ANATOMICAL VARIANTS OF INFERIOR MESENTERIC VEIN ACCORDING ON THE DATA OF MULTISPIRAL COMPUTED TOMOGRAPHY

Knowledge of the variants of the anatomical variability of the liver vascular bed can be of critical importance in liver resection, liver transplantation, laparoscopic operations, resection of the pancreas, surgical treatment of portal hypertension The main vessels of the hepatic portal vein system are characterized by pronounced anatomical variability in the formation of the portal vein trunk, the greatest variability is characterized by inferior mesenteric vein. The aim of the investigation was to study the variant anatomy of the inferior mesenteric vein according to multispiral computed tomography. The material was 100 multispiral computed tomograms of the abdominal organs from the archive of the clinics of the Samara State Medical University for 2018-2019. For mathematical modeling and the creation of three-dimensional models based on tomograms of the vascular bed, plugins were used in the programs «Luch» and «Autoplan». Variants of the portal vein formation, the angle of inflow of the inferior mesenteric vein into the superior mesenteric and splenic veins, the distance from the point of confluence of the inferior mesenteric vein to the point of confluence with the portal vein were studied. The study revealed that the inferior mesenteric vein in 40% of cases flows into the splenic vein, in 39% - into the angle of confluence of the superior mesenteric and splenic veins, in 16% - into the superior mesenteric vein. In 5% of cases, the absence of the inferior mesenteric vein was revealed. The angle of fusion of the inferior mesenteric vein with the superior mesenteric vein was statistically significantly greater than the angle of fusion of the inferior mesenteric vein with the splenic vein. The angles were 76.36 ± 1.53 ° and 64.89 ± 3.52 °, respectively (p = 0.004). The length of the common trunk of the inferior mesenteric and splenic veins was significantly greater than the common trunk of the mesenteric veins and amounted to 16.98 ± 1.09 mm and 9.37 ± 0.65 mm (p = 0.001), respectively. Thus, the study showed a high degree of anatomical variability of the inferior mesenteric vein.

1. Kolsanov A.V., Manukyan A.A., Zel'ter P.M., Chaplygin S.S., Zvonareva Z.N. Variant anatomy of the portal vein according to computed tomography. Journal of Anatomy and Histopathology. 2017;6(4):31-36. (In Russ.) https://doi.org/10.18499/2225-7357-2017-6-4-31-36

2. Munguti J., Sammy M., Cheruiyot I., Kariuki B., Olabu B. Pattern and position of portal vein formation in a kenyan population // MOJ Anat. & Physiol. – 2017. – Vol. 3, N 3. https://doi.org/10.15406/mojap.2017.03.00093

3. Gaivoronskii I.V., Kotiv B.N., Nichiporuk G.I., Kotiv A.B.. Morfologicheskaya kharakteristika kornei vorotnoi veny v aspekte eksperimental'nogo modelirovaniya rekonstruktivnykh operatsii na sosudakh. Morfologiya. 2018;153(3):68-69.

4. Efanov MG, Vinevskij AV, Karmazanovskij GG. i dr. Spiral'naja komp'juternaja tomografija: vozmozhnosti razlichnyh pokolenij tomografov v opredelenii normal'noj sosudistoj anatomii pecheni. Chast' 1. Anatomija afferentnyh sosudov pecheni. Annaly hirurgicheskoj gepatologii. 2009; 2:44–51.

5. Rzaev, R.T., Kamalov Ju.R., Tatarkina M.A. i dr. Sovremennye neinvazivnye metody vizualizacii v opredelenii anatomicheskih variantov delenija vorotnoj i stroenija pechenochnyh ven pri rodstvennoj ortotopicheskoj transplantacii pecheni. Hirurgija. 2012;10:70-76.

6. Covey AM, Brody LA, Getrajdman GI, Sofocleous CT, Brown KT. Incidence, patterns, and clinical relevance of variant portal vein anatomy. AJR. 2004; 183:1055–1064 doi:10.2214/ajr.183.4.1831055

7. Soyer P, Bluemke DA, Choti MA, Fishman EK. Variations in the intrahepatic portions of the hepatic and portal veins: findings on helical CT scans during arterial portography. AJR. 1995;164:103–108 doi:10.2214/ajr.164.1.7998521

8. Prives M.G., Lysenkov N.K., Bushkovich V.I. Anatomiya cheloveka: uchebnik dlya studentov meditsinskikh vuzov. Izdanie 11-e, pererabotannoe i dopolnennoe. Spb.: Gippokrat; 1998: 704

9. Kovanov V.V., Anikina T.I. Operativnaya khirurgiya i topograficheskaya anatomiya. M.: Meditsina; 1985: 367

10. Benninger B. Splenomesenteric vein: formally recognising a clinically relevant section of the portal venous drainage system. Folia Morphologica. 2013; 72(1): 63- 66

11. Krumm P., Schraml C., Bretschneider C., et al. Depiction of variants of the portal confluence venous system using multidetector row CT: analysis of 916 cases. RöFo. 2011;183: 1123–1129.

12. Raut R, Bahetee B. Study of variations in the formation of portal vein. Sch J App Med Sci. 2015;3(3):1370‒1375.

13. Purcell H.K., Connor J.J., Alexander W.F., Scully N.M. Observations on the major radicles of the extrahepatic portal systems. AMA Arch. Surg. 1951; 62(5): 670-677.

14. Chaijaroonkhanarak W et al. (2010). Length, Diameter and Variations in Types of Portal Vein Formations in Northeastern Thais. Srinagarind Medical Journal;25(4): 323-327.

15. Papadopoulos N.J. Stereotactic patterns of the extrahepatic portal venous system. Anat. Clin. 1981; 3: 143-148.

16. Khoron'ko Yu.V., Dmitriev A.V., Shitikov I.V. i dr. Vorotnaya vena kak ob"ekt operatsii trans"yugulyarnogo vnutripechenochnogo portosistemnogo shuntirovaniya (TIPS/TIPS) pri portal'noy gipertenzii, vyzvannoy tsirrozom. Fundamental'nye issledovaniya. 2013; 11-1: 95–99