Folia morphologica最新文献

Background: This study aimed to determine normative pancreatic volume (PV) values in healthy Western Asian adults using computed tomography and 3D Slicer software, and to evaluate the relationship between PV and demographic parameters including age, sex, and body mass index (BMI).

Materials and methods: A retrospective analysis was conducted on 905 adults (403 females, 502 males; mean age: 43.88 ± 17.11 years) who underwent abdominal CT between January and December 2023. Individuals with diabetes mellitus, pancreatic or peripancreatic pathology, prior malignancy, or inadequate imaging were excluded. Pancreas segmentation was manually performed on axial slices using 3D Slicer v.4.11.2, excluding ducts and vascular structures. Statistical analyses included t-tests, Pearson's correlation, and multivariate linear regression.

Results: The mean PV was 84.33 ± 5.74 cm³. Males had significantly higher PV than females (85.68 ± 6.05 cm³ vs 82.65 ± 4.83 cm³, p < 0.001). PV peaked in the fourth decade in males and the fifth decade in females, followed by a decline. A significant negative correlation between age and PV was observed in males (r = -0.321, p < 0.001), but not in females. PV positively correlated with BMI in both sexes. Age, BMI, and male sex were identified as independent predictors of PV (R² = 0.326, p < 0.001).

Conclusions: Pancreatic volume varies with age, sex, and BMI in healthy Western Asian adults. These normative values may assist in future clinical and radiological evaluations of pancreatic morphology.

Background: The quadriceps femoris is the main extensor of the knee joint, traditionally described as having four heads. Since the 19th century, reports have suggested an additional head between the vastus lateralis and vastus intermedius. In 2016, Grob et al. described this structure in detail, naming it the tensor vastus intermedius (TVI) and proposing a morphological classification. This study aimed to assess the prevalence, morphology, and dimensions of the TVI in cadaveric specimens and compare the results with the literature.

Materials and methods: Ten lower limbs from five preserved cadavers (four male, one female) were dissected using a standardized protocol. The presence, Grob type, and dimensions of the TVI were recorded with an electronic caliper. A literature review included only cadaveric studies consistent with Grob's classification and containing quantitative data.

Results: The TVI was present in all specimens (100%). The most common type was VL (50%), followed by VI (30%) and bicipital (20%). VI and bicipital types occurred only in males; females showed only the VL type. Identical bilateral types were found in 20% of cases (females). The mean belly length was 105.99 mm, and width was 19.15 mm. Literature reports prevalence ranging from 34% to 100% with variable type distribution.

Conclusions: The TVI was a consistent anatomical feature in this sample, with type VL predominating and notable sex-related differences. Findings confirm considerable morphological variability, highlighting potential relevance in imaging interpretation, surgical planning, and rehabilitation. Further imaging-based studies on larger populations are needed to clarify its biomechanical and clinical roles.

Background: The kidney is covered with a renal fascia consisting of a fibrous capsule and a fatty capsule and is located extraperitoneally. The properties of this organ allow for mechanical protection, protecting against injury.

Materials and methods: We describe an anatomical variation observed during the dissection of the body of an 85-year-old man.

Results: The right kidney was located intraperitoneally, freely among the loops of the small intestine, and had normal vascularization. In addition, it measured 12.5 cm in length and 5.7 cm in width. The left kidney was significantly smaller, with no abnormalities.

Conclusions: According to the databases, this is the third case of intraperitoneal kidney described in the world. Such a localization variant should be considered because of the complications it brings to diagnostic imaging and surgical management.

Background: The recurrent branch of the median nerve (RBMN) is a critical structure in carpal tunnel surgeries, where inadvertent injury can lead to significant functional impairment. While soft tissue landmarks are commonly used for RBMN localization, they often vary between individuals and are susceptible to intraoperative shifts. This study aims to establish fixed bony landmarks for the reliable localization of the RBMN, potentially reducing the risk of iatrogenic nerve injury.

Materials and methods: This clinical-surgical study included 58 patients (59 hands) undergoing open carpal tunnel release between January 2020 and September 2022. Intraoperative measurements were taken from the origin of the RBMN to three fixed bony landmarks: the apex of the first metacarpal head, the apex of the third metacarpal head, and the tip of the radial styloid process. Distances were recorded using a sterile, millimeter-calibrated ruler by two independent observers. Statistical analysis included inter- and intra-observer reliability assessments.

Results: The mean distance from the RBMN origin to the first metacarpal head was 39.7 ± 5.2 mm, to the third metacarpal head 50.2 ± 4.7 mm, and to the radial styloid process 59.4 ± 4.9 mm. There were no statistically significant differences in these measurements between male and female patients (p > 0.05). The majority of RBMN branches (67%) were extraligamentous, followed by subligamentous (25%) and transligamentous (8%), as classified by the Lanz classification. Postoperative clinical evaluations using the Boston Carpal Tunnel Questionnaire (BCTQ) showed significant improvements in both symptom severity and functional status (p < 0.001).

Conclusions: Fixed bony landmarks provide a reliable and reproducible method for localizing the RBMN during carpal tunnel release, potentially reducing the risk of nerve injury. These findings support the use of bony reference points as consistent intraoperative guides for safer surgical outcomes.

Background: The arterial supply of the liver originates from the celiac trunk, which gives rise to the common hepatic artery. This artery subsequently bifurcates into the gastroduodenal artery and the proper hepatic artery, of which the latter further divides into the right and left hepatic arteries. This anatomical variability is described in order to highlight the high incidence of arterial hepatic vascular variations, to underline their clinical significance, and to classify the missing of proper hepatic artery within the framework of established hepatic arterial variation typologies.

Case report: The observed variation was identified during routine anatomical dissection of a 77-year-old female cadaver, who had voluntarily donated her body for scientific purposes as part of the Body Donation Program conducted by the Department of Anatomy of Wroclaw Medical University. Our case report presents an anatomical variant in which the proper hepatic artery is absent. Instead, the common hepatic artery gives rise to a common trunk that trifurcates into the right and left hepatic arteries, along with the gastroduodenal artery. Another part of this variation was that the right gastric artery originated from the left hepatic artery instead of the proper hepatic artery.

Conclusions: A thorough understanding of hepatic arterial anatomy is essential for a variety of surgical interventions, including liver transplantation, hepatic resection, cholecystectomy, and embolization of the right gastric artery. In cases of hepatocellular carcinoma, hepatic arteries may also serve as a route for intra-arterial chemotherapy. Therefore, precise knowledge of hepatic vascularization is of critical importance in the diagnosis and treatment of liver pathologies.

Background: A thorough understanding of paranasal sinus anatomy and its variations is essential for accurate diagnosis, effective treatment of sinus-related conditions, and safe surgical intervention. Preoperative assessment of sinus morphology plays a vital role in minimizing intraoperative risks and postoperative complications.

Materials and methods: During routine dissection of a 78-year-old female cadaver at the Department of Biomedical Sciences, Mercer University School of Medicine (Columbus, GA), an unique case of bilateral septa in both the sphenoid and maxillary sinuses was observed.

Results: Four accessory septa (AS) were identified in the sphenoid sinuses. On the left, one septum extended from the lateral wall to the internal carotid artery (ICA) prominence. The second one arose from the anterolateral wall. On the right, one septum was located on the inferior wall, and another on the posterosuperior wall, also attached to the ICA prominence. In the maxillary sinuses, vertical septa were present on both sides. On the left, a septum extended from the anterior wall to the infraorbital canal (IOC). On the right, a septum connected the anterior wall to the sinus roof.

Conclusions: With the increasing use of functional endoscopic sinus surgery and transsphenoidal approaches, it is important to recognize anatomical variations like AS. Septa that involve the ICA prominence or IOC present significant surgical risks. Preoperative imaging and careful surgical planning are essential to reduce complications and improve outcomes.

Background: The coccyx exhibits significant anatomical variation in its morphology, vertebral number, and joint fusion patterns. These variations can influence the development of coccygodynia, a common yet often underdiagnosed cause of chronic lower back pain. Understanding coccygeal anatomy is essential for accurate diagnosis and effective clinical management.

Materials and methods: A retrospective analysis was performed on 107 lumbosacral CT scans (63 males and 44 females; age range: 18-84 years). The study evaluated the number of coccygeal segments, coccyx type (as per established classification), presence of sacrococcygeal and intercoccygeal fusion, and the occurrence of coccygeal spicules.

Results: Type I coccyx was the most frequently observed (n = 43), followed by type II (n = 37), type III (n = 21), and type IV (n = 6). The majority of subjects had four coccygeal vertebrae (n = 53), followed by five (n = 39), three (n = 12), and two (n = 3). Sacrococcygeal fusion (partial or complete) was present in 47 subjects (43.66%), while 60 subjects (56.33%) showed no evidence of fusion. Intercoccygeal fusion affecting one or more segments was noted in 95 individuals, with only 12 showing no such fusion. Coccygeal spicules were identified in 10 subjects.

Conclusions: These findings underline the substantial morphological diversity of the coccyx and reaffirm the importance of high-resolution imaging in assessing coccygeal anomalies and planning interventions for conditions such as coccydynia.

Background: This review aims to provide a current, comprehensive, and evidence-based overview of the anatomy of the lesser occipital nerve.

Materials and methods: Major online databases (PubMed, Scopus, Embase, ScienceDirect, Web of Science) were searched to identify all studies reporting data on the anatomy of cutaneous branches of the cervical plexus. This review includes original studies containing morphometric and branching pattern data concerning LON. The risk of bias was assessed using the Anatomical Quality Assurance (AQUA) Tool. The authors strictly adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines in this study. This review was registered in the PROSPERO database, ID CRD420251005988.

Results: A total of 13 articles (526 nerves) met all inclusion criteria. LON emerges at the posterior border of the sternocleidomastoid muscle (SCM). It courses superiorly on the occipital area. It can be located using the distance from the y-axis (a line going through the spinal processes of the cervical vertebrae or external occipital protuberance) and the x-axis (a line perpendicular to the y-axis). Several compression sites for LON have been identified and highlighted in the study.

Discussion and conclusions: This is the most comprehensive review of the anatomy of the lesser occipital nerve to date. Because the included studies were of variable quality and had inconsistent methodology, further research is necessary. This study identified standardised landmarks for describing LON anatomy: EOP, MP, SCM border, external auditory canal and the superior nuchal line. Significant progress has been made in identifying the most optimal surgical approaches to regions concerning LON anatomy.

Background: This study aimed to describe the anatomical features and variations of the abdominal aorta and its major visceral branches - the celiac trunk, superior mesenteric artery (SMA), and inferior mesenteric artery (IMA) - using 128-slice computed to-mography (CT) imaging.

Materials and methods: A descriptive, retrospective study was conducted on 193 adult Vietnamese patients who underwent contrast-enhanced 128-slice abdominal CT scans at Tam Anh General Hospital between December 2023 and December 2024. Origins, diameters, branching angles, and anatomical variants were recorded and an-alyzed using MIP and 3D VR reconstructions. Variations were classified using Uflack-er's (celiac trunk) and Kornafel's (SMA) systems.

Results: The most common origin levels were T12-L1 for the celiac trunk (33.7%), L1 for the SMA (36.3%), and L3 for the IMA (30.6%). Classical branching patterns were present in 68.0% for the celiac trunk, 96.3% for the SMA, and 97.4% for the IMA. Several uncommon variants, such as hepatosplenic trunks and IMA origin from the SMA, were identified.

Conclusions: 128-slice CT provides high-resolution imaging to reliably assess vascular anatomy. Significant anatomical variation exists in the abdominal aorta and its branches, under-lining the importance of individualized preoperative evaluation.

Background: The ovarian veins (OVs) are paired vessels that drain deoxygenated blood from the ovaries, fallopian tubes, and adjacent pelvic structures. The objective of this study is to systematically synthesize cadaveric and imaging-based data to describe the anatomy, variations, and clinical relevance of the OVs.

Materials and methods: To conduct this meta-analysis, a systematic literature search was carried out to identify all studies concerning the anatomy of the ovarian vein. Searches were performed in major medical databases, including PubMed, Scopus, Embase, Web of Science, Google Scholar, and the Cochrane Library.

Results: A total of 35 studies were included in this meta-analysis. The overall mean diameter of the OV was estimated at 4.88 mm (SE = 0.24). The diameter of the right OV reached 4.44 mm (SE = 0.28), while the left OV measured 4.99 mm (SE = 0.34). The pooled prevalence of valves in the ovarian veins was calculated at 91.93% (95% CI: 83.32-97.79%). Competent valves were found in 72.16% of cases (95% CI: 58.72-83.89%), while incompetent valves were present in 27.84% (95% CI: 16.11-41.28%). On the right side, a double OV was present in 1.00% of specimens (95% CI: 0.00-3.08%). On the left, this variation occurred slightly more frequently, with a pooled prevalence of 2.08% (95% CI: 0.43-4.72%).

Conclusions: This meta-analysis highlights critical anatomical and clinical features of the ovarian veins. The left OV is wider and more frequently incompetent than the right, supporting the left-sided predominance of pelvic congestion syndrome. Drainage patterns confirm classical anatomy - right OV to inferior vena cava, left OV to left renal vein - but rare variants must be considered during interventions. OV duplication, though rare, poses a risk of incomplete embolization if unrecognized. These findings underscore the need for side-specific imaging and thorough anatomical evaluation to improve diagnosis, embolization outcomes, and surgical planning in pelvic venous disorders.