morphoМорфологические ведомостиMorphological newsletter1812-31712686-8741Private Medical University REAVIZ10.20340/mv-mn.2022.30(3).651morpho-651Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯRESEARCH ARTICLESНОВАЯ КОНЦЕПЦИЯ ЗОНАЛЬНОГО И СЕГМЕНТАРНОГО СТРОЕНИЯ ПОЧКИ ЧЕЛОВЕКАA NEW CONCEPT OF ZONAL AND SEGMENTAL STRUCTURE OF THE HUMAN KIDNEYhttps://orcid.org/0000-0001-9735-9981КафаровЭдгар СабировичKafarovEdgar S.

доктор медицинских наук, профессор, заведующий кафедрой нормальной и топографической анатомии с оперативной хирургией

Doctor of Medical Sciences, Professor, Head of the Department of Normal and Topographic Anatomy with Operative Surgery

edgar-kafaroff@yandex.ruhttps://orcid.org/0000-0002-5447-1989ЗенинОлег КонстантиновичZeninOleg K.

профессор, доктор медицинских наук, профессор кафедры анатомии человека

Professor, Doctor of Medical Sciences, Professor of Human Anatomy Department

zen.olegz@gmail.comЧеченский государственный университет имени А.А. Кадырова, ГрозныйРоссияKadyrov Chechen State University, GroznyRussian FederationПензенский государственный университет, ПензаРоссияPenza State University, PenzaRussian Federation2022090820223035665Copyright © Кафаров Э.С., Зенин О.К., 20222022Кафаров Э.С., Зенин О.К.Kafarov E.S., Zenin O.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.morpholetter.com/jour/article/view/651

До настоящего времени отсутствует единая точка зрения о долевом, зональном и сегментарном строении артериального дерева почки. Нет общепризнанного подхода в определении признаков, по которым почку делят на доли и/или сегменты. До сих пор ведется дискуссия относительно деления почечной артерии на дочерние ветви. Цель исследования состояла в установлении вариантов индивидуальной анатомической изменчивости внутриорганного артериального русла почки с учетом зональной и сегментарной топографии. Были изучены 116 коррозионных препаратов артериальной системы почки человека. В 3D-проекциях исследовали количество артериальных сосудов в воротах почки, топографо-анатомические особенности стволов почечных артерий в воротах почки, варианты деления почечных артерий, зоны локального кровоснабжения участков вещества почки в зависимости от вариантов деления почечной артерии на ветви 2-го и 3-го порядков. Исследование проведено с использованием методов цифровой визуализации, обработки цифровых изображений и соответствующего программного обеспечения. В результате установлено, что почечная артерия может делиться на две (двухзональная система кровоснабжения почки) и три (трехзональная система кровоснабжения почки) зональные артерии. В случае двухзональной системы почечная артерия делится на вентральную и дорсальную ветви (54,2% случаев), а также на верхнюю полюсную и нижнюю полюсную зональные ветви (15,5% случаев). В случае трехзональной системы установлены следующие варианты деления почечной артерии. Первый вариант - на верхнюю полюсную, вентральную и дорсальную зональные ветви (в 13,3% случаев); 2-й вариант - на вентральную, дорсальную и нижнюю полюсную зональные ветви (в 9,4% случаев); 3-й вариант - на две вентральные и одну дорсальную зональные ветви (в 5,1% случаев) и 4-й вариант на верхнюю полюсную, центральную и нижнюю полюсную зональные артерии (в 2,5% случаев). Результаты исследования убедительно свидетельствуют о необходимости пересмотра распространенного представления о пятисегментном строении почки у человека.

To date, there is no single point of view on the lobar, zonal and segmental structure of the arterial tree of the kidney. There is no generally accepted approach in determining the signs by which the kidney is divided into lobes and/or segments. There is still a discussion regarding the division of the renal artery to daughter branches. The aim of the study was to establish variants of individual anatomical variability of the intra-organ arterial bed of the kidney, taking into account zonal and segmental topography. 116 corrosive preparations of the arterial system of the human kidney were studied. In 3D projections, the number of arterial vessels in the hilum of the kidney, topographic and anatomical features of the trunks of the renal arteries in the hilum of the kidney, variants of division of the renal arteries, zones of local blood supply to areas of the substance of the kidney, depending on the variants of division of the renal artery into branches of the 2nd and 3rd orders. The study was carried out using digital visualization methods, digital image processing and appropriate software. As a result, it was found that the renal artery can be divided into two (two-zonal system of blood supply to the kidney) and three (three-zone system of blood supply to the kidney) zonal arteries. In the case of a bizonal system, the renal artery divides into ventral and dorsal branches (54,2% of cases), as well as superior polar and inferior polar zonal branches (15,5% of cases). In the case of a three-zone system, the following options for the division of the renal artery have been established. The first option - on the upper polar, ventral and dorsal zonal branches (in 13,3% of cases); 2nd option - on the ventral, dorsal and lower polar zonal branches (in 9,4% of cases); 3rd variant - on two ventral and one dorsal zonal branches (in 5,1% of cases) and 4th variant on the superior pole, central and inferior pole zonal arteries (in 2,5% of cases). The results of the study convincingly indicate the need to revise the widespread idea of ​​the five-segment structure of the human kidney.

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The authors declare that there are no conflicts of interest present.