CT angiography and image fusion for anatomy of the gastric and colic trunk

Objective To study the anatomical characteristics of gastrocolic vein trunk(GCT) in vivo by using CT angiography (CTA) and image fusion. Methods From January 2017 to February 2018, 80 cases of abdominal CT plain scan and enhanced scan imaging data were analyzed retrospectively. In this study, there were 46 males and 34 females, aged 39-83(68±10.1) years. The original images were reconstructed by computed tomography angiography(CTA), computed tomography colonography(CTC) and fused to obtain three-dimensional images of blood vessels and intestines.Observation indexes included length, diameter and running of GCT, composition of GCT, distribution of the middle colon vein into the superior vein, distribution of superior venous confluence of anterior pancreaticoduodenal vein into superior vein. Results (1)Sixty-nine cases(86.25%) had GCT, the length was 2.5-25.2(9.2±3.6) mm, the average length was 3.3-7.2(4.8±0.9) mm. The trunk of the stomach and colon ran from the ventral to the right side. There were 4 origins of its branches: right colon vein, middle colon vein, right gastroepiploic vein and superior anterior pancreaticoduodenal vein. Among them, 35 cases(50.73%) consisted of right gastroepiploic vein, right colon vein and middle colon vein. In 7 cases(10.14%), the "2 branches" type of gastric and pancreatic trunk consisted of the right gastroduodenal vein and the anterior superior pancreaticoduodenal vein; 27 cases(39.13%) consisted of right colon vein, middle colon vein, right gastroepiploic vein and superior anterior pancreaticoduodenal vein. (2)The middle colon veins were found in 77 patients. Among of them, the middle colon vein entered superior mesenteric vein in the 53 patients (68.83%), entered GCT in the 20 patiens (25.97%), entered inferior mesenteric vein in the 2 patiens (2.60%), and entered splenic vein in the 2 patiens(2.60%). (3)The superior anterior pancreaticoduodenal vein directly entered the superior mesenteric vein in 46 cases(57.50%), and the superior anterior pancreaticoduodenal vein participated in the composition of GCT in 34 cases(42.50%), including 12 cases of right gastroepiploic vein, 10 cases of right colon vein, 7 cases of right omental vein and right colon vein. Five cases were enrolled in GCT. Conclusions CTA and image fusion technology can visually display the anatomy and variation of GCT vessels, provide reliable information for preoperative evaluation of abdominal vessels, and have high clinical value. Key words: Veins; Gastrocolic venous trunk; Angiography; Volume reconstruction; Anatomy