Background : Most of colonic polyp and colorectal carcinoma are found in inferiormesenteric artery (IMA) supplied segments. Complication such as bleedingis crucial role for endovascular embolization and chemotherapy. Knowledgeof vascular anatomy is important for successful interventional procedure.Objective : To determine the branching patterns and different aberrant arterialbranches of IMA in Thai population by using multidetector computedtomography (MDCT) angiography.Setting : Department of Radiology, King Chulalongkorn Memorial Hospital.Study design : Retrospective descriptive study.Methods : A total of 165 patients who underwent MDCT angiography of the wholeaorta from January 2009 to December 2011 were retrospectively reviewed.The vertebral level of IMA origin, branching pattern and the presence ofaberrant arterial branches were recorded. Researcher and anotherexperienced radiologist performed image analysis in consensus.Results : IMA originates from the abdominal aorta at any level between superiorendplate of second lumbar vertebra and inferior endplate of forth lumbarvertebra. The body of third lumbar vertebra is the most frequent level oforigin, 49 cases (29.7%). Five branching patterns are founded. The mostfrequent pattern is sigmoid artery (SA) branches off from superior rectalartery (SRA), 57 cases (34.5%). One of five branching patterns is newlydiscovered pattern which are two left colic arteries (LCAs) branch offfrom IMA, 20 cases (12.1%). Only two cases with aberrant branches wereobserved, including IMA branching from superior mesenteric artery (SMA)and LCA branches off from SMA (1.2%).Conclusions : There were anatomical variations of IMA, including level of origin, branchingpatterns and aberrant branches. In the Thai population, the branchingpattern and aberrant branches show some variation from the previouslyreported cases. Using of MDCT angiography provides good informationfor detection of vascular variation before interventional procedure.
Faculty of Medicine, Chulalongkorn University
Ubolviroj, Punnaporn and Arjhansiri, Kiat
"Multidetector computed tomography angiographic imagingof the inferior mesenteric artery: Aberrant branchesand branching patterns,"
Chulalongkorn Medical Journal: Vol. 58:
5, Article 1.
Available at: https://digital.car.chula.ac.th/clmjournal/vol58/iss5/1