Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2019; 7(23): 3980-3989
Published online Dec 6, 2019. doi: 10.12998/wjcc.v7.i23.3980
Celiomesenteric trunk: New classification based on multidetector computed tomography angiographic findings and probable embryological mechanisms
Wei Tang, Jing Shi, Lian-Qin Kuang, Shuang-Yue Tang, Yi Wang
Wei Tang, Lian-Qin Kuang, Shuang-Yue Tang, Yi Wang, Department of Radiology, Daping Hospital, Army Medical University, Chongqing 400042, China
Wei Tang, Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Jing Shi, Department of Nursing, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan Province, China
Author contributions: Tang W and Shi J contributed equally to this work; Wang Y conceived the study; Tang W and Shi J designed the study, performed the data collection and wrote the manuscript; Tang W, Shi J and Kuang LQ contributed to analysis and interpretation of the data; Tang SY contributed to technical or material support; Wang Y obtained funding and revised the manuscript; all authors have read and approved the final version of this manuscript.
Supported by the National Natural Science Foundation of China, No. 81671943.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Daping Hospital, Army Medical University, China.
Informed consent statement: The patients were not required to provide informed consent for the study because the analysis used anonymous clinical data that were obtained after the completion of treatment.
Conflict-of-interest statement: None of the authors have conflicts of interest that are related to the work submitted for consideration for publication. There are no commercial, personal, intellectual, political or religious interests by any of the authors.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yi Wang, MD, PhD, Assistant Professor, Department of Radiology, Daping Hospital, Army Medical University, No. 10, Changjiangzhilu Daping, Yuzhong District, Chongqing 400042, China. ywhxl@qq.com
Telephone: +86-23-68757622 Fax: +86-23-68757620
Received: August 14, 2019
Peer-review started: August 14, 2019
First decision: September 10, 2019
Revised: October 21, 2019
Accepted: November 14, 2019
Article in press: November 14, 2019
Published online: December 6, 2019
ARTICLE HIGHLIGHTS
Research background

Most of previous studies focused on celiomesenteric trunk (CMT) based on case reports or corpse dissection, and some studies defined CMT as a hepato-gastro-spleno-mesenteric trunk and ignored other possible types. Abdominal multidetector computed tomography (MDCT) angiography is widely performed in daily radiological practice, a large sampling of data regarding CMT can be obtained and analyzed, and a new classification system for CMT may be created based on its MDCT angiographic findings and variation patterns.

Research motivation

With the wide use of abdominal MDCT angiography, CMT variants can be systematically and comprehensively described. By analyzing MDCT findings of CMT variants, a new redefinition and classification system for CMT may be created.

Research objectives

The study aimed to identify the spectrum and prevalence of CMT according to a new classification based on MDCT angiographic findings, and discuss the probable embryological mechanisms of various type of CMT.

Research methods

A total of 5580 patients who underwent abdominal MDCT angiography were retrospectively analyzed by three abdominal radiologists for the prevalence and classification of CMT based on the new definition. CMT was redefined as a single common trunk arising from the aorta and its branches including the SMA and at least two major branches of the celiac trunk.

Research results

According to the new definitions and classification, a total prevalence of 3.06% (171/5580) was found on MDCT for CMT variants. The CMT variants included five types: I (56.14%), II (33.33%), III (2.34%), IV (1.75%) and V (4.68%). The CMT variants also were classified as long type (61.99%) and short type (38.01%) based on the length of the single common trunk. Further CMT classification was based on the origin of the left gastric artery: Type a (53.80%), type b (33.33%), type c (6.43%) and type d (4.68%).

Research conclusions

The study systematically and comprehensively classified various types of CMT variants according to our new classification system based on MDCT findings. Dislocation interruption, incomplete interruption and persistence of the longitudinal anastomosis could all be embryological mechanisms of various types of CMT variants.

Research perspectives

Knowledge about the spectrum of CMT variants is important for planning surgical or interventional procedures in the upper abdomen. Future studies need to further assess the effect of using the proposed classification system on interventional and surgical procedures.