Surgical And Radiologic Anatomy[JOURNAL]
Sun
200 papers
Variant mesenteric and pancreatic vasculature. A case report.
Lather M, Brekke-Kumley B, McAravey B … +2 more , Roberts N, Funk PIC
Surg Radiol Anat · 2026 Jun · PMID 42262461 · Publisher ↗
PURPOSE: The vasculature of the pancreas and colon is highly variable and clinically relevant in pancreatic and colon surgeries. Although variant arterial branching between colonic and pancreatic arteries has been descri...
PURPOSE: The vasculature of the pancreas and colon is highly variable and clinically relevant in pancreatic and colon surgeries. Although variant arterial branching between colonic and pancreatic arteries has been described, the variant in this study has not previously been reported. This study highlights variant arterial anatomy between the colon and pancreas to enhance anatomic knowledge for surgical planning. METHODS: During a routine cadaveric dissection in our medical school anatomy laboratory, we identified an unusual branching pattern of the superior mesenteric artery (SMA) on a 72 y/o male donor. RESULTS: An unnamed artery originated from the posterior middle colic artery (MCA). This artery descended from its origin and bifurcated into an inferior branch and a transverse branch that crossed the SMA anteriorly. The transverse branch bifurcated into a small intestinal branch and a long ascending branch that supplied the head, uncinate process, body, and tail of the pancreas. CONCLUSION: This case represents a previously undescribed arterial branching pattern of the colon and pancreas. Knowledge of unique arterial variants benefits fields of anatomy and surgery and supports efforts to reduce operative complications in colorectal and pancreatic surgeries.
Radioanatomical relationships of the carotid arteries to the superior cornu of the thyroid cartilage.
Karangeli N, Triantafyllou G, Papadopoulos-Manolarakis P … +4 more , Arkoudis NA, Velonakis G, Papanagiotou P, Piagkou M
Surg Radiol Anat · 2026 Jun · PMID 42262407 · Full text
PURPOSES: The carotid arteries demonstrate variable relationships with adjacent laryngeal structures. Although thyroid cartilage (TC) is commonly used as a surgical landmark, the relationship between the carotid arteries...
PURPOSES: The carotid arteries demonstrate variable relationships with adjacent laryngeal structures. Although thyroid cartilage (TC) is commonly used as a surgical landmark, the relationship between the carotid arteries and the superior cornu of the thyroid cartilage (SCTC) remains insufficiently quantified. Previous clinical reports have suggested that close proximity between the vessel and cartilage may have anatomical significance in selected cases of vascular compression. This study aimed to evaluate these relationships and propose a classification system. METHODS: A retrospective analysis of 214 head and neck computed tomography angiography (CTA) scans (153 males, 61 females; mean age 63.07 years) was performed. The level of the carotid bifurcation (CB) relative to the SCTC, spatial relationships, and minimum distances between vessels and the SCTC were recorded. SCTC morphology, length, and angulation were also assessed. RESULTS: The CB was suprathyroid in 89% of sides and infrathyroid in 11%. The CCA was lateral to the SCTC in 73.4% of sides, whereas the ECA and ICA were lateral in 19.6% and 11%, respectively. Medial configurations were uncommon. Mean distances increased from the CCA (2.33 ± 1.82 mm) to the ECA (4.38 ± 3.07 mm) and ICA (6.18 ± 3.67 mm). SCTC length demonstrated a moderate positive correlation with ECA distance (R = 0.401), while coronal angulation showed weak negative correlations with ECA and ICA distances. Eleven relationship types were identified, with Type 1 (CCA lateral) representing the predominant configuration (64.5%). CONCLUSIONS: A consistent proximity pattern was observed, with the CCA located closest to the SCTC, followed by the ECA and ICA. SCTC morphology modestly contributed to carotid artery positioning. The proposed classification system captures the variability of these anatomical relationships and may facilitate standardized radiological description and preoperative anatomical assessment. Further studies incorporating dynamic imaging and clinical correlation are required to determine the potential pathological significance of these configurations.
Morphometric and morphological assessment of the piriform aperture in dry crania: anatomical observations and surgical implications.
Bedre Duygu O, Govsa F, Gokmen G
Surg Radiol Anat · 2026 Jun · PMID 42262393 · Publisher ↗
OBJECTIVE: The piriform aperture (PA) is a critical anatomical structure that forms the bony framework of the nasal inlet and influences nasal airway patency and support of the nasal base. This study aimed to present det...
OBJECTIVE: The piriform aperture (PA) is a critical anatomical structure that forms the bony framework of the nasal inlet and influences nasal airway patency and support of the nasal base. This study aimed to present detailed morphometric and morphological data on the PA to contribute to the surgical anatomy of PA enlargement. MATERIALS AND METHODS: Seventy adult crania (female, n = 34; male, n = 36) were included. Using standardized digital images, PA length, PA width, related craniometric distances, and planimetric area were measured with ImageJ software. PA morphology was classified into six types. RESULTS: PA length was 4.71 ± 0.67 cm in females and 5.54 ± 0.50 cm in males; PA width was 3.52 ± 0.39 cm in females and 3.80 ± 0.35 cm in males. PA area was 12.61 ± 2.77 cm in females and 15.99 ± 2.82 cm in males. PA length, width, width at the level of the infraorbital foramen, the nasion-anterior nasal spine distance, inter-infraorbital distance, rhinion-right/left infraorbital foramen distances, and PA area were significantly higher in males. Regarding morphological type distribution, the pear type was most frequent (42.86%), followed by inverted heart (21.43%), round (12.86%), teardrop (10%), and oval (8.6%). PA length in the round type was lower than in the pear/oval/teardrop types, whereas PA area in the oval type was higher than in the round type. CONCLUSION: PA morphometry demonstrates marked sexual dimorphism. In males, PA length was approximately 18% greater and PA area approximately 27% greater, reflecting the combined effect of increased length and width.
Terminal branching pattern of posterior tibial artery in the tarsal tunnel: a cadaveric study with its clinical importance in medial ankle surgeries.
Khan N, Gupta C, Shekhar R … +6 more , Pathak S, Thaker S, Jha M, Mehta S, Das S, Idli B
Surg Radiol Anat · 2026 Jun · PMID 42234176 · Full text
PURPOSE: The posterior tibial artery (PTA) branching within the tarsal tunnel is subject to significant anatomical variation, which can complicate surgical procedures such as tarsal tunnel decompression, flap harvesting,...
PURPOSE: The posterior tibial artery (PTA) branching within the tarsal tunnel is subject to significant anatomical variation, which can complicate surgical procedures such as tarsal tunnel decompression, flap harvesting, and medial ankle fixation. This study aimed to quantify the morphometry of the PTA bifurcation relative to the Dellon-McKinnon malleolar-calcaneal line (DML) in order to define vascular "safe zones." METHODS: Twenty-five formalin-fixed adult cadaveric limbs were dissected. The bifurcation of the PTA into the medial and lateral plantar arteries was identified. Measurements were taken in cm with the help of digital vernier calipers and angle with the help of goniometer. The following measurements included the bifurcation level relative to the DML (superior to, at, or inferior to), the distance from the DML, the bifurcation angle, and total foot length. The SSPS software was used for data analysis. Descriptive statistics were conducted for all the parameters. Correlation analysis was done to check for any association between foot length and artery branching length and artery branching angle. Spearman's Rank Correlation was done to check for the correlation between foot length and the medial and lateral plantar artery lengths. To establish whether there is any difference in foot length, angle of bifurcation, and distance of bifurcation from DML between limbs whose PTA divides superior to and inferior to the DML we have used an independent samples t- test. RESULTS: The PTA bifurcated superior to the DML in 52%, at the level of the DML in 28%, and inferior to the DML in 20% of specimens. The mean bifurcation angle was 22.60°. A strong positive correlation was found between foot length and angle of division below the DML line, but it was not significant. (r = 0.516, p value-0.374). Rare variations, including arterial trifurcation and early anastomosis, were documented. CONCLUSION: The majority of PTA bifurcations occur proximal to or at the level of the DML. This high prevalence of proximal branching suggests that surgical incisions for medial ankle exposure are statistically safer when positioned at or distal to the DML to avoid iatrogenic arterial trauma.
Mastoid emissary vein, mastoid emissary foramen, and mastoid emissary canal: anatomy, variability, imaging, and clinical implications.
Rusu MC, Tudose RC, Vrapciu AD
Surg Radiol Anat · 2026 Jun · PMID 42223687 · Full text
PURPOSE: The mastoid emissary vein (MEV), mastoid emissary canal (MEC), and mastoid emissary foramen (MEF) are common but variably reported structures of the mastoid-posterior fossa region. Existing literature is fragmen...
PURPOSE: The mastoid emissary vein (MEV), mastoid emissary canal (MEC), and mastoid emissary foramen (MEF) are common but variably reported structures of the mastoid-posterior fossa region. Existing literature is fragmented across osteological, imaging-based, and clinical studies, with inconsistent prevalence and morphometric estimates, and with limited integration of anatomical variation into surgical and radiological decision-making. This SANRA-guided narrative review aimed to synthesise the anatomy, variability, imaging assessment, and clinical implications of MEV/MEC/MEF. METHODS: This SANRA-guided narrative review synthesised anatomical, imaging, and clinical studies identified through PubMed/MEDLINE, Scopus, and Google Scholar from database inception through March 2026. Eligible studies included dry-skull, cadaveric, CBCT, MDCT/HRCT, and case-based reports addressing morphology, morphometrics, prevalence, or clinical relevance. Owing to methodological heterogeneity, findings were synthesised narratively. RESULTS: Across osteological and imaging studies, MEF/MEC prevalence was generally high but heterogeneous, with frequent unilateral or bilateral multiplicity. Most canals/foramina were small, whereas a minority were markedly enlarged and potentially relevant to surgical bleeding, collateral venous drainage, or venous pulsatile tinnitus. Enlarged MEVs have been implicated in selected cases of venous pulsatile tinnitus, with reported treatments including conservative management, surgical clipping/ligation, and endovascular or percutaneous occlusion. In mastoid and posterior fossa surgery, prominent MEVs have been reported as potential sources of difficult venous bleeding. In paediatric Osia implantation, larger preoperative MEV calibre correlated with intraoperative bleeding. CONCLUSIONS: MEV/MEC/MEF should be assessed systematically on preoperative imaging, including presence, number, calibre, and relationships to surgical landmarks. Consistent reporting may reduce avoidable haemorrhagic and diagnostic complications.
Anatomic variations uncommon variant of the callosomarginal artery originating from A1 segment of the anterior cerebral artery with an unruptured aneurysm and distal A1 fenestration.
Oyamada Y, Isoda M, Mori K … +8 more , Fukui I, Tamase A, Kodama N, Yamada R, Kojima M, Nakano T, Nomura M, Yamamoto T
Surg Radiol Anat · 2026 Jun · PMID 42223500 · Publisher ↗
Some anatomical variations in the A1 segment of the anterior cerebral artery have been reported, but large cortical branches arising from this A1 segment are rare. Herein, we report an unusual case of a callosomarginal a...
Some anatomical variations in the A1 segment of the anterior cerebral artery have been reported, but large cortical branches arising from this A1 segment are rare. Herein, we report an unusual case of a callosomarginal artery originating from the A1 segment associated with an unruptured aneurysm and distal A1 fenestration in an 85-year-old woman. These variants and aneurysm were incidentally identified on magnetic resonance angiography performed for the evaluation of cerebral infarction. Magnetic resonance imaging is useful in identifying anomalies in cerebrovascular structures. Conservative management was selected because of the small size of the aneurysm and the patient's advanced age.
Correction: Bilateral extensor pollicis et indicis accessorius: clinical and anatomical perspectives.
Oni OA, Adams W, Prem P … +5 more , Ramakrishnan RM, Sira A, Vachon EA, Shima MT, Ibrahim W
Surg Radiol Anat · 2026 May · PMID 42207324 · Full text
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Supreme nasal conchae in human cadavers: prevalence, morphometry, and a new classification proposal.
Montello MB, Cardenas SHR, da Silva Negreiros Neto T … +6 more , de Araújo Suassuna GV, Lira-Bandeira WG, Landfald IC, Olewnik Ł, Cavalcante JC, Abreu BJ
Surg Radiol Anat · 2026 May · PMID 42207303 · Full text
BACKGROUND: Extranumerary nasal conchae, including the supreme nasal concha (SupNC) and Zuckerkandl's concha (ZC), are uncommon variants relevant to endoscopic sinus and skull base surgery, yet their prevalence and morph...
BACKGROUND: Extranumerary nasal conchae, including the supreme nasal concha (SupNC) and Zuckerkandl's concha (ZC), are uncommon variants relevant to endoscopic sinus and skull base surgery, yet their prevalence and morphometry remain poorly defined. No cadaveric study has simultaneously evaluated prevalence, detailed morphometry, and a data-driven SupNC classification using principal component analysis (PCA). This study determined SupNC prevalence in cadavers and proposed a clinically oriented classification integrating morphological and quantitative parameters. MATERIAL AND METHODS: A cross-sectional cadaveric study analyzed 59 hemisections with preserved nasal conchae. Conchae were counted, and SupNCs classified according to Orhan and a new system. Morphometry was obtained using digital calipers and ImageJ. RESULTS: Of 59 hemisections, 37 (63%) had three conchae, 21 (35%) four, and 1 (2%) five. SupNC was present in 22/59 (37.3%) and ZC in 1/59 (1.7%), associated with SupNC. Significant differences were found between hemisections with and without extranumerary conchae in middle concha area (3.68 ± 1.07 vs. 4.45 ± 1.20 mm), superior concha area (1.26 ± 0.40 vs. 0.94 ± 0.36 mm), length (26.13 ± 4.19 vs. 21.93 ± 3.94 mm), and height (0.72 ± 0.24 vs. 0.45 ± 0.13 mm). Concha number strongly correlated negatively with nasal cavity height (r = -0.83). PCA identified two clusters: Straight (Type I) and Triangular (Type II) SupNCs. CONCLUSION: SupNC was relatively common, whereas ZC was rare. The proposed morphology- and morphometry-based classification may improve preoperative CT evaluation and intraoperative orientation.
Ultrasound-based morphometry of the cephalic vein for cannulation in pediatric patients: a prospective cohort study.
Samocki P, Franczyk R, Ciszek B
Surg Radiol Anat · 2026 May · PMID 42189292 · Publisher ↗
PURPOSE: Risk factors for difficult cannulation of the cephalic vein in children remain underexplored. This study aimed to perform an ultrasound-based morphometric assessment of the vein in pediatric patients. METHODS: A...
PURPOSE: Risk factors for difficult cannulation of the cephalic vein in children remain underexplored. This study aimed to perform an ultrasound-based morphometric assessment of the vein in pediatric patients. METHODS: An ultrasound examination of the proximal third of the dominant forearm was conducted in the emergency department of a children's hospital using a Philips Lumify device with a linear transducer (4-12 MHz). Measurements included internal vein diameter, depth from the skin surface, and calculated cannula insertion path length for inclinations of 20° and 30°. Demographic and morphometric data were recorded for each patient. The study protocol was approved by the institutional Bioethics Committee (decision number KB/169/2024). RESULTS: Cephalic vein diameter correlated positively with age (r = 0.52, p < 0.001), height (r = 0.55, p < 0.001), and weight (r = 0.64, p < 0.001). Larger forearm circumference was associated with greater vein diameter (r = 0.60, p < 0.001), increased depth from the skin (r = 0.28, p < 0.01), and longer cannula insertion path length (r = 0.28, p < 0.01). Vein diameter was best predicted by patient weight, whereas prediction of vein depth and cannula insertion path length based on forearm circumference was limited (8% explained variance). CONCLUSION: Prediction of vein depth and cannula insertion path length based on demographic and morphometric variables is limited. Ultrasound guidance should be considered to improve first-attempt success and reduce procedural time and trauma in pediatric patients.
Reexploring the normal and variational anatomy of neurovascular contents of anatomical snuff box and their clinosurgical implications.
Gupta R, Janagal R, Kumari C … +2 more , Gupta T, Aggarwal A
Surg Radiol Anat · 2026 May · PMID 42189277 · Publisher ↗
PURPOSE: Owing to its superficial location and accessibility, the anatomical snuff box is increasingly used for minimally invasive and image-guided procedures. This study evaluated the morphology and variations of its ke...
PURPOSE: Owing to its superficial location and accessibility, the anatomical snuff box is increasingly used for minimally invasive and image-guided procedures. This study evaluated the morphology and variations of its key neurovascular structures. METHODS: The study was conducted on 60 upper limbs (30 right and 30 left) from embalmed adult cadavers (15 males and 15 females; age range: 20-90 years). After exposure of superficial structures, detailed dissection of the anatomical snuff box was performed. The tendons forming its boundaries, along with the cephalic vein, superficial branch of the radial nerve, and radial artery, were assessed for their course, depth, diameter, and related morphometric parameters. RESULTS: The cephalic vein diameter ranged from 1.22 to 3.98 mm. The mean radial artery diameter was 2.65 ± 0.64 mm. Both cephalic vein and radial artery diameters were significantly greater in males than females. A tortuous radial artery course was observed in 73.3% of cases, while the remainder showed a relatively straight course. Radial artery tortuosity was significantly more common on the right side. CONCLUSION: A cephalic vein diameter of at least 2 mm, considered suitable for arteriovenous fistula creation, was observed in 88.8% of cases. The radial artery diameter exceeded 2.3 mm in 80% of specimens, supporting the feasibility of distal radial catheterization. Overall, the anatomical snuff box demonstrates favorable vascular dimensions for arteriovenous fistula creation and distal radial access. However, frequent radial artery tortuosity, particularly on the right side, should be considered during clinical interventions to minimize complications.
Fibrous and membranous tissues of the tarsal tunnel; quantitative 3D anatomy using a digital microscribe.
Bruechert GK, Thorpe Lowis CG, Edwards WHB … +1 more , Fogg QA
Surg Radiol Anat · 2026 May · PMID 42189268 · Full text
PURPOSE: The aetiology of tarsal tunnel syndrome is not always clear. Treatment commonly involves a single release of the flexor retinaculum, but post-operative outcomes are not always successful. This may be due to the...
PURPOSE: The aetiology of tarsal tunnel syndrome is not always clear. Treatment commonly involves a single release of the flexor retinaculum, but post-operative outcomes are not always successful. This may be due to the lack of understanding the tissues that may compress the neurovasculature. The aim of this study was to define the tissues that separate the contents of the tarsal tunnel. METHODS: Feet from embalmed body donors (n = 15; mean age = 83.9 ± 10.2 years; female = 9, male = 6) were examined. One underwent magnetic resonance imaging. All were dissected and modelled in virtual three-dimensional space. RESULTS: The tarsal tunnel was divided into at least five spaces by a fibrous skeleton, formed by septae that were much thicker than previously understood. CONCLUSION: These data strongly suggest that the fibrous skeleton may compress the neurovasculature and may need to be considered in the diagnosis and management of tarsal tunnel syndrome. Surgically, this may more precisely inform which tissues need to be targeted for tarsal tunnel release.
Radioanatomical assessment of the subtympanic sinus and its relationship to facial nerve position and temporal bone pneumatization in adults: CT study.
Campostrini C, Wojciechowski T, Szopiński K … +1 more , Fermi M
Surg Radiol Anat · 2026 May · PMID 42189264 · Full text
BACKGROUND: The subtympanic sinus (STS) is a recess of the inferior retrotympanum of various morphology and depth. Its shape and dimensions may depend on the configuration of surrounding bony ridges and the degree of tem...
BACKGROUND: The subtympanic sinus (STS) is a recess of the inferior retrotympanum of various morphology and depth. Its shape and dimensions may depend on the configuration of surrounding bony ridges and the degree of temporal bone pneumatization. Despite increasing interest in retrotympanic anatomy, quantitative radiological descriptions of STS variability in adults remain limited. Our aim was to describe the morphology, dimensions, and distribution of the subtympanic sinus in adults and to analyze its anatomical relationships with the facial nerve, the subcochlear canaliculus, and pneumatization of the temporal bone. MATERIALS AND METHODS: Computed tomography (HRCT and CBCT) scans of 82 adults (164 temporal bones) without otologic disease were retrospectively analyzed. The STS was classified according to its extension relative to the mastoid segment of the facial nerve. Sinus depth and width were measured, and the presence of facial nerve-adjacent pneumatization, subcochlear canaliculus, and pneumatization within the vascular compartment of the petrous bone were assessed. RESULTS: Type A STS configuration was most prevalent (80.5%), followed by type B (16.5%) and type C (3.0%). STS depth increased progressively from type A to type C, with statistically significant differences among groups (p < 0.001), whereas sinus width did not differ significantly. A connection with the subcochlear canaliculus was present in 62.8% of temporal bones and was significantly associated with greater STS depth. Facial nerve-adjacent pneumatization was frequent (85.4%) and correlated with increased STS depth. CONCLUSIONS: The subtympanic sinus exhibits substantial morphological variability in adults, primarily expressed through differences in depth. Its configuration may reflect broader patterns of temporal bone pneumatization and may support the concept of an integrated retrotympanic and infracochlear anatomical system.
Venous valves of the head and neck: a narrative review.
Rusu MC, Bănică DA, Tudose RC
Surg Radiol Anat · 2026 May · PMID 42189241 · Full text
BACKGROUND: Classical anatomical teaching has long described head and neck veins as largely valveless, allowing free bidirectional flow. Modern cadaveric, imaging, and surgical studies challenge this oversimplification....
BACKGROUND: Classical anatomical teaching has long described head and neck veins as largely valveless, allowing free bidirectional flow. Modern cadaveric, imaging, and surgical studies challenge this oversimplification. OBJECTIVE: This narrative review synthesises current anatomical evidence regarding the presence, morphology, distribution, and functional significance of venous valves throughout the head and neck venous system. METHODS: A literature search was conducted across PubMed and Semantic Scholar. The review was structured following the Scale for the Assessment of Narrative Review Articles (SANRA) quality framework. All primary research references were verified against PubMed. RESULTS: Valves have been documented in the facial, lingual, labial, pharyngeal, superior ophthalmic, superficial temporal, glabellar/forehead, external jugular, and internal jugular veins, as well as at the lymphovenous junction. These valves are predominantly bicuspid and cluster near venous junctions. The internal jugular vein has a valve near its termination in approximately 86-93% of specimens; functional competence is context-dependent, being present in patients with normal central venous pressure but frequently absent in those with chronically elevated pressure, and further compromised by cannulation trauma. Jugular venous reflux from valve insufficiency has been associated with several neurological conditions. The cerebral venous system, dural sinuses, emissary veins, and the internal vertebral venous plexus are consistently valveless. CONCLUSIONS: Contemporary evidence demonstrates that head and neck veins are not uniformly valveless. Valve presence and competence carry implications for infection spread, microvascular surgery, central venous cannulation, and cerebral hemodynamics.
Determination of vertebral levels and distances between unpaired visceral branches of abdominal aorta using three-dimensional multi-detector computed tomography angiographies.
Çimen K, Doğruyol G, Gül E … +1 more , Şalk İ
Surg Radiol Anat · 2026 May · PMID 42189239 · Publisher ↗
PURPOSE: The unpaired visceral branches of the abdominal aorta (AA) are the coeliac artery (CA), superior mesenteric (SMA), and inferior mesenteric (IMA) arteries. In endovascular surgery and interventional radiology, it...
PURPOSE: The unpaired visceral branches of the abdominal aorta (AA) are the coeliac artery (CA), superior mesenteric (SMA), and inferior mesenteric (IMA) arteries. In endovascular surgery and interventional radiology, it is crucial to understand the positions of these arteries and the distance between them and the aortic bifurcation (AB). This study aims to determine the vertebral positions of AA unpaired visceral branches, their distances from each other, and male-female differences in a large sample group using three-dimensional multi-detector computed tomography angiography (MDCTA) images. METHODS: This study was performed in a retrospective manner using radio-anatomical planes and included 500 MDCTA images with an equal gender distribution. RESULTS: The most common CA, SMA, IMA, and AB vertebral positions were determined as T12-L1 disc, L1-middle, L3-middle, and L4-lower in females and males, respectively. The median values of CA-SMA, CA-IMA, CA-AB, SMA-IMA, SMA-AB, and IMA-AB distances were obtained as 1.55, 1.65, 8.62, 9.07, 12.09, 13.01, 7.04, 7.32; 10.47, 11.20; 3.48, 3.84 cm in females and males, respectively. The difference between females and males was statistically significant in each measurement (p < 0.05). CONCLUSIONS: Arteries were positioned closer to each other in females than in males. When radio navigators are unavailable, the positions of IMA and AB can be used by both genders to detect CA and SMA. We believe that this MDCTA-based study, conducted in a relatively large clinical imaging cohort, may provide descriptive anatomical reference data that could contribute to the understanding of vascular relationships in radiological and surgical contexts.
The oblique vein of the left atrium: an overlooked vein in anatomical education with emerging clinical importance in atrial fibrillation ablation.
Akdemir Aktaş H
Surg Radiol Anat · 2026 May · PMID 42189226 · Publisher ↗
The oblique vein of the left atrium (Vein of Marshall) is frequently underemphasized in anatomical education and classical texts, often regarded as a minor or vestigial structure. However, contemporary electrophysiologic...
The oblique vein of the left atrium (Vein of Marshall) is frequently underemphasized in anatomical education and classical texts, often regarded as a minor or vestigial structure. However, contemporary electrophysiological practice has revealed its significant role in the pathophysiology and ablation of atrial fibrillation, particularly through ethanol infusion techniques. This letter highlights the discrepancy between traditional anatomical descriptions and the vein's emerging clinical importance, emphasizing the need for a more integrated anatomical perspective that reflects modern interventional and electrophysiological advances.
High-resolution intraoral ultrasonography of the intrinsic tongue muscles: detailed anatomical visualization.
Ji HJ, Heo YR, Piao JZ … +3 more , Gil YC, Hu KS, Kim HJ
Surg Radiol Anat · 2026 May · PMID 42189224 · Publisher ↗
PURPOSE: The tongue plays a key role in speech and swallowing, and its intrinsic muscles enable fine coordinated movements. High-resolution ultrasonography is a non-invasive method that allows detailed visualization of t...
PURPOSE: The tongue plays a key role in speech and swallowing, and its intrinsic muscles enable fine coordinated movements. High-resolution ultrasonography is a non-invasive method that allows detailed visualization of tongue structures and blood vessels. This study investigated the morphology of the intrinsic tongue muscles and deep lingual artery by correlating the high-resolution intraoral ultrasonography with known anatomical structures. METHODS: Ultrasonographic examinations were performed on 33 Korean adults (6 males and 27 females; mean age: 34.9 ± 12.3 years) using a B-mode system with a 15 MHz hockey-stick transducer. Five predefined areas on the dorsal and lateral tongue surfaces were systematically scanned. A total of 182 images were acquired to evaluate intrinsic tongue structures and the deep lingual artery. Muscle visualization rates were summarized descriptively, and Fisher's exact test was used to examine age-related differences in visualization status. RESULTS: The intrinsic tongue muscles (superior longitudinal, transverse lingual, vertical lingual, and inferior longitudinal muscles) were distinctly visualized in layered structure from surface inward. Muscle separation was clear on the dorsal surface, though vertical and transverse lingual muscles appeared in the same layer. Visualization detail decreased slightly in the tongue tip and lateral regions. The deep lingual artery was identified in 70.6% of participants, primarily in the anterior tongue, at a mean depth of 0.9 cm (range, 0.6-1.2 cm). An age-related trend toward lower visibility of the right vertical lingual muscle was observed in older participants (P = 0.123). CONCLUSION: High-resolution intraoral ultrasonography successfully provided detailed, anatomically consistent visualization of intrinsic tongue muscles and the deep lingual artery, supporting its utility for both clinical assessment and educational purposes.
Sacral morphological variations in the Korean population using PMCT-based 3D reconstruction: a case series.
Kwon HW, Park J, Cho J … +6 more , Choi YJ, Kim D, Choe Y, Park ES, Park S, Park KR
Surg Radiol Anat · 2026 May · PMID 42165824 · Publisher ↗
INTRODUCTION: The purpose of this study was to analyze morphological variations of the sacrum in a Korean population, with particular emphasis on the number and configuration of sacral foramina in relation to lumbar vert...
INTRODUCTION: The purpose of this study was to analyze morphological variations of the sacrum in a Korean population, with particular emphasis on the number and configuration of sacral foramina in relation to lumbar vertebral count. We aimed to describe sacral morphological features that may occur even in the absence of overt transitional anomalies and to highlight potential limitations of conventional definitions based solely on lumbosacral fusion. CASE REPORT: Postmortem computed tomography (PMCT) data from three Korean individuals were reconstructed into three-dimensional models using Mimics software. Sacral segmentation patterns, lumbar vertebral counts, and key morphometric parameters were documented for each case. The measured parameters included sacral length (SL), sacral width (SW), superior transverse diameter (STD), and the vertical diameter of the sacral auricular surface (VDSA). DISCUSSION: Each case demonstrated a distinct sacral morphology. Case 1 exhibited five lumbar vertebrae, unilateral non-fusion of the L5 transverse process, and asymmetric sacroiliac articular surfaces (SL 137.5 mm; SW 119.5 mm; STD 52.6 mm; VDSA 66.9 mm right, 58.9 mm left). Case 2 showed four lumbar vertebrae due to bilateral L5-sacral fusion, accompanied by asymmetric fusion patterns and an indistinct S1-S2 boundary (SL 122.4 mm; SW 113.3 mm; STD 53.1 mm; VDSA 59.1 mm right, 60.1 mm left). Case 3 demonstrated five lumbar vertebrae and a six-segmented sacrum (S1-S6) with symmetrical auricular surfaces (SL 128.9 mm; SW 105.6 mm; STD 53.2 mm; VDSA 69.4 mm right, 70.7 mm left). CONCLUSION: These findings suggest that sacral elongation and remodeling of the auricular surface may occur independently of lumbar vertebral number. This highlights the importance of individualized morphometric assessment in clinical procedures such as sacroiliac joint fusion and caudal epidural anesthesia. Conventional definitions based solely on L5-S1 fusion may not adequately capture the complexity of sacral structure. Consideration of both sacral segmentation patterns and lumbar vertebral counts may enhance anatomical interpretation and clinical applicability.
Morphologic variations of the sigmoid sinus on computed tomography: a classification-based study.
Medişoğlu MS, Öçbe M
Surg Radiol Anat · 2026 May · PMID 42154332 · Full text
PURPOSE: The sigmoid sinus is a vital dural venous structure whose anatomical variability has direct implications for lateral skull base and otologic surgeries. Understanding the sinus's positional variations is consider...
PURPOSE: The sigmoid sinus is a vital dural venous structure whose anatomical variability has direct implications for lateral skull base and otologic surgeries. Understanding the sinus's positional variations is considered important for minimizing surgical risks. This study aimed to evaluate the morphological classification of the sigmoid sinus using a surgical reference-based system and to assess its relationship with demographic variables. METHODS: A retrospective analysis was conducted on high-resolution temporal bone CT scans of 241 patients (114 females [47.30%], 127 males [52.70%]) with an age range of 18-92 years (mean age: 47.95 ± 17.84). The morphology of the sigmoid sinus was classified into four types based on the system defined by Dong-Il Sun et al., using three anatomical reference lines. The width and depth of the sigmoid sinus were measured bilaterally and analyzed in relation to age and gender. Statistical analysis included paired tests for bilateral measurements, chi-square tests and ordinal logistic regression for associations with age and sex, and reliability assessment using Cohen's kappa and intraclass correlation coefficients. RESULTS: A total of 241 patients were included. Mean sigmoid sinus depth and width were 6.57 ± 1.73 mm and 14.55 ± 4.06 mm on the right, and 6.33 ± 1.52 mm and 15.18 ± 4.93 mm on the left, respectively. Left-sided width was significantly greater than the right (p < 0.05), whereas depth did not differ. Type 3 and Type 4 configurations predominated bilaterally; Type 1 was not observed. Age was significantly associated with left-sided sigmoid sinus type (p = 0.0048), with more medial configurations in older individuals. Ordinal regression showed decreasing odds of higher-type anatomy with increasing age (OR = 0.84 per decade). Gender was associated with left-sided type distribution but not independently predictive after adjustment. Inter- and intraobserver reliability was excellent. CONCLUSION: The positional morphology of the sigmoid sinus varies significantly with age and gender. The absence of Type 1 and predominance of high-risk configurations in younger individuals suggests the potential relevance of individualized preoperative assessment. This classification system may provide additional anatomical insight for radiologic evaluation; however, its direct impact on surgical decision-making requires further validation.
Bilateral pentafurcation of the common carotid arteries: a cadaveric case study.
Mardis TA, Crawford KE, Koontz DM … +1 more , Sloan SS
Surg Radiol Anat · 2026 May · PMID 42154320 · Publisher ↗
PURPOSE: Arterial variations in branching patterns off the external carotid artery are of clinical significance, especially in surgical operations and procedures of the head and neck. Variations of the eight typical bran...
PURPOSE: Arterial variations in branching patterns off the external carotid artery are of clinical significance, especially in surgical operations and procedures of the head and neck. Variations of the eight typical branches off the carotid artery and their branching patterns have been documented in the literature and several classification systems have been proposed. The common carotid artery typically bifurcates at the upper border of the thyroid cartilage into the external carotid and internal carotid arteries. This case report details the rare occurrence of a bilateral common carotid artery pentafurcation, with the external and internal carotid artery and three additional branches that typically branch off of the external carotid artery. Limited documentation of pentafurcation of the carotid artery exists, and bilateral pentafurcation has not been previously documented in the literature. METHODS: A bilateral pentafurcation of the common carotid artery was found during routine cadaveric anatomy dissection by first year medical students at Kansas City University College of Osteopathic Medicine. Detailed dissection of the carotid system branches was then performed to verify findings and identify the atypical branching patterns. Measurements were taken and characteristics of all branches were documented. RESULTS: In addition to the typical internal and external carotid branches, the right and left common carotid artery produced the superior thyroid, ascending pharyngeal, and occipital arteries, resulting in bilateral carotid artery pentafurcation. CONCLUSIONS: This case presents a rare finding of bilateral carotid artery pentafurcation. Documentation and reporting of the variability in carotid vasculature benefits both radiologic and surgical specialties and assists in predicting the impact of carotid artery anomalies on the pathophysiology of carotid atherosclerosis.
Computed tomography-based assessment of sacroiliac joint variations: associations with sacral types, sex, and side.
Dogmus S, Uysal II, Yılmaz PD … +1 more , Arık O
Surg Radiol Anat · 2026 May · PMID 42154298 · Publisher ↗
PURPOSE: To evaluate sacroiliac joint (SIJ) variations and to examine their associations with sacral morphology types across sex and side using computed tomography. METHODS: This retrospective study included computed tom...
PURPOSE: To evaluate sacroiliac joint (SIJ) variations and to examine their associations with sacral morphology types across sex and side using computed tomography. METHODS: This retrospective study included computed tomography images of 400 adults (200 females, 200 males). Sacral morphology was classified on sagittal images based on the presence and morphology of the S1-S2 intervertebral disc. SIJ variations were identified on corresponding axial images. The distribution of SIJ variations according to sex and side and their associations with sacral types were analyzed. RESULTS: SIJ variations were observed in 43% of individuals with type 1 sacrum, 41% of those with type 2 sacrum, and 25% of those with type 3 sacrum. Overall, variations were detected 60.5% of females and 25.5% of males, indicating a significantly higher prevalence in females. Most variations demonstrated bilateral involvement. The accessory SIJ was the most frequent variation, followed by the iliosacral complex and semicircular defect. Sacral morphology was predominantly type 1, followed by type 2, with a significant sex-related difference in distribution. Although SIJ variations were observed across different sacral types, no clear linear association with sacral morphology was identified. CONCLUSION: SIJ variations are common, predominantly bilateral, and more frequently observed in females, supporting a mechanical rather than inflammatory origin. The high prevalence of accessory SIJ highlights its importance as a potential source of diagnostic confusion in SIJ imaging. Combined evaluation of sacral morphology and SIJ variations provides an integrated anatomical framework that improve radiological interpretation and reduce diagnostic uncertainty in clinical practice.
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