Surgical and Radiologic Anatomy最新文献

Purpose: This meta-analytical systematic review aims at investigating the variability of the pterion, focusing on its morphological types and precise distances from various bony landmarks. Additionally, the neurosurgical significance of this critical cranial landmark is examined in depth.

Methods: The systematic review was conducted following PRISMA 2020 and Evidence-based Anatomy Workgroup guidelines for anatomical studies. The risk of bias was assessed using the Anatomical Quality Assurance Tool (AQUA). The meta-analysis was performed using R programming software and RStudio, employing the "meta" and "metafor" packages.

Results: A total of 79 studies were included, encompassing 18,694 skull sides. The sphenoparietal type was identified as the most prevalent pterion variant, with a pooled prevalence of 78.54%. The epipteric type followed at 8.41%, while the frontotemporal (5.74%) and stellate (4.26%) types were the rarest. Significant differences in the prevalence of the epipteric, frontotemporal, and stellate types were observed across different nationalities. However, sex, side, and study type did not significantly influence pterion morphological variation. The study also extracted and calculated the distances between the pterion and key anatomical landmarks, including the midpoint of the zygomatic arch, the frontozygomatic suture, the mastoid process, and the external acoustic meatus.

Conclusion: This study offers critical anatomical insights by accurately mapping the pterion's location relative to essential cranial landmarks. These findings are vital for neurosurgical planning, particularly for procedures involving the anterior and middle cranial fossae. The detailed anatomical data provided can enhance the precision and safety of neurosurgical interventions, ultimately improving patient outcomes.

Purpose: The aim was to establish a functional MRI protocol for analyzing human stereoscopic vision in clinical practice. The feasibility was established in a cohort of 9 healthy subjects to determine the functional cortical areas responsible for virtually relief vision.

Methods: Nine healthy right-handed subjects underwent orthoptic examination and functional MRI. The activation paradigms used were based on a block sequence with the projection of static and dynamic 2D and 3D test patterns during three experiments. The test patterns were projected through two separate eyepieces to create stereoscopic vision. SPM software was used for post-processing and data analysis.

Results: Among the three different test patterns used, the second, which corresponded to a static high-relief image of a billiard, appeared to be significant for identifying cortical area activation during stereoscopy. In the group analysis, only areas V3A and V6 showed statistically significant activation. Individual analysis revealed activation of the rostral IPS and V5/MT+.

Conclusion: More data is needed to determine the precise cortical area of activation for stereoscopy. This study proposes a useful and accessible method for functional MRI analysis of stereoscopy.

Purpose: To describe a case of short common trunk of the occipital artery (OA) and ascending pharyngeal artery (APA) arising from the internal carotid artery (ICA).

Methods: A 36-year-old woman with a history of surgical resection of a right lateral ventricular meningioma and atheromatous plaque of the right ICA underwent cranial magnetic resonance (MR) imaging and MR angiography of the head and neck region with a 3-Tesla scanner.

Results: MR angiography of the neck region showed a small atheromatous plaque at the origin of the right ICA and an anomalous artery arising from the posteromedial aspect of the right ICA at the distal end of the carotid bulb. After creating partial volume-rendering (VR) images of the right carotid system, a short common trunk of the OA and APA arising from the ICA were clearly identified.

Conclusion: Using MR angiography, we report a case of a short common trunk of the OA and APA arising from the ICA. OA rarely arises from the ICA, while APA sometimes arises from both the ICA and the OA. APA arising from the OA can be regarded as having a long common trunk of the OA and APA. Only one case of a short common trunk has previously been reported using catheter angiography. This is the second case of this variation reported in the relevant English-language literature. Partial VR MR angiography images are useful for identifying small anomalous arteries located beside a large artery.

Introduction: The anterior division of the internal iliac artery (ADIIA) is a crucial vascular structure that supplies blood to the pelvic organs, perineum, and gluteal region. The present study demonstrates practical data concerning the anatomy of the ADIIA and its branches. It is hoped that the results of the current study may aid in localizing the pelvic arteries effectively.

Methods: The present study is a retrospective analysis that was carried out to determine the anatomical variations, prevalence, and morphometric data of the ADIIA and its branches. Ultimately, 148 ADIIAs from 73 patients met the necessary criteria and were evaluated in 45 categories.

Results: The most prevalent branch of the ADIIA was found to be the internal pudendal artery, as it was present in 134 of the studied cases (90.5%). The most common first branch of the ADIIA was found to be the umbilical artery (48.5%), whereas the most common last branch of the ADIIA was found to be the inferior gluteal artery (68.4%). The median distance between the origin of the ADIIA and the origin of the uterine artery was found to be 12.00 mm (LQ = 7.49; HQ = 18.63). The median diameter of the ADIIA at its origin was found to be 5.76 mm (LQ = 4.80; HQ = 6.45), whereas the median cross-sectional area at the same point was set to be 24.77 mm2 (LQ = 17.65; HQ = 31.95).

Conclusion: It is hoped that the results of the present study will assist in the localization of the branches of the ADIIA in cases of pelvic hemorrhage and during various pelvic surgeries, including laparoscopic hysterectomies.

The unique structure and location of the internal thoracic artery make it an ideal conduit for coronary artery bypass grafting surgery and autologous breast reconstruction. Variants with different characteristics have the potential to impact surgical success. This report presents a female body donor with a novel bilateral variation of the internal thoracic artery. The vessel arose from third segment of the subclavian artery, distal to it coursing deep to the anterior scalene muscle, and then proceeded to course anterior to the first rib, instead of posteriorly. This variation could detract from the desirability of the internal thoracic artery as a graft. Tractioning the artery over the first rib may render it too stenotic for surgical utility. In an individual who has undergone autologous breast reconstruction, this variation may prohibit adequate length preservation for use in subsequent coronary artery bypass grafting. Also, in the setting of thoracic outlet syndrome, this arterial variation may cause unforeseen complications post-grafting.

Purpose: Anatomical variations in the anterior choroidal artery (AChA) and/or the posterior cerebral artery (PCA) are rare. Hyperplastic AChA is an anatomical variant supplying both the AChA area and the PCA area. In accessory PCA, a hyperplastic AChA supplies part of the PCA territory. To our knowledge, there are no previous reports of accessory PCA associated with duplicated AChAs.

Methods: We report a case of accessory PCA as a duplicated AChA associated with contralateral accessory middle cerebral artery, diagnosed by digital subtraction angiography.

Results: A 34-year-old man visited our hospital because of headache and neck pain. Magnetic resonance imaging showed flow voids around the left medial temporal lobe. Magnetic resonance angiography showed vascular structures in the left PCA. Left internal carotid angiography revealed the accessory PCA supplying not only the AChA (plexal segment) territory but also part of the PCA (anterior and posterior temporal arteries) territory. Three-dimensional rotational angiography revealed a tiny branch proximal to accessory PCA. Careful assessment revealed that the tiny branch perfused the left AChA (cisternal segment) territory. Therefore, we made a diagnosis of duplicated AChAs. Right internal carotid angiography also showed the accessory middle cerebral artery originating from the anterior cerebral artery (proximal A1 segment).

Conclusion: Careful imaging assessment is important to identify the rare anatomical variations seen in this case, in which three-dimensional rotational angiography was useful and provided a better understanding of the vascular structure, including tiny vessels.

Purpose: The maxillary tuberosity, a critical anatomical landmark in dentistry and maxillofacial surgery, is burdened by terminological confusion. This inconsistency hampers clinical practice and communication across disciplines.

Method: Different resources were used to argue for the necessity of standardising the terminology related to maxillary tuberosity to enhance diagnostic precision and ultimately improve patient outcomes.

Results: Most clinical and surgical studies dealing with the distal alveolar bone of the maxilla erroneously indicate it as "maxillary tuberosity". By recognising the diverse definitions of this structure, errors and misinterpretation of studies could be reduced, and interdisciplinary collaboration could be improved. The term "alveolar tuberosity" is recommended to refer specifically to the distal end of the alveolar process of the maxilla. Anatomically, the maxillary tuberosity belongs to the body of the maxilla and forms part of the posterior wall of the maxillary sinus; therefore, it should not be located in the alveolar process.

Conclusion: Adhering to the Terminologia Anatomica will clarify the critical clinical and surgical landmarks and enhance communication in clinical and academic settings.

Purpose: The aim of this study is to determine the exact locations of vascular pedicles that supply the fibularis longus and brevis, to identify the morphometric features of those vessels in the lateral compartment of the leg, and to indicate the branching points of the pedicles from the main arteries.

Methods: The popliteal arteries of 40 lower limbs from 20 adult cadavers (12 males, 8 females) were bilaterally injected with colored latex. After dissection, the branches of the arteries were identified and counted. The distances between the apex of the head of the fibula and the branching points of the anterior tibial, fibular, and posterior tibial arteries supplying the fibularis longus and brevis muscles were measured.

Results: In all cases, a single artery coursing in the lateral compartment of the leg was identified; it was a branch of the anterior tibial artery and it supplied the proximal and middle thirds of the fibular muscles anteriorly. The mean distance between the origin of this artery and the apex of the fibular head was 8.65 cm. Its mean length was 10.9 cm and the mean number of its branches was 5.1. In all specimens, the fibular artery supplied the proximal and distal portions of the fibular muscles posteriorly.

Conclusions: This study provides a detailed description of the morphometric properties and branching patterns of the axial pedicle of the anterior tibial artery, which runs longitudinally in the lateral compartment and supplies the fibularis longus and fibularis brevis muscles. We propose naming the pedicle of anterior tibial artery the lateral fibular artery. If this nomenclature is accepted, the fibular artery could be renamed the "posterior fibular artery".

Purpose: Stereoscopic immersive virtual reality (SIVR) is a technology that fully immerses the user in a digital environment and permits the perception of two different three-dimensional images of a digital object with each of the two eyes. We conducted a literature review to explore to what extent SIVR can significantly contribute to anatomy education.

Methods: We searched PubMed, Scopus, ERIC, and the Cochrane Library for papers investigating the outcomes (effectiveness, perceptions about effectiveness, and side effects) of implementing SIVR in anatomy education.

Results: Eight articles were included. Six examined the effectiveness of the educational intervention, while two papers explored only participants' perceptions. Those perceptions were positive, but there was a considerably higher frequency of side effects compared with other methods. SSIVR was not significantly more effective than non-stereoscopic delivery, mainly when the users interacted with the virtual environment.

Conclusion: Using SIVR in anatomy education has led to positive participants' perceptions and notable side effects, while its effectiveness has not been proven higher than non-stereoscopic images, mainly when the users interacted with the digital objects. Future research will further clarify to what extent this technology should be implemented in anatomy education to minimize side effects and maximize its educational potential.