Study on the anatomy and typing of splenic artery based on 3D visualization technique
Authors: Gao Xu dong , Wang Xiao ming 
Published: August 2024

Abstract

Objective:To explore the anatomy and classification of the splenic artery based on 3D visualization technology in order to provide guiding value for the clinical implementation of splenic and pancreatic surgery.
Methods: The study objects were 100 patients undergoing enhanced CT examination admitted to the Department of Hepatobiliary Surgery, the first affiliated hospital of Wannan Medical College from September 2020 to March 2023. All patients underwent thin-layer enhanced CT scanning, and the stored data extracted in Medical Digital Imaging and Communication format were imported into a 3D visualization system for 3D reconstruction. The reconstruction condition and reconstruction rate of 3DVT, the origin of SA, the number of curves, the relationship between the position of SA and the pancreas, and the number of first-stage branches at the end of SA were observed and counted. The length of SA, the diameter of the initial part, the diameter of the final part, the distance between the terminal branch of SA and the hilum of the spleen, the distance between the total fulcrum of SA and the end of the pancreatic tail, and the distance between the hilum of the spleen and the pancreatic tail were measured, and then the three-dimensional visualization classification was performed.
Results: A total of 100 patients underwent 3D reconstruction of CT data, and the rate of SA, spleen and pancreas reconstruction in 100 cases was 100% (100/100). Among 100 cases, 99 cases (99/100) of SA originated from the abdominal trunk, and 1 case (1%) of SA originated from the abdominal aorta. The shortest length of SA was 49.77mm, the longest was 272.99mm, and the average length was 116.60±30.71mm. The diameter of the initial part of SA was 3.27mm, 5.47mm and 5.59±1.06mm on average. The diameter of the SA terminal was 2.58mm, 7.58mm, and 4.63±0.98mm on average. The distance between the terminal branch of SA and the splenic hilum was 19.21 (0-68.15) mm. The distance between the SA fulcrum and the end of pancreatic tail was 15.99 (0-127.23) mm. The distance between splenic hilum and pancreatic caudal end was 21.34 (0-138.23) mm. There was 1 case (1/100) with no bending in the SA stroke. There were 23 cases (23%) with 1 curve. 45 cases (45/100) had two curves. There were 31 cases (31/100) with more than 2 bends. There were 4 cases (4%, 4/100) in which one branch of the first level was emitted from the end of SA. 76 cases (76/100) had two branches. 15 cases (15/100) had 3 branches. 5 cases (5/100) had more than 3 branches. The multidimensional classification results of SA showed that the form credit type was L-type: 1 case, 1% (1/100); p type: 23 cases (23/100); Type s: 45 cases (45/100); Irregular type: 31 cases, 31% (31/100); The spatial classification of SA was type Ⅰ : 23 cases (23/100). Type Ⅱ : 57 cases (57/100); Type Ⅲ : 4 cases, 4% (4/100); Type Ⅳ : 16 cases (16/100); The differentiated type of splenic hilum was one line type: 4 cases (4%, 4/100). Two branch type: 76 cases, 76% (76/100); Three branches type: 15 cases (15/100); Multibranched type: 5 cases (5/100). Right pancreatic caudal type: 55 cases, 55% (55/100); Left pancreatic caudal type: 45 cases, 45% (45/100); The distance classification between the SA branch and the splenic hilum was scattered: 47 cases (47%, 47/100). Concentrated type: 42 cases, 42% (42/100); Comb type: 11 cases, 11% (11/100).
Conclusion: 1. Of the 100 cases of SA in this study, 99% (99/100) originated from the abdominal trunk, with an average length of 116.60 ± 30.71 mm, an average diameter of 5.59 ± 1.06 mm at the beginning and 4.63 ± 0.98 mm at the end. 2. This study classifies SA into the following types according to different criteria: SA can be divided into four types according to morphological criteria: l type, p type, s type and irregular type. Type l accounted for 1% (1/100), type p for 23% (23/100), type s for 45% (45/100), and irregular type for 31% (31/100). SA can be divided into type I, type II, type III and type IV according to the spatial classification of the relationship between SA and pancreas. Among them, type I accounted for 23% (23/100), type II accounted for 57% (57/100), type III accounted for 4% (4/100), and type IV accounted for 16% (16/100). The types of splenic hilar region of SA can be divided into six types: one branch type, two branch type, three branch type, multiple branch type, right type of pancreatic tail and left type of pancreatic tail. Among them, one-branch type accounted for 4% (4/100), two-branch type accounted for 76% (76/100), three-branch type accounted for 15% (15/100), multi-branch type accounted for 5% (5/100), right-side type of pancreatic tail accounted for 55% (55/100), and left-side type of pancreatic tail accounted for 45% (45/100). According to the distance between the primary branch of SA and the splenic hilum, it can be divided into three types: scattered type, concentrated type and comb-type. The dispersed type accounts for 47% (47/100), the concentrated type accounts for 42% (42/100), and the comb type accounts for 11% (11/100). 3. The SA anatomical data and 3DVT typing results in this study may provide corresponding anatomical basis and guiding significance for the clinical implementation of pancreatic and splenic surgery.