Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Basic Arterial Anatomy and Interpretation of CT Angiography for Intra-Abdominal or Gastrointestinal Bleeding: Correlation with Conventional Angiographic Findings for Beginners

복강 내 혹은 소화기계 출혈을 이해하기 위한 기본적인 혈관해부학과 혈관조영술의 해석: 입문자를 위하여

  • Dong Yoon Han (Department of Radiology, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University) ;
  • Ji Hye Hwang (Department of Radiology, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University) ;
  • Hye Jin Kang (Department of Radiology, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University) ;
  • Jehong Yoon (Department of Radiology, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University) ;
  • Se Hwan Kwon (Department of Radiology, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University) ;
  • Tae-Seok Seo (Department of Radiology, Korea University Guro Hospital, College of Medicine, Korea University) ;
  • Joo Hyeong Oh (Department of Radiology, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University)
  • 한동윤 (경희대학교 의과대학 의학전문대학원 경희대학교병원 영상의학과) ;
  • 황지혜 (경희대학교 의과대학 의학전문대학원 경희대학교병원 영상의학과) ;
  • 강혜진 (경희대학교 의과대학 의학전문대학원 경희대학교병원 영상의학과) ;
  • 윤제홍 (경희대학교 의과대학 의학전문대학원 경희대학교병원 영상의학과) ;
  • 권세환 (경희대학교 의과대학 의학전문대학원 경희대학교병원 영상의학과) ;
  • 서태석 (고려대학교 의과대학 의학전문대학원 구로병원 영상의학과) ;
  • 오주형 (경희대학교 의과대학 의학전문대학원 경희대학교병원 영상의학과)
  • Received : 2019.05.20
  • Accepted : 2019.08.06
  • Published : 2020.01.01
Download PDF
⟨ Previous Next ⟩

Abstract

It is essential to identify the causative artery in case of active intra-abdominal or gastrointestinal bleeding. A thorough understanding of the basic arterial anatomy is required to identify the causative artery on contrast-enhanced CT angiography and conventional catheter angiography. If one is familiar with the basic arterial anatomy, obtaining access to the bleeding artery will be easier, despite the variations in the origin and course of the vessels. We describe the basic arterial anatomy that will help beginners in diagnostic radiology to identify the blood vessels that can cause active intra-abdominal or gastrointestinal bleeding.

복강 내 혹은 소화기계의 활동성 출혈이 있는 경우, 원인이 되는 동맥 혈관을 파악하는 것이 중요하다. 조영증강 컴퓨터단층촬영술을 이용한 혈관조영술과 고식적인 카테터 혈관조영술에서 원인이 되는 동맥을 파악하기 위해서는 기본적인 혈관 해부학을 숙지하고 있어야 한다. 기본 해부학을 숙지하고 있다면 혈관의 기원과 주행에 다양한 변이가 있다고 하더라도 이에 대한 접근이 한결 쉬워질 것이다. 영상의학에 갓 입문한 초심자들을 대상으로 하여, 복강 내 혹은 소화기계 활동성 출혈의 원인이 될 수 있는 혈관들을 파악하는 데 도움이 될만한 기본 해부학을 설명하고자 한다.

Keywords

References

  1. Artigas JM, Marti M, Soto JA, Esteban H, Pinilla I, Guillen E. Multidetector CT angiography for acute gastrointestinal bleeding: technique and findings. Radiographics 2013;33:1453-1470
  2. Dobritz M, Engels HP, Schneider A, Wieder H, Feussner H, Rummeny EJ, et al. Evaluation of dual-phase multi-detector-row CT for detection of intestinal bleeding using an experimental bowel model. Eur Radiol 2009;19:875-881
  3. Kuhle WG, Sheiman RG. Detection of active colonic hemorrhage with use of helical CT: findings in a swine model. Radiology 2003;228:743-752
  4. Rimola J, Perendreu J, Falco J, Fortuno JR, Massuet A, Branera J. Percutaneous arterial embolization in the management of rectus sheath hematoma. AJR Am J Roentgenol 2007;188:W497-W502
  5. Nakayama T, Ishibashi T, Eguchi D, Yamada K, Tsurumaru D, Sakamoto K, et al. Spontaneous internal oblique hematoma successfully treated by transcatheter arterial embolization. Radiat Med 2008;26:446-449
  6. Garg A, Gupta AK, Khandelwal N. Diagnostic radiology: chest and cardiovascular imaging. 4th ed. New Delhi: Jaypee Brothers Medical Pub 2018:2
  7. White RD, Weir-McCall JR, Sullivan CM, Mustafa SA, Yeap PM, Budak MJ, et al. The celiac axis revisited: anatomic variants, pathologic features, and implications for modern endovascular management. Radiographics 2015;35:879-898
  8. Ahluwalia N, Futterman B. Anatomy, abdomen and pelvis, celiac trunk. Treasure Island: StatPearls Publishing LLC 2019
  9. Korean Society of Interventional Radiology. Interventional radiology. 2nd ed. Seoul: Ilchokak 2014
  10. Madoff DC, Denys A, Wallace MJ, Murthy R, Gupta S, Pillsbury EP, et al. Splenic arterial interventions: anatomy, indications, technical considerations, and potential complications. Radiographics 2005;25 Suppl 1:S191-S211
  11. Oderich GS. Mesenteric vascular disease current therapy. Berlin: Spinger 2015:15
  12. Horton KM, Fishman EK. Volume-rendered 3D CT of the mesenteric vasculature: normal anatomy, anatomic variants, and pathologic conditions. Radiographics 2002;22:161-172
  13. Joy P, Prithishkumar IJ, Isaac B. Clinical anatomy of the inferior epigastric artery with special relevance to invasive procedures of the anterior abdominal wall. J Minim Access Surg 2017;13:18-21
  14. Selcuk I, Yassa M, Tatar I, Huri E. Anatomic structure of the internal iliac artery and its educative dissection for peripartum and pelvic hemorrhage. Turk J Obstet Gynecol 2018;15:126-129
  15. Yoon W, Kim JK, Jeong YY, Seo JJ, Park JG, Kang HK. Pelvic arterial hemorrhage in patients with pelvic fractures: detection with contrast-enhanced CT. Radiographics 2004;24:1591-1605; discussion 1605-1606
  16. Tansatit T, Chokrungyaranont P, Sanguansit P, Wanidchaphloi S. Anatomical study of the superior gluteal artery perforator (S-GAP) for free flap harvesting. J Med Assoc Thai 2008;91:1244-1249
  17. Song SY, Chung JW, Kwon JW, Joh JH, Shin SJ, Kim HB, et al. Collateral pathways in patients with celiac axis stenosis: angiographic-spiral CT correlation. Radiographics 2002;22:881-893
  18. Kalva SP, Athanasoulis CA, Greenfield AJ, Fan CM, Curvelo M, Waltman AC, et al. Inferior pancreaticoduodenal artery aneurysms in association with celiac axis stenosis or occlusion. Eur J Vasc Endovasc Surg 2007;33:670-675
  19. Kwon SH, Ahn HJ, Oh JH. Is it the Arc of riolan or meandering mesenteric artery? J Endovasc Ther 2015;22:825-826