMV评估的患者)。结果:患者平均年龄48.7岁(范围24 ~ 92岁),其中男性449例(51.2%),女性428例(48.8%)。根据IMV引流方式,患者分布如下:1型,n=379 (43.2%);2型,n=398 (45.4%);3型,n=71 (8.1%);4型,n=15 (1.7%);5型,n=14(1.6%)。结论:我们的研究结果表明,在土耳其人群中,IMV主要流入SMV,然后加入脾静脉。这种与文献中某些研究的差异强调了内静脉引流模式的可变性,强调了在这方面个体化患者评估的重要性。
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