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Duplication of the inferior vena cava (IVC) is a congenital condition where there are 2 large vessels: right IVC (RIVC) and left IVC (LIVC) on both sides of the abdominal aorta. Here, we present 2 cases of duplicated inferior cava coexisting with rare morphology of left gonadal (ovarian/testicular) vein. Both were observed during multidetector 64-row computer tomography. In first case atherosclerotic, tortuous abdominal aorta models both inferior venae cavae. The shape of veins were more- (RIVC) and less-arcuate (LIVC). Two years ago, the patient had been diagnosed with pulmonary thromboembolism. In second case abdominal aortic aneurysm models both large veins. The RIVC has a highly right-arcuate shape, while the LIVC has a less left-arcade shape. Our observation would seem to be especially important, because the tortuous abdominal aorta changes the shape of both IVC, and may predispose them for thrombosis formation. The presented report precisely describes the topography and measurements of the vessels in the retroperitoneal area. The literature concerning this anomaly, potential clinical implications and vascular complications are reviewed and the possible practical aspects are discussed. A familiarity with the anatomy of the most common types of venous anomalies is crucial for all surgeons, urologists and oncologists to reduce the risk of severe haemorrhage during all abdominal procedures. (Folia Morphol 2014; 73, 4: 521–526)
Background: Cases of renal artery entrapment (RAE) by extrinsic compression have been infrequently reported in the literature. We aimed to describe RAE and elucidate anatomical factors that may be related to renal artery stenosis. Materials and methods: Two hundred and four patients’ computed tomography scans made for various reasons in Radiology Department from 2011 to 2015 were retrospectively analysed and 7 cases of RAE were found. Authors studied the level of origin of renal arteries vs. coeliac trunk (CT), superior mesenteric artery (SMA) and vertebrae. Diameter of renal arteries, distance between main left renal artery (LRA) and right renal artery (RRA) as well as renal arterial patterns were also investigated. Results: The origin of main renal arteries off the aorta was between the upper margin of L1 and lower margin of L2 vertebra, with the predominant lower 1/3 of L1 vertebra and L1 intervertebral disc. However, in patients with highest range of stenosis of renal artery the origin was most commonly located at the level of Th12 intervertebral disc and upper part of L1. Statistically significant relationships were proven between range of stenosis and level of origin of stenotic renal artery vs. vertebrae (Pearson’s correlation coefficient: –0.393, p < 0.01), distance between main LRA and RRA (Pearson’s correlation coefficient: 0.398, p < 0.0001), renal artery–CT distance (Pearson’s correlation coefficient: –0.263, p < 0.0001), renal artery–SMA distance (Pearson’s correlation coefficient: –0.149, p < 0.033). Conclusions: Analysis of RAE allowed finding anatomical factors of renal artery stenosis and classifying them regarding to their importance. Relationship of renal artery origin vs. vertebrae and distance between main LRA and RRA were proven the most important. However, distances between higher originated renal artery and CT, higher originated renal artery and SMA should also be taken into consideration. (Folia Morphol 2016; 75, 4: 486–492)
Background: Coronary computed tomography angiography (CCTA) is helpful in making a precise noninvasive evaluation of coronary anatomy, allowing concomitant evaluation of other cardiac structures. The aim of this study was to determine the prevalence of coronary artery variations detected by 64-slice mutidetector CT. Materials and methods: The results of ECG-gated CCTA in 726 consecutive patients (mean age 58 years) were analysed retrospectively. The main indications for CCTA were atypical chest pain, angina pectoris, screening for coronary artery disease and determination of the patency of bypass grafts or stents. Acquisition was performed with a 64-detector CT scanner with retrospective ECG gating. Imaging results were assessed by experienced cardiovascular radiologist. Results: The overall incidence of coronary artery anomalies was 1.1% (8 out of 726 participants). The most common anomaly was an anomalous origin of the circumflex artery from the right coronary sinus with a retroaortic course (4 patients, 0.6%), followed by origin of right coronary artery from the left coronary sinus (2 patients, 0.3%). One patient with abnormal origin of the left main artery from the right coronary sinus (0.1%) and 1 patient with a circumflex artery origin from the proximal segment of the right coronary artery (0.1%) were observed, both with retroartic course. Conclusions: CCTA is a noninvasive imaging technique useful for the precise evaluation of variations of the coronary arteries. This study shows similar results to other reports on this subject. (Folia Morphol 2014; 73, 1: 51–57)
Background: The suprascapular notch is a clinically important site because it is the main site of injury and compression of the suprascapular nerve. Its shape and size are the most important factors in the aetiopathology of suprascapular nerve neuropathy. This article reports the first computed topography (CT) study on the correlation between the diameters of the suprascapular notch and anthropometric measurements of the human scapula. Materials and methods: A total of 130 scans of shoulders by a helical 32-row multidetector CT scanner were retrospectively analysed. The following scapular measurements were performed: morphological length, morphological width, projection length of the scapular spine, maximal width of the scapular spine, length of the acromion, maximal length of the coracoid process, length of the superior border of the scapula, morphological height of the supraspinous fossa, length of the lateral border of the scapula, and morphological height of infraspinous fossa. The following suprascapular notch dimensions were measured: maximal depth, superior transverse diameter, middle transverse diameter. Results: The maximum depth of the suprascapular notch correlates with the morphological length of the scapula, the length of the lateral border of the scapula and the morphological width of the scapula. The superior transverse diameter of the suprascapular notch correlates with the length of the superior border of the scapula and negatively with the length of the lateral border of the scapula. In addition it has been shown that the length of the superior border of the scapula correlates more closely with the superior transverse diameter of the suprascapular notch than the middle transverse diameter of the suprascapular notch. Conclusions: It could be supposed that humans with longer scapulae have deeper notches. It may be also concluded that scapulae with a wider superior border have a shallower suprascapular notch. (Folia Morphol 2016; 75, 1: 87–92)
Background: Confirming the branching pattern of the deep femoral artery (DFA) is vital in planning radiological and surgical procedures involving the medial circumflex femoral artery (MFCA) and the lateral circumflex artery (LFCA). The aim of this study was to characterise the course and morphology of branches of the DFA. Materials and methods: The anatomical dissection included 80 lower limbs which were fixed in 10% formalin solution. A dissection of the femoral region was carried out according to a pre-established protocol, using traditional techniques. Morphometric measurements were obtained twice by two researchers. Results: Six types of medial and lateral femoral circumflex artery variations were distinguished. In type I, the DFA divides into the MFCA and the LFCA (observed in 45% of cases). In type II, the MFCA is absent and the LFCA origin normally from the DFA (18.75%). In type III, the MFCA arises from the femoral artery above the origin of the DFA, while the LFCA starts from the DFA (15%). Finally, in type IV, the LFCA arises from the femoral artery above the origin of the DFA, while the MFCA starts from the DFA (10%). In type V, the LFCA origin alone from the femoral artery below the origin of the DFA, while the MFCA origin from the DFA (7.5%), while in type VI (3.75%), both the MFCA and the LFCA origin from the femoral artery. The mean diameter of the femoral artery at the level of the DFA origin was greatest in type 2 (10.62 ± 2.07 mm) and the least in type 6 (7.90 ± 1.72 mm; p = 0.0317). The distance from inguinal ligament to where the DFA arose was the greatest in type 6 (78.24 ± 29.74 mm) and least in type 5 (28.85 ± 11.72 mm; p = 0.0529). Conclusions: The medial and lateral femoral circumflex arteries were characterised by high morphological variations. The diameter of the femoral artery at the level of inguinal ligament correlated with the diameter of the DFA and distance to where the DFA arises from femoral artery. (Folia Morphol 2019; 78, 4: 738–745)
Congenital anomalies of systemic veins are usually asymptomatic and found incidentally during ultrasonography, computed tomography (CT) or magnetic resonance examinations performed for other clinical indications. Persistent left superior vena cava (PLSVC) with absent right superior vena cava (RSVC) is the congenital aberration in the thoracic venous system which occurs in only 0.09% to 0.13% of patients who have congenital heart defects. In this paper, we present the extremely rare case of a 72-year-old male with PLSVC associated with an absence of RSVC, referred for coronary CT angiography. Multidetector CT angiography is a powerful tool for the detection of venous anomalies, which is essential before invasive procedures such as the implantation of pacemakers. (Folia Morphol 2013; 71, 3: 271–273)
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