Role of multidetector computed tomography in evaluating superior mesenteric artery characteristics in adults

Abstract

Objectives: The study aimed to perform an anatomical analysis of the superior mesenteric artery (SMA) in Vietnamese adults by using multidetector computed tomography (MDCT).

Methods: A cross-sectional and predominantly descriptive study, utilizing arterial phase contrast-enhanced MDCT images of 218 patients from January 2023 to May 2023 at Oncology Hospital Ho Chi Minh City. The MDCT images were meticulously reviewed to identify the origin, diameter, variations of the SMA, colic pattern of SMA, and the topographic relationship between the ileocolic artery (ICA), right colonic artery (RCA) and the superior mesenteric vein (SMV).

Results: The study findings demonstrated that SMA primarily originated from the aorta (97.2%), predominantly at the level of the L1 vertebral body (70%). Furthermore, apart from the branches commonly observed, the study identified the presence of branching of the right hepatic artery in 15 cases, as well as one case of the splenic artery. The mean diameter of SMA was determined to be 7.07 ± 1.10 mm, with women displaying a smaller diameter compared to men (p<0.05). The ICA was present in all cases, with the ICA running dorsal to the SMV in 60.5% of instances. The RCA was found in only 30.7% of cases and ran ventral to the SMV in the majority of cases (91.2%); furthermore, 21.1% of cases presented an accessory RCA. When the ICA was noted to traverse the ventral aspect of the SMV, the RCA likewise coursed ventral to the SMV in all cases. Type IV, the most common topographical relationship observed between the branches of the SMA and the SMV (41,5%), is characterized by the absence of the RCA and the ICA running ventral to the SMV. The mean RCA and ICA crossing length was 19.02 ± 3.66 mm and 11.35 ± 2.87 mm, respectively. The ICA to RCA distance was 13.33 ± 4.09 mm.

Conclusion: MDCT is a reliable and noninvasive method that can provide anatomical accuracy of the SMA, as well as their intersectional pattern with the SMV, bears considerable importance in the strategic planning of surgical interventions and serves as a valuable tool in mitigating the occurrence of unforeseen vascular injuries during laparoscopic right-sided colon surgery.