Surgical And Radiologic Anatomy[JOURNAL]
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200 papers
Proximal femoral morphometry and its association with hip fracture patterns: a systematic review with meta-analysis.
Kotzias D, Giovanoulis V, Koutserimpas C … +6 more , Triantafyllou G, Veizi E, Arkoudis NA, Tsakotos G, Troupis T, Piagkou M
Surg Radiol Anat · 2026 May · PMID 42154258 · Full text
PURPOSES: Proximal femoral fractures (PFFs) represent a major cause of morbidity and mortality in the elderly population. Beyond bone mineral density, proximal femoral (PF) and hip joint (HJ) morphometry have been implic...
PURPOSES: Proximal femoral fractures (PFFs) represent a major cause of morbidity and mortality in the elderly population. Beyond bone mineral density, proximal femoral (PF) and hip joint (HJ) morphometry have been implicated in fracture susceptibility and fracture pattern. However, the relative contribution of individual geometric parameters remains incompletely defined. The purpose of this study was to systematically evaluate the association between PF and HJ morphometry and hip fracture (HF) patterns, and to assess the predictive value of radiographic morphometric parameters derived from standard anteroposterior radiographs. MATERIALS AND METHODS: A systematic review with meta-analysis was conducted in accordance with PRISMA guidelines. PubMed and MEDLINE databases were searched up to September 2025 for observational studies reporting radiographic morphometric parameters in patients with unilateral PFFs. Statistical meta-analysis was performed with random-effect models to compare intracapsular-ICF/subcapital-SCF fractures with intertrochanteric (ITF) and extracapsular (ECF) fracture patterns. RESULTS: Twenty-two studies comprising 4184 patients (77.8% female; pooled mean age 77.4 years) were included. Meta-analysis using a random-effects model revealed that ITF were significantly associated with a smaller femoral head diameter (p < 0.001) and increased medial neck cortex thickness (p = 0.021) compared with ICF. ECF demonstrated significantly longer femoral neck axis length (p = 0.012), increased horizontal offset (p = 0.048), smaller absolute offset (p = 0.026) and shorter hip axis length (p = 0.026) than ICFs. Angular parameters provided the most robust stratification. ITFs and ECFs exhibited significantly lower (more varus) neck-shaft angles (p < 0.001) and significantly higher Wiberg angles (p < 0.001) compared with the ICF group. CONCLUSIONS: PF and HJ morphometry are associated with distinct HF patterns, independently of bone mineral density. Simple linear and angular measurements obtained from standard anteroposterior radiographs may assist fracture pattern stratification, risk assessment, and preoperative planning in elderly patients.
Morphometric analyses of neurovascular triangles in pterional craniotomy: a cadaveric study in Eastern India.
Bhattacharya A, Ghosh SP, Saha A
Surg Radiol Anat · 2026 May · PMID 42154239 · Publisher ↗
PURPOSE: The pterional approach facilitate access to particular neurovascular structures through the optic-carotid and carotid-oculomotor triangles. Even with broad adoption, quantitative morphometric data remain limited...
PURPOSE: The pterional approach facilitate access to particular neurovascular structures through the optic-carotid and carotid-oculomotor triangles. Even with broad adoption, quantitative morphometric data remain limited, particularly in South Asian populations. Main objectives were to evaluate and compare the distance of optic-carotid (Triangle I) and carotid-oculomotor (Triangle II) triangles from internal aspect of pterion of both sides in cadaveric specimens using standardized pterional craniotomy techniques. METHODS: A cross-sectional cadaveric study was conducted on seven formalin embalmed adult specimens (14 sides of 3 males, 4 females) at a tertiary medical institution. Following standard pterional exposure, linear dimensions from internal aspect of pterion to proximity of the intracranial landmarks: (a) Optic-carotid triangle, (b) Carotid-oculomotor triangle, (c) Lateral border of optic nerve, (d) lateral border of optic canal were measured using digital callipers (± 0.01 mm precision). Statistical analysis included t-tests for comparisons of means. RESULTS: Distance for Triangle I from internal aspect of pterion demonstrated significant large value on left-sided than right side (54.14 ± 5.44 mm vs. 46.14 ± 5.30 mm; p = 0.002; Cohen's d = 1.49). Triangle II showed similar asymmetric distance for left and right side from internal aspect of pterion (56.00 ± 6.95 mm vs. 47.14 ± 4.78 mm; p = 0.002; Cohen's d = 1.47). Landmarks for optic nerve and optic canal exhibited bilateral symmetry (p > 0.05). No significant sex-based differences were observed across parameters. CONCLUSIONS: Significant large distance for left-sided neurovascular working triangles contrasts with symmetric nerve and bony landmarks, suggesting the need for subjective surgical planning in pterional approaches. These findings may have direct inferences for operative technique modification and surgical training.
Double vertebral artery-connected persisting proatlantal artery coexisting with a persisting carotid duct in an adult case: first evidence.
Rusu MC, Jianu AM, Grigoriţă LO … +1 more , Tudose RC
Surg Radiol Anat · 2026 May · PMID 42154230 · Full text
PURPOSE: The persistent proatlantal artery represents persistence of the embryonic first cervical intersegmental artery and creates a carotid-vertebral anastomosis. A persisting carotid duct is an exceptionally rare pers...
PURPOSE: The persistent proatlantal artery represents persistence of the embryonic first cervical intersegmental artery and creates a carotid-vertebral anastomosis. A persisting carotid duct is an exceptionally rare persistence of the dorsal aortic segment between the third and fourth aortic arches. It may be associated with segmental occlusion/stenosis of the proximal external carotid artery. METHODS: Archived computed tomography angiography files in a 62 year-old man were studied anatomically. RESULTS: A right-sided persisting carotid duct arising from the subclavian artery with short proximal ECA occlusion/stenosis and reconstitution of the distal ECA was found. A large type II PPA arose from the reconstituted ECA, formed a suboccipital loop giving rise to the occipital segment of the occipital artery, and established two distinct junctions with the vertebral artery: an anterior branch to the V3 segment near the posterior condylar foramen and an inferior branch to the V2 segment immediately before entry into the C1 transverse foramen. CONCLUSION: This configuration provides imaging evidence of a true 'double-connection' of a persisting proatlantal artery, coexisting with a persisting carotid duct and proximal external carotid occlusion/stenosis, with potential implications for carotid interventions and posterior-circulation haemodynamics.
Double insertion of superior oblique muscle of the eye: a rare variation.
Nayak SB, Ranade AV, Packirisamy V … +1 more , Vasudeva SK
Surg Radiol Anat · 2026 May · PMID 42154222 · Publisher ↗
Superior oblique muscle of the eye is involved in depression, abduction and intorsion of the eyeball. Knowledge of its variations is useful for understanding and repairing strabismus cases and other visual problems. We r...
Superior oblique muscle of the eye is involved in depression, abduction and intorsion of the eyeball. Knowledge of its variations is useful for understanding and repairing strabismus cases and other visual problems. We report a rare unilateral variation of right superior oblique muscle. The superior oblique muscle had a normal origin. However, it had two insertions. Its tendon passed through the fibrous trochlea and was inserted to the sclera in a usual manner. In addition, it had an additional insertion to the roof of the orbit through an aponeurosis. We also observed the encroachment of the roof of the orbit by the frontal and ethmoidal air sinuses. The knowledge of these variations could be important to ophthalmologists.
Microsurgical anatomy of the cerebral aqueduct and periaqueductal region: implications for microscopic and neuroendoscopic approaches.
Bilgin B, Yuncu ME, Karadag A … +2 more , Middlebrooks EH, Tanriover N
Surg Radiol Anat · 2026 May · PMID 42154090 · Publisher ↗
PURPOSE: The cerebral aqueduct (CA) is the narrowest part of the ventricular system, connecting the third and fourth ventricles. This structure is encircled by important neuroanatomical features, and with the increasing...
PURPOSE: The cerebral aqueduct (CA) is the narrowest part of the ventricular system, connecting the third and fourth ventricles. This structure is encircled by important neuroanatomical features, and with the increasing application of neuroendoscopic techniques, a comprehensive understanding of the anatomy of the CA is essential. This study aims to provide a comprehensive, multi-perspective anatomical analysis of the cerebral aqueduct and its surrounding structures, integrating microsurgical dissections with endoscopic anatomical correlations to support safer surgical planning. METHODS: Three formalin-fixed human brainstem specimens were prepared using the Klingler technique and microscopically dissected with a focus on the cerebral aqueduct. In addition, endoscopic exposure was simulated in two separate formalin-fixed cadaveric heads to correlate intraventricular landmarks with aqueductal anatomy. RESULTS: The CA is positioned ventromedially to the colliculi, which are located dorsal to the mesencephalon. The frenulum veli structure, which contains the crossing of the fourth cranial nerve, was observed inferior to the colliculi. The periaqueductal gray matter surrounds the CA dorsally and ventrolaterally on both sides. A region topographically corresponding to the oculomotor nuclear complex was approximated based on known anatomical relationships and the intramesencephalic course of cranial nerve III, without direct visualization. As the dissection progressed, the courses of the deep tracts ventral to the CA were demonstrated. The medial longitudinal fasciculus, the trigeminal mesencephalic tract, and the superior cerebellar peduncle were identified. Fibers of the central tegmental tract were observed running posterior to, and also traversing, the decussation of the superior cerebellar peduncle. CONCLUSIONS: The relationship of the CA with adjacent anatomical structures presents challenges to micro-endoscopic interventions of this region, necessitating a thorough understanding of the related anatomy.
Shaping anatomical theatre's teaching environment: Antonio Scarpa and the places of anatomy.
Trucas M, Armocida E, Cani V … +3 more , Vincis M, Barry D, Garbarino MC
Surg Radiol Anat · 2026 May · PMID 42113185 · Full text
PURPOSE: Antonio Scarpa (1752-1832) was an Italian anatomist who represented an important junction point between clinical and didactic anatomy and surgery. His discoveries and anatomical illustrations offer valuable insi...
PURPOSE: Antonio Scarpa (1752-1832) was an Italian anatomist who represented an important junction point between clinical and didactic anatomy and surgery. His discoveries and anatomical illustrations offer valuable insights that have contributed meaningfully to the development of modern medicine and anatomy. By combining his roles as physician, surgeon, and anatomist, he established himself as a respected figure among anatomists and medical specialists of his time. However, Scarpa's contribution to the development of spaces dedicated to anatomical teaching remains relatively overlooked. This study aims to highlight his influence on the evolution of institutions and environments where anatomy was taught and practised. METHODS: Through literature review and archival documents, we have obtained original data on the fact that Scarpa has always considered teaching, and its place as a fundamental component for the progress of anatomical sciences and not a marginal aspect. RESULTS: We have analysed the history of the places where he studied, taught, and gave an indelible imprint on anatomical theatres, which we inherit today in modern dissecting theatres. From our study, it emerges that Scarpa's ideas on how to disseminate anatomical knowledge were shaped by his experiences in Padua, Modena, and Pavia, places that played a meaningful role in refining his vision of anatomical education. At the same time, Scarpa himself contributed to transforming these institutions and their anatomical spaces, leaving a lasting mark on how anatomy was practised. CONCLUSIONS: The present work contributes to the historiography of anatomical education, offering new insights into the relationship between anatomical knowledge and its spatial contexts.
What is the optimum incision for superficial temporal artery biopsy? An anatomical study using body donors.
Vij O, Soon CY, Smith C … +3 more , Neil M, Fawcett S, Brassett C
Surg Radiol Anat · 2026 May · PMID 42095934 · Full text
PURPOSE: Superficial temporal artery (STA) biopsy remains an important diagnostic investigation for giant cell (temporal) arteritis. Incisions should optimise STA exposure while avoiding the temporal branch of the facial...
PURPOSE: Superficial temporal artery (STA) biopsy remains an important diagnostic investigation for giant cell (temporal) arteritis. Incisions should optimise STA exposure while avoiding the temporal branch of the facial nerve. However, the widely used Gillies incision, a 2 cm temporal incision 2.5 cm anterior and superior to the auricular helix within the hairline, has been shown to be inconsistent for STA access. METHODS: In this study of 20 hemifaces from 10 body donors (mean age 87.1; range 75-93; n = 3 females), STA branches were mapped using a Cartesian grid referenced to the anterior crus-lateral canthus axis. Four 2 cm incisions were modelled: Gillies, pre-auricular, and two novel algorithmically optimised incisions targeting frontal and parietal branches. Access was defined as incision-to-vessel distance of ≤ 0.5 cm or ≤ 1.0 cm. All donors had provided written consent for anatomical research under the Human Tissue Act 2004. RESULTS: The Gillies incision accessed the frontal branch in ≤ 1.0 cm in 11/20 (55%) and ≤ 0.5 cm in 3/20 (15%); parietal access was ≤ 1.0 cm in 8/19 (42%) and ≤ 0.5 cm in 4/19 (21%). Pre-auricular incision improved access: ≤ 1.0 cm for frontal 13/20 (65%) and parietal 18/19 (94.7%) branches. Optimised frontal and parietal incisions achieved ≤ 1.0 cm access in 19/20 (95%) and 18/19 (94.7%) respectively. CONCLUSION: Our findings suggest that the Gillies incision may not be a reliable approach for accessing the frontal or parietal branches of the STA. Pre-auricular and algorithmically optimised frontal and parietal incisions achieved high, branch-specific access but require clinical validation.
Splenic artery fenestration - a previously undescribed arterial variant.
Triantafyllou G, Arkoudis NA, Moschovaki-Zeiger O … +3 more , Velonakis G, Filippiadis DK, Piagkou M
Surg Radiol Anat · 2026 Apr · PMID 42053779 · Full text
PURPOSE: The splenic artery exhibits considerable morphological variability; however, true arterial fenestrations are exceedingly rare within the abdominal vasculature. We report a previously undocumented splenic artery...
PURPOSE: The splenic artery exhibits considerable morphological variability; however, true arterial fenestrations are exceedingly rare within the abdominal vasculature. We report a previously undocumented splenic artery fenestration identified on computed tomography angiography (CTA) in a 70-year-old male. ANATOMIC VARIATION: The artery followed an intrapancreatic course and demonstrated a true fenestration located 33.1 mm from its origin. The fenestrated segment consisted of a superior limb measuring 6.1 mm in diameter and an inferior limb measuring 6.1 mm, with distal reconstitution into a single lumen over a length of 15.4 mm. The finding was consistently visualized using multiplanar reconstructions and three-dimensional volume-rendered CTA images, without evidence of mural irregularity, intimal flap, or arterial dissection. CONCLUSIONS: Recognition of this rare arterial configuration is important for radiologists, surgeons, and interventionalists, as it may mimic arterial duplication or dissection and has potential implications for endovascular and surgical procedures involving the splenic artery.
Right non-bifurcating cervical carotid artery with a long-segment incomplete carotid bifurcation, a right accessory middle cerebral artery arising from a common trunk with a cortical branch at the distal A1 segment.
Liu B, Yao W, Zhang Y … +3 more , Wang K, Yang Q, Xu G
Surg Radiol Anat · 2026 Apr · PMID 42053778 · Publisher ↗
INTRODUCTION: Both non-bifurcating cervical carotid artery (NBCA) and accessory middle cerebral artery (aMCA) have been reported previously. Here, we report a rare case of right NBCA with a long-segment incomplete caroti...
INTRODUCTION: Both non-bifurcating cervical carotid artery (NBCA) and accessory middle cerebral artery (aMCA) have been reported previously. Here, we report a rare case of right NBCA with a long-segment incomplete carotid bifurcation, associated with a right aMCA arising from a common trunk with a cortical branch at the distal A1 segment. METHODS: The patient was a 70-year-old woman who was transferred to our department from another hospital for further evaluation and treatment after an anterior communicating artery aneurysm had been identified. No obvious neurological abnormalities were found on admission. Whole-brain angiography was performed via right transradial access. Contrast medium was selectively injected into the bilateral common carotid arteries and bilateral vertebral arteries. RESULTS: Cerebral angiography demonstrated an anterior communicating artery aneurysm, left subclavian artery stenosis, and basilar artery stenosis. In addition, multiple cerebrovascular variants were identified. On the right side, the NBCA gave rise to proximal branches of the external carotid artery (ECA) and continued distally as the internal carotid artery (ICA), with a fenestration-like configuration caused by a long-segment incomplete carotid bifurcation. The distal right A1 segment gave rise to an anomalous common trunk, which further divided into an AMCA and a cortical branch. Vascular measurements showed that the main limb of the fenestration-like structure was 32.49 mm in length with an average diameter of approximately 4.56 mm, whereas the side limb was 32.23 mm in length with an average diameter of 2.68 mm. After comprehensive risk assessment, only left subclavian artery stenting was performed during this hospitalization. The patient recovered well after the procedure, with no new neurological deficits at discharge. Follow-up DSA at 1 month demonstrated stent patency, and no new cerebrovascular events occurred during follow-up. CONCLUSION: We report an extremely rare case of multiple coexisting cerebrovascular variants involving the right carotid system, including an atypical right NBCA with a long-segment incomplete carotid bifurcation and a right aMCA arising from a common trunk with a cortical branch at the distal A1 segment. These atypical variants may provide additional insight into the developmental mechanisms of NBCA and aMCA and help further expand current understanding of cerebrovascular development and anatomy.
Occipital spur: a common but underreported finding on lateral cephalograms-an observational study.
M B, M S, S LK
Surg Radiol Anat · 2026 Apr · PMID 42053627 · Publisher ↗
BACKGROUND: Bony projections arising from the ligament, tendon, or joint capsule site rarely seen in radiographs are generally termed enthesophytes. One such incidental finding noted prevalently in cephalometric radiogra...
BACKGROUND: Bony projections arising from the ligament, tendon, or joint capsule site rarely seen in radiographs are generally termed enthesophytes. One such incidental finding noted prevalently in cephalometric radiographs of young individuals is occipital spurs or external occipital protuberance. The present study aims to assess the prevalence of occipital spurs in lateral cephalograms and correlate their type and shape with age and sex. MATERIAL AND METHODS: This retrospective observational study assessed the prevalence of occipital spurs in a sample of 986 lateral cephalograms. Two trained maxillofacial radiologists under the supervision of experienced maxillofacial radiologists classified the type and shape of occipital spurs according to age group and sex. Data were entered into an Excel sheet and then statistically analysed with a statistical significance set at a 95% confidence interval. RESULTS: Cohen’s kappa statistics revealed a strong inter- and intra-observer agreement (0.83 and 0.81, respectively). The prevalence of occipital spurs was 23.32%. Females exhibited longer occipital spurs and the smooth or flat spurs were most prevalent between both sexes. Analysis according to age group revealed that smooth type was commonly observed among all the assessed age groups. Additionally, the present study identified the presence of ossification of ligamentum nuchae (ONL) in 13 individuals. CONCLUSION: Occipital spurs are notable incidental findings on lateral cephalograms, particularly prevalent in younger age groups. The aetiology of these bony protrusions remains unclear. While often asymptomatic, understanding their potential for enlargement and associated clinical implications is crucial for appropriate patient management.
Morphometric and topographic analysis of the flexor carpi radialis tendon, its tunnel, and the median nerve: an MRI-based anatomical guide for wrist interventions.
Kaya S, Secgin Y, Senol D … +3 more , Harmandaoglu O, Ozturk O, Önbaş Ö
Surg Radiol Anat · 2026 Apr · PMID 42053581 · Publisher ↗
PURPOSE: This study aimed to evaluate the morphometric features of the flexor carpi radialis(FCR) tendon and its tunnel, and their topographical relationships, using wrist magnetic resonance(MR) images. METHODS: Axial MR...
PURPOSE: This study aimed to evaluate the morphometric features of the flexor carpi radialis(FCR) tendon and its tunnel, and their topographical relationships, using wrist magnetic resonance(MR) images. METHODS: Axial MR images of 190 individuals aged 18–45 years (95 women and 95 men) were retrospectively analysed. Measurements included distances of the FCR tendon to the radial artery (RA), ulnar artery (UA), median nerve (MN), and scaphoid; trapezium tubercle dimensions; FCR tunnel angle, area, and retinacular thicknesses; retinaculum bending ratio; FCR tendon–to–MN area ratio; and FCR tunnel–to–carpal tunnel ratios. The topographic relationship between the FCR tendon and MN was assessed at the levels of the FCR tunnel and pisiform. Positions of the MN and other tendons in the carpal tunnel were also recorded. RESULTS: The mean FCR tunnel area was 8990 ± 2238 mm2 in males and 7979 ± 1792 mm2 in females. Significant sex-related differences were identified in the distances of the FCR to the RA, UA, and MN, as well as in tunnel areas (p < 0.05). Right–left comparisons revealed significant differences in the distances of the FCR to the scaphoid, UA, and MN, in the FCR tunnel area, and in retinacular thickness above and below the tunnel (p < 0.05). Variations were observed in the structures between the FCR tendon and MN, and in MN positioning relative to other tendons. CONCLUSION: The findings may provide an anatomical guide to how FCR-region variations influence invasive procedures, particularly in conditions such as carpal tunnel syndrome and FCR tendinopathy, considering sex and laterality.
Anatomical variability of the lingual artery: a comprehensive narrative review with clinical and surgical applications.
Dincă V, Calotă RN, Hostiuc S … +3 more , Tudose RC, Varga I, Rusu MC
Surg Radiol Anat · 2026 Apr · PMID 41975105 · Full text
BACKGROUND: The lingual artery (LA) provides primary blood supply to the tongue and floor of the mouth. Precise anatomical knowledge is essential for head and neck surgery and neurointervention to prevent haemorrhage, li...
BACKGROUND: The lingual artery (LA) provides primary blood supply to the tongue and floor of the mouth. Precise anatomical knowledge is essential for head and neck surgery and neurointervention to prevent haemorrhage, lingual necrosis, or non-target embolisation. OBJECTIVES: This comprehensive narrative review synthesises current evidence on LA anatomy, variations, and clinical significance whilst critically appraising methodological limitations across the literature. METHODS: A literature search of PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar was conducted from database inception to 15 May 2025. Studies addressing LA anatomy, morphometry, variants, and clinical applications were qualitatively assessed for methodological quality. RESULTS: The LA typically originates from the external carotid artery at the greater horn of the hyoid bone and courses deep to the hyoglossus muscle. Common arterial trunks represent the most prevalent variants: linguofacial trunk (16–25%), thyrolingual trunk (0.3–3.3%), and thyrolinguofacial trunk (~ 1%). The hypoglossal nerve serves as a reliable surgical landmark, with the LA located inferior to or contacting the nerve in approximately 85% of cases. Dynamic topographic studies demonstrate that tongue extension and surgical retraction significantly alter vessel position, narrowing the midline safety corridor. CTA data suggest tongue extension reduces LA depth beneath the lingual surface by approximately 4 mm (27.9 ± 3.2 mm to 24.0 ± 2.7 mm at foramen cecum level) and decreases bilateral LA distance by approximately 6 mm (20.1 ± 3.1 mm to 13.9 ± 3.2 mm). Critical analysis revealed substantial inconsistencies in prevalence rates for cervical triangles, internal numerical discrepancies in foundational studies, absence of systematic bilateral assessment, and potential non-independence across sequential publications. CONCLUSIONS: Mastery of LA anatomy is indispensable for safe surgical practice. However, clinicians should interpret prevalence data cautiously given methodological limitations, small sample sizes, and potential sample overlap. Future studies with rigorous bilateral assessment and diverse populations are warranted.
Bifid mandibular canals: anatomical variations and morphometric analysis based on a modified CBCT classification.
Türker N, Kucuk Kurtgoz M, Cecen Erol E … +1 more , Aktuna Belgin C
Surg Radiol Anat · 2026 Apr · PMID 41973131 · Publisher ↗
PURPOSE: Anatomical variations of the mandibular canal may increase complication risk during surgical and prosthetic procedures. This study aimed to evaluate the prevalence, subtypes, and morphometric characteristics of...
PURPOSE: Anatomical variations of the mandibular canal may increase complication risk during surgical and prosthetic procedures. This study aimed to evaluate the prevalence, subtypes, and morphometric characteristics of bifid mandibular canals (BMCs) in the Hatay subpopulation using a modified classification system. METHODS: Cone beam computed tomography (CBCT) images of 500 patients aged 18–85 years were retrospectively analyzed and evaluated by an experienced oral and maxillofacial radiologist. Patient age, sex, and the presence of BMCs were recorded. BMCs were classified into five morphological subtypes and further categorized according to their origin and termination. Canal length, diameter, and minimum distance to the mandibular cortex were measured. RESULTS: BMCs were identified in 182 of 500 patients (36.4%). No significant differences were observed according to sex, age, or side distribution. The anterior type was the most prevalent (42.1%) and exhibited the greatest mean canal length (22.65 mm). In the posterior region, the dental type BMC was more common in fully and partially dentate patients, whereas the NA type predominated in edentulous individuals. The largest canal diameter was identified in the retromolar type (2.12 mm). CONCLUSION: CBCT is a reliable tool for identifying BMC subtypes and their morphometric features. An origin- and termination-based classification improves anatomical understanding and contributes to safer surgical and prosthetic procedures by facilitating the prediction of potential complications.
The relationship between anthropometric measurements and coronary flow models: morphofunctional assessment using thrombolysis in myocardial infarction frame counting.
Tahta Y, Nisari M, Akkaya H … +1 more , Şahingöz Tahta M
Surg Radiol Anat · 2026 Apr · PMID 41945155 · Publisher ↗
PURPOSE: This study aims to compare Coronary Slow Flow (CSF) with Coronary Normal Flow (CNF) and CSF in Thrombolysis in myocardial infarction (TIMI) frame count results using anthropometric measurements. MATERIALS AND ME...
PURPOSE: This study aims to compare Coronary Slow Flow (CSF) with Coronary Normal Flow (CNF) and CSF in Thrombolysis in myocardial infarction (TIMI) frame count results using anthropometric measurements. MATERIALS AND METHODS: The study was performed in 78 subjects with CSF and 72 with CNF on coronary angiography according to the inclusion criteria. In our study, 66.7% of the individuals with CSF were male and the mean age was 52.62 ± 11.23 years. RESULTS: In our study, 88.1% of obese individuals had CSF and 75.8% of normal weight individuals had CNF. The mean scores of weight, body mass index (BMI), Neck Circumference (NC), Neck Length (NL), Neck Heingt/Neck Circumference Rate (NL/NC), Upper Chest Circumference (UCC), Waist Circumference (WC), Saggital Waist Height (SWH), Triceps Skinfold Thickness (TTS) Subscapular Skinfold Thickness (SST), Femur Diameter (FD), Humerus Diameter (HD) and Waist Circumference/Height Rate (WC/H rate) were higher in individuals with CSF than in individuals with CNF and the difference between the groups was statistically significant (p < 0.05). In the TIMI frame count results, CSF was detected in the ACS coronary artery in 76.9% and in three coronary arteries in 19.2% of the individuals. CONCLUSION: The mean weight, BMI, NC, WC, HC, SWH, TTS, SST, FD and HD scores of individuals with CSF in three coronary arteries in TIMI frame count results were significantly higher than those without CSF (p < 0.05). Anthropometric measurements such as weight, BMI, NC, NL/NC, UCC, WC, HC, SWH, TTS, SST, FD, HD and WC/H rate may be predictors of CSF.
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 Apr · PMID 41945113 · Full text
PURPOSE: The extensor muscles of the hand play a crucial role in thumb and finger movement. Thumb extension is primarily mediated by the extensor pollicis longus muscle and extensor pollicis brevis muscle, and extension...
PURPOSE: The extensor muscles of the hand play a crucial role in thumb and finger movement. Thumb extension is primarily mediated by the extensor pollicis longus muscle and extensor pollicis brevis muscle, and extension of the index finger is facilitated by the extensor indicis muscle and extensor digitorum muscle. This report describes a rare anatomical variation, the extensor pollicis et indicis accessorius, in which a single tendon bifurcated to insert on both the index finger and thumb. METHODS: This variation was identified bilaterally during routine dissection of a 92-year-old female donor. The donor had been embalmed with a formaldehyde-based fixation method. RESULTS: On each side, an accessory extensor pollicis et indicis accessorius muscle was present in the deep posterior compartment of the forearm, giving rise to a single tendon that bifurcated distally to insert on both the dorsal aspect of the thumb and the dorsal expansion of the index finger. Measurements of the extensor pollicis et indicis accessorius muscle were not significantly different. Several case studies have documented the existence of such anomalies, but bilateral descriptions are rare. CONCLUSION: Historical and contemporary sources differ in defining extensor pollicis et indicis accessorius. Based on a comprehensive literature review and the present bilateral anatomical finding, this report recommends using the term extensor pollicis et indicis accessorius muscle for this configuration and proposes revising existing classification systems to include accessory extensor muscles originating from the extensor pollicis longus muscle, the extensor indicis muscle, or the ulna, rather than limiting them to extensor pollicis longus muscle anomalies.
The Körner septum as a reliable reference point in temporal bone surgery: clinical-morphometric relationship with the facial nerve and surrounding structures.
Kamar Z, Kalaycı D, Koyuncu E … +4 more , Yakabağı MB, Tuğtağ Demir B, Akduman D, Bilecenoğlu B
Surg Radiol Anat · 2026 Apr · PMID 41940990 · Publisher ↗
PURPOSE: The Körner septum (KS) represents a critical anatomical pitfall that may mimic the medial wall of the antrum, potentially leading to surgical disorientation and iatrogenic injury. This study aims to quantify its...
PURPOSE: The Körner septum (KS) represents a critical anatomical pitfall that may mimic the medial wall of the antrum, potentially leading to surgical disorientation and iatrogenic injury. This study aims to quantify its prevalence and topographical variations while evaluating the morphometric impact of its presence on vital temporal bone landmarks to enhance surgical safety. METHODS: The study included CT images of 942 temporal bones which were divided into two groups according to KS presence; KS + cases were further subdivided according to anatomical localization (malleus head, superior semicircular canal, and tympanic sinus levels). Mastoid pneumatization (MP) and mastoid antrum (MA) volumes as well as linear distances of the KS to the malleus, facial nerve canal, and Cog were measured. RESULTS: KS prevalence was 39.6% and was uninfluenced by sex or laterality. It was most prevalent at the level of the HM (54.2%), followed by the SSC (27.3%) and TS (18.5%). Although most parameters, including MP and MA volumes, tubotympanic angle, Eustachian tube length, and distances to key surgical landmarks, showed no significant difference between the three localizations, a significant difference was found in KS thickness (p-value < 0.05. Despite reassuring mean values, extreme anatomical configurations revealed critical risk corridors as narrow as 2.14 mm, underscoring the necessity of individualized radiological mapping. CONCLUSION: Our results demonstrate that the KS should not merely be regarded as an anatomical variant but as a radiologically quantifiable surgical landmark defining critical safety corridors in mastoid surgery.
The persistent proatlantal artery: types and subtypes.
Rusu MC, Tudose RC, Vrapciu AD
Surg Radiol Anat · 2026 Apr · PMID 41940960 · Full text
BACKGROUND: The persistent proatlantal artery (PPA) is the most caudal of the four persistent carotid–vertebrobasilar anastomoses and is frequently misclassified because “Type I/Type II” terminology variably reflects art...
BACKGROUND: The persistent proatlantal artery (PPA) is the most caudal of the four persistent carotid–vertebrobasilar anastomoses and is frequently misclassified because “Type I/Type II” terminology variably reflects arterial origin and/or cervical course. OBJECTIVE: To synthesise embryology, imaging criteria, and clinically relevant PPA variants, and to harmonise nomenclature including Cohen’s Type II “spinal” and “occipital” subtypes. METHODS: A Scale for the Assessment of Narrative Review Articles (SANRA)-guided narrative review of PubMed/MEDLINE and Google Scholar (inception to February 2025) was performed. Data extracted included origin (internal carotid artery, external carotid artery [ECA], or common carotid artery), relationship to the C1 transverse foramen, vertebral artery (VA) status, occipital artery (OA) incorporation, and procedural relevance. An illustrative computed tomography angiography (CTA) index case was included. RESULTS: Evidence is dominated by case reports and small series. PPA is very uncommon (reported incidence ~ 0.01% in multi-slice CTA cohorts) and often accompanies ipsilateral VA hypoplasia/aplasia, sometimes providing the dominant posterior fossa supply. Course-forward interpretation distinguishes canonical Type I suboccipital pathways from Type II ECA/occipital-system pathways, including “occipital” Type II channels that bypass transverse foramina and can mimic Type I. In the index case, a 73-year-old woman had an ECA-origin Type II (occipital subtype) PPA that gave rise to the OA and continued as the extracranial VA before entering the skull via the foramen magnum. CONCLUSION: Standardised, course-based reporting, explicitly documenting origin, transverse foramen traversal, and posterior circulation dependence, reduces diagnostic ambiguity and supports safer planning for ECA interventions, carotid endarterectomy, and craniovertebral junction/skull-base surgery.
Hepatic arterial variants on CT angiography: applicability and coverage of the CRL classification system.
Taşkındere Abbasoğlu T, Paslı B, Yücedağ Gündoğdu H … +2 more , Karçaaltıncaba M, Fırat A
Surg Radiol Anat · 2026 Apr · PMID 41934519 · Publisher ↗
PURPOSE: Hepatic arterial anatomy exhibits considerable variability with important implications for hepatobiliary surgery, transplantation, and interventional procedures. This study aimed to evaluate hepatic arterial ana...
PURPOSE: Hepatic arterial anatomy exhibits considerable variability with important implications for hepatobiliary surgery, transplantation, and interventional procedures. This study aimed to evaluate hepatic arterial anatomy using the CRL classification system and to assess its applicability and coverage on computed tomography angiography (CTA), with particular emphasis on rare variants. METHODS: A total of 803 abdominal CTA examinations were retrospectively assessed. Hepatic arterial anatomy was categorized according to the CRL classification system based on the origin of the common, right, and left hepatic arteries. The frequency and distribution of each type and subtype were analyzed, and unclassifiable cases were described separately. RESULTS: The most common arterial configuration was Type 1 (standard anatomy), identified in 65.0% (n = 522) of cases. Branching patterns were observed in the remaining cases, with replaced right hepatic artery from the superior mesenteric artery and replaced left hepatic artery from the left gastric artery representing the most frequent variants. Overall, the CRL classification system demonstrated a high classification coverage of 99.5%, with only four cases (0.5%) remaining unclassifiable due to complex arterial configurations. CONCLUSION: The CRL classification system provides a comprehensive and practical framework for evaluating hepatic arterial anatomy using CTA. Its high coverage rate supports its clinical utility in hepatobiliary surgery and transplantation, while the presence of rare unclassifiable patterns suggests potential refinement with additional combination types.
Microsurgical anatomy of the corpus callosum: a fiber microdissection, tractography and illustrative study.
Ülkü G, Elbir Ç, Demirtaş OK … +10 more , Tubbs RS, Yazgan P, Çeltikçi E, Alpergin BC, Dolgun H, Doğulu F, Aykol Ş, Pamir MN, Beger O, Güngör A
Surg Radiol Anat · 2026 Apr · PMID 41934516 · Publisher ↗
OBJECTIVE: The corpus callosum (CC) is the largest commissural white matter structure in the human brain, responsible for interhemispheric communication. Despite its clinical significance in neurosurgical procedures, det...
OBJECTIVE: The corpus callosum (CC) is the largest commissural white matter structure in the human brain, responsible for interhemispheric communication. Despite its clinical significance in neurosurgical procedures, detailed anatomical studies of its fiber organization remain limited. The aim of this study was to investigate the fiber architecture and topography of the CC through combined microsurgical dissection, tractography, and illustrative analysis. METHODS: Ten formalin-fixed adult human brains (20 hemispheres) were prepared using Klingler’s method. Fiber dissections were performed under an operating microscope in medial-to-lateral, superior-to-inferior, and lateral-to-medial orientations. High-resolution diffusion data from the Human Connectome Project were used for tractographic validation via DSI Studio. The findings were further supported by schematic illustrations. RESULTS: Dissection revealed a three-layered organization of callosal fibers: dorsal, intermediate, and ventral layers. Dorsal fibers connected homotopic cortical areas, particularly the motor and premotor cortices. Intermediate fibers projected toward the corona radiata and internal capsule. Ventral fibers included tapetal connections and fibers linking subcortical structures such as the caudate nuclei. Additionally, we identified accessory callosal bundles and cingular-splenial fibers, which have seldom been emphasized in the previous literature. Tractographic results confirmed the trajectories and lamination patterns observed during dissection. CONCLUSION: Our integrative analysis provides a comprehensive educational depiction of corpus callosum lamination and topography. These findings should enhance anatomical understanding and inform neurosurgical approaches, particularly in callosotomy and transcallosal tumor surgery. Further studies are needed to explore the functional and clinical implications of these anatomical subdivisions.
Radioanatomical study of the proximity of the sciatic nerve and the pelvic bone.
Ollivier I, Koch G, Ludes G … +3 more , Dannhoff G, Clavert P, Garnon J
Surg Radiol Anat · 2026 Apr · PMID 41934510 · Publisher ↗
PURPOSE: Percutaneous thermal ablation of pelvic bone tumours carries a risk of iatrogenic injury to the sciatic nerve. This study aimed to determine the proximity of the sciatic nerve to the iliac bone as it exits the p...
PURPOSE: Percutaneous thermal ablation of pelvic bone tumours carries a risk of iatrogenic injury to the sciatic nerve. This study aimed to determine the proximity of the sciatic nerve to the iliac bone as it exits the pelvis and evaluate its anatomical variability. METHODS: This retrospective, non-interventional study reviewed consecutive MRI scans of the lumbar spine performed at our institution between September and October 2021. Two experienced musculoskeletal radiologists independently measured the shortest distance between the sciatic nerve and the adjacent bone at six predefined levels on coronal T2-weighted images: 1.5 cm above the acetabulum; at the acetabular roof; at the femoral head apex; at the fovea; at the acetabular notch; and at the ischio-pubic ramus apex. The nature of the interposed tissue and the anatomical variant of the sciatic nerve (according to the Beaton and Anson classification) were also recorded. RESULTS: Ninety-six patients (192 sides) were included. The sciatic nerve was found to be closest to the bone at the femoral head apex (mean distance: 1.48 mm [95% CI: 1.11–1.86]), with no interposed tissue present in 53.1% of cases. The greatest nerve-to-bone distance was observed at the ischio-pubic ramus (mean distance: 16.42 mm [95% CI: 15.59–17.25]), where hamstring tendon interposition was present in 97.4% of cases. Anatomical variants (Beaton type B) were identified in 14.1% of hips but were not associated with greater nerve-to-bone proximity except at a distance of 1.5 cm above the acetabulum (p = 0.021). Inter- and intra-observer reliability were good to excellent. CONCLUSION: The sciatic nerve is most vulnerable to thermal injury at the femoral head apex, where it lies within 1.48 mm of the greater sciatic notch and there is no interposed tissue in over half of cases. These findings suggest that hydrodissection may be technically challenging at this level and should be carefully planned during pelvic thermoablation procedures.
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