Surgical And Radiologic Anatomy[JOURNAL]
Sun
200 papers
Microsurgical approaches to the pineal region: anatomic and radiological principles based on the characteristics of the neurovascular structures.
Yuncu ME, Bilgin B, Sevgi UT … +5 more , Camlar M, Cevik OM, Bozkurt B, Middlebrooks EH, Karadag A
Surg Radiol Anat · 2026 Jan · PMID 41609897 · Publisher ↗
BACKGROUND: The pineal region presents considerable challenges for neurosurgical interventions owing to its deep anatomical location and the intricate network of critical neurovascular structures that encase it. The capa...
BACKGROUND: The pineal region presents considerable challenges for neurosurgical interventions owing to its deep anatomical location and the intricate network of critical neurovascular structures that encase it. The capacity to conduct effective and safe neurosurgical procedures in this area necessitates a comprehensive understanding of anatomical variations. This study aims to conduct an in-depth analysis of radiologic measurements pertinent to accessing the pineal region, alongside their supported by qualitative cadaveric dissections. METHODS: The supracerebellar infratentorial (SCIT) approach, occipital transtentorial (OT) approach, and posterior interhemispheric (PIH) approach were performed on four cadaveric heads (eight sides). All dissections were performed with the head positioned to simulate the orientation employed in the operating room. Magnetic resonance imaging (MRI) scans from 50 male to 50 female patients were also retrospectively assessed. Descriptive statistics were presented for the quantitative data. RESULTS: MRI analysis of 100 adult subjects revealed a mean tentorial angle of 31.5° (range: 14.4–47.7°), indicating substantial anatomical variability. Measurements from external landmarks to the pineal gland and tentorium were quantified to assist in surgical planning. The Torcular Herophili was found to exhibit variable vertical positioning, and its distance from the inion was measured radiologically. These findings were categorized into distinct morphometric types based on tentorial inclination and torcular location. Cadaveric dissections were performed in surgical positions simulating SCIT, OT, and PIH approaches, and were used to qualitatively illustrate key anatomical corridors. Each dissection demonstrated the spatial relationships among the tentorium, splenium, deep venous system, and surrounding neurovascular structures, consistent with the anatomical context of the radiologic measurements. CONCLUSION: In neurosurgical practice, a lesion’s location is a critical determinant in selecting the approach for addressing pineal region lesions, given the complex microsurgical anatomy and deep positioning of these structures. Additionally, conducting thorough radiologic examinations during the preoperative phase is essential in informing the choice of surgical approach. We posit that employing radiologic measurements and identifying vascular variations will lead to reduced complication rates.
The similarities and differences among the cerebral perforating arteries, and their clinical implications.
Djulejić V, Valjarević S, Damjanović G … +3 more , Milić I, Maliković A, Marinković S
Surg Radiol Anat · 2026 Jan · PMID 41609883 · Publisher ↗
PURPOSE: Our hypothesis was that some differences exist among the corresponding groups of the perforating arteries (PAs), which could have important implications in radiology, neurology, and neurosurgery. To test the hyp...
PURPOSE: Our hypothesis was that some differences exist among the corresponding groups of the perforating arteries (PAs), which could have important implications in radiology, neurology, and neurosurgery. To test the hypothesis, we performed a detailed study of these vessels. METHODS: The vasculature of 22 cerebral hemispheres was injected with a 10% India ink and gelatin. After fixation, all the perforators were microdissected under the stereoscopic microscope. The PAs territories were examined as much as possible. The remaining 4 hemispheres were injected with methylmethacrylate to obtain the vascular casts. KEY FINDINGS: The PAs are very rarely absent on one side (7.8%, and 11.6%; p < 0.01). They range from 0 to 12 in number (mean, 3.22), and between 0.06 and 1.32 mm in diameter (mean, 0.31 mm) (p = 0.022 each). They originate from the parent arteries (46.2-100.0%), either solely or by common stems (0.0-65.4%), or along with certain pial vessels (0.0-69.3%), with significant correlation among them (p < 0.029, p = 0.001, p = 0.038). Larger and smaller PAs are distinguished. An occlusion of the larger common stems could cause a massive central hemispheric, or a larger thalamic or paramedian brain stem infarction, associated with certain symptoms and neurologic signs. An obturation of both PAs and pial arteries could result in a combined deep and peripheral ischemia. The smaller PAs mostly nourish the hypothalamus and optic structures. Close proximity of the PAs and aneurysms or arteriovenous malformations could complicate surgical or endovascular interventions. CONCLUSION: Knowledge of the PAs microanatomic similarity and differences, including their supplying regions, can help in understanding neurologic signs following their occlusion. This is also important in neuroradiologic diagnostics, and for safe neurosurgical and endovascular interventions.
Right anterior inferior cerebellar artery supplied by the hypoglossal branch of the ascending pharyngeal artery diagnosed by magnetic resonance angiography.
Sato H, Uchino A, Kobayashi S … +1 more , Baba Y
Surg Radiol Anat · 2026 Jan · PMID 41609851 · Publisher ↗
PURPOSE: To report the first documented case of an enlarged hypoglossal branch of the ascending pharyngeal artery (APA) traversing the hypoglossal canal and continuing to the anterior inferior cerebellar artery (AICA). M...
PURPOSE: To report the first documented case of an enlarged hypoglossal branch of the ascending pharyngeal artery (APA) traversing the hypoglossal canal and continuing to the anterior inferior cerebellar artery (AICA). METHODS: Magnetic resonance imaging (MRI), including extracranial and intracranial magnetic resonance angiography (MRA), was performed for the evaluation of suspected cerebrovascular disease in a 58-year-old man presenting with acute-onset right hemianopsia. The examinations were performed using a 3-Tesla scanner, and intracranial MRA was performed using a standard 3-dimensional time-of-flight technique. RESULTS: MRA demonstrated an enlarged right APA entering the hypoglossal canal and continuing to the AICA. The right vertebral artery was hypoplastic and continued to the posterior inferior cerebellar artery. CONCLUSION: We report the first documented case of continuity between the APA traversing the hypoglossal canal and the AICA. A meticulous review of MRA source images and the creation of maximum-intensity-projection and partial volume-rendering images are useful for the reliable recognition of this variation.
Aberrant right posterior hepatic artery originating from the gastroduodenal artery with a concomitant replaced left hepatic artery: a rare clinical variant.
Reis ME, Angın YS, Ulfanov O … +3 more , Ulaş M, Kılıç M, Gündoğdu E
Surg Radiol Anat · 2026 Jan · PMID 41609845 · Full text
Variations in the hepatic arterial system, observed in up to 22% of the population, significantly influence the outcomes of hepatobiliary and pancreatic procedures. This study describes an extremely rare variant involvin...
Variations in the hepatic arterial system, observed in up to 22% of the population, significantly influence the outcomes of hepatobiliary and pancreatic procedures. This study describes an extremely rare variant involving an aberrant right posterior hepatic artery (aRPHA) originating from the gastroduodenal artery (GDA) alongside a replaced left hepatic artery (LHA). Awareness of such variants is critical during pancreaticoduodenectomy to prevent ischemic complications.
Letter to the editor "Total colonic supply via the inferior mesenteric artery".
Barone V, Bracco S, Bertelli E
Surg Radiol Anat · 2026 Jan · PMID 41571863 · Publisher ↗
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Evaluating fluctuating and directional asymmetry in postnatal petrous bone growth: a 3D morphometric study.
Bourgoin M, Landais P, Subsol G … +1 more , Captier G
Surg Radiol Anat · 2026 Jan · PMID 41555047 · Publisher ↗
PURPOSE: The objective was to assess fluctuating asymmetry (FA) and directional asymmetry (DA) of the petrous bone (PB) and the petromastoid V (PMV) in children using 3D morphometric data. METHODS: CT scans of normal chi...
PURPOSE: The objective was to assess fluctuating asymmetry (FA) and directional asymmetry (DA) of the petrous bone (PB) and the petromastoid V (PMV) in children using 3D morphometric data. METHODS: CT scans of normal children (0 to 30 months) were included. After segmentation, the geometric characteristics were calculated (volume, three inertial semi-axes (ISA), centroid, distance, angle). The FA and DA were studied according to stages of postural development and sex. RESULTS: 116 CT scans were studied (70 boys, 46 girls). The two sides of the PB and PMV were symmetric (FA between 1.87% and 3.01%). PB volumes showed FA along the stages of postural development (p = 0.034) and were sex-independent. No FA was found for the 3D shape of the PB, but there was a DA for the 3rd ISA of the right side (p = 0.017). The FA of the PMV was greater in boys. A DA of the PMV (p = 1.17 e−11) (distance from the CS = left > right) was present in boys regardless of the stages of postural development. CONCLUSION: Changes in posture did not influence PB and PMV geometry and symmetry. However, a FA appeared in PB volume. Moreover, we highlighted a right DA for PB and PMV.
Anatomical variability of the corticospinal decussation: a diffusion tensor imaging study.
Ribault N, Lemée JM, Codron P … +2 more , Fournier HD, Bernard F
Surg Radiol Anat · 2026 Jan · PMID 41555003 · Publisher ↗
PURPOSE: The corticospinal tract (CST) is a well-known white matter tract of the motor projection described by Hippocrates. The morphological anatomical decussation has not been specifically studied using tractography. W...
PURPOSE: The corticospinal tract (CST) is a well-known white matter tract of the motor projection described by Hippocrates. The morphological anatomical decussation has not been specifically studied using tractography. We aim to investigate the anatomy and variability of the CST decussation in healthy patients using high-resolution tractography technique. METHODS: MRI data from the Human Connectome Project were acquired on a modified 3T scanner with 64-channel coil. Image data from 35 subjects were processed using Freesurfer and FSL. A 2 ROI approach was used to identify each CST in each diffusion MRI. CST deccusation types, variations and localization were analyzed. RESULTS: Pyramidal decussation was visible in 32 patients. There was no difference between right and left CST characteristics. Three patterns of pyramidal decussation were identified. In 56,2% of patients the CST decussation was a crossing (i.e. with fibers entanglement) of left and right CSTs fibers. In 40,6% of patients the CSTs did not cross but rotated around each other without entanglement. In one case, the CST did not cross the midline. In one case, the right CST completely crossed the midline. CONCLUSION: CST decussation is variable in its organization: complete versus partial crossing, rotation vs. crossing. It may have some significance in rare clinical conditions. Clinical and embryological implications are discussed.
Comment on ''The zygomatico-orbital artery: anatomical study of zygomatico-orbital artery: implication for eyelid reconstruction and improving the safety of temporal augmentation''.
Yücedağ Gündoğdu H, Paslı B
Surg Radiol Anat · 2026 Jan · PMID 41533084 · Publisher ↗
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A novel division of the nasalis muscle of face with special reference to the elastic fiber-mediated insertion: a cadaveric study.
Kitamura K, Kim JH, Hirano-Kawamoto A … +4 more , Katori Y, Murakami G, Abe SI, Yamamoto H
Surg Radiol Anat · 2026 Jan · PMID 41530581 · Publisher ↗
PURPOSE: The nasalis muscle of face is known to comprise of two divisions: the transverse and alar parts. We aimed to describe the novel or third division of the nasalis with special reference to the specific muscle atta...
PURPOSE: The nasalis muscle of face is known to comprise of two divisions: the transverse and alar parts. We aimed to describe the novel or third division of the nasalis with special reference to the specific muscle attachment to elastic fiber-rich tissues. METHODS: The nasalis was histologically examined in 20 elderly cadavers. RESULTS: The third division was seen in all 20 cadavers examined. The muscle fibers arose from (1) submucosal tissues at the mucocutaneous junction between the vestibule and nasal cavity and (2) the greater alar cartilage and it inserted to the subcutaneous tissue of the external skin of the nasal ala. Notably, at the origin, elastic fibers connected the endomysium to the cartilage matrix. Along the lateral course, the third division muscle fibers crossed and interdigitated with the alar part of nasalis. Thus, in contrast to the classically described nasalis, the third division connected between the nasal mucocutaneous junction and external skin. In the subcutaneous tissue, each of the muscle fibers inserted into a lattice comprising of thick collagen fiber bundles and elastic fibers crossing each other at an almost right angle. A site-dependent difference in submucosal and subcutaneous tissues was also demonstrated. CONCLUSION: The elastic fiber-mediated muscle insertion was reported in the middle ear against vibration. The origin or insertion of the third division of nasalis seemed to be specialized possibly for adjusting the working distance when the nasal alar skin is pushed, pinched or bent. It was a proper nasal subcutaneous muscle without bony attachments.
Anatomical analysis of maxillary third molars with cone-beam computed tomography: implications for autotransplantation operation.
Xiang M, Sun Y, Hong S … +4 more , Yan Y, Ge Q, Wu Q, Feng B
Surg Radiol Anat · 2026 Jan · PMID 41530525 · Publisher ↗
PURPOSE: Maxillary third molars (MTMs) are frequently utilized as donor teeth in autogenous tooth transplantation (ATT). This study aimed to characterize and grade MTMs' CBCT features to inform ATT operation. METHODS: Th...
PURPOSE: Maxillary third molars (MTMs) are frequently utilized as donor teeth in autogenous tooth transplantation (ATT). This study aimed to characterize and grade MTMs' CBCT features to inform ATT operation. METHODS: This retrospective CBCT analysis evaluated 800 MTMs from 537 patients regarding tooth morphology, root canal configuration, and impaction status. A CBCT-based binary complexity grading for MTM autotransplantation was established, and its clinical relevance to the operative difficulty of ATT and its adjunctive procedures (root canal treatment, RCT) was analyzed in 26 ATT cases using both a subjective five-point scale and operation time. RESULTS: Predominant characteristics of MTMs included: 1-rooted morphology (65.63%), Vertucci's Type-I canal configuration (76.17%), root canal curvature 10°-30° (35.44%), and non-impaction status (77.75%). Mean root length was 10.66 ± 1.56 mm, canal length 16.95 ± 1.79 mm, crown-to-root ratio 1:1.8, and maximum root cross-sectional area (CSA) 60.21 ± 13.08 mm. Significant clinical relevance (p < 0.05) was found between atraumatic tooth extraction and root number, impaction direction, and depth of MTMs; between recipient-site preparation and cervical buccolingual width, mesiodistal width, root number, and maximum root CSA; between RCT and the canal configuration and curvature; and between ATT operation time and impaction depth and root number. CONCLUSIONS: MTM CBCT characteristics exhibit significant anatomical variation and are relevant to ATT complexity. The CBCT-based binary complexity grading for MTM autotransplantation predicts procedural difficulty and would facilitate comprehensive preoperative evaluation for ATT.
Arterial variation relevant to transfemoral transcatheter aortic valve replacement (TF-TAVR): a cadaveric and literature based analysis.
Heins RJ, Konstanty J, Morehouse J … +2 more , Hodge T, Sloan SS
Surg Radiol Anat · 2026 Jan · PMID 41530497 · Publisher ↗
PURPOSE: Transfemoral transcatheter aortic valve replacement (TF-TAVR) is the preferred vascular access route for aortic valve implantation, but procedural success is highly dependable on iliofemoral vascular anatomy. Th...
PURPOSE: Transfemoral transcatheter aortic valve replacement (TF-TAVR) is the preferred vascular access route for aortic valve implantation, but procedural success is highly dependable on iliofemoral vascular anatomy. This study aimed to directly assess anatomic risk factors for TF-TAVR using cadaveric dissection and highlight their relevance in the context of imaging-based literature. METHODS: Thirty-two formalin-embalmed cadavers (64 limbs) were dissected to assess luminal diameters of the common femoral (CFA), external iliac (EIA), and common iliac arteries (CIA). Anatomical configurations of the femoral triangle, bifurcation patterns of the CFA, atherosclerotic burden, and sheath-to-artery ratios (SFAR, SEIAR, SCIAR) for 14–18 F sheath sizes were recorded. RESULTS: High CFA bifurcation and posteriorly originating deep arteries of the thigh (DAT) were present in 39.1% and 57.8% of limbs, respectively. Mean diameters were 8.44 ± 1.75 mm for the CFA, 7.90 ± 1.55 mm for the EIA, and 9.53 ± 1.97 mm for the CIA. SFAR and SEIAR values increased with sheath size, reaching high-risk thresholds (≥ 1.05) in up to 19.4% of cadavers for SFAR and 28.1% for SEIAR at 18 F. Female cadavers had significantly greater SFAR and SEIAR values across all sheath sizes (p < 0.007). Moderate-to-severe atherosclerosis was present in 11.3% of CFA specimens and was associated with significantly reduced CFA diameter (p < 0.001). CONCLUSIONS: Commonly used sheath sizes in TF-TAVR may approach or exceed anatomical thresholds in a subset of patients. These findings provide anatomical context that supports preprocedural imaging practices and may inform device development and procedural education, particularly with attention to sex-specific vascular differences.
Evaluation of aortic arch branching pattern variations with computed tomography angiography images.
Yigit A, Peker TV, Gulekon IN … +2 more , Golpinar M, Yanarates G
Surg Radiol Anat · 2026 Jan · PMID 41530281 · Publisher ↗
PURPOSE: Variations in the branching pattern of the aortic arch are highly diverse and are often encountered incidentally during routine computed tomography angiography scans. This study aimed to determine the prevalence...
PURPOSE: Variations in the branching pattern of the aortic arch are highly diverse and are often encountered incidentally during routine computed tomography angiography scans. This study aimed to determine the prevalence of variations in aortic arch branching patterns in the Turkish population using computed tomography angiography (CTA) images. METHODS: CTA images of 1000 patients (500 males, 500 females) who presented to the radiology clinic for various indications between May 2018 and June 2024 were evaluated. The branching variations of the aortic arch were classified into seven main types. The relationship between aortic arch branching pattern variations and sex was assessed using the Chi-square test. RESULTS: A normal branching pattern (Type 1) was observed in 853 of the 1000 cases, while variations were found in 147 cases. The most common variation was Type 2, in which the brachiocephalic trunk and the left common carotid artery originate from a common trunk, observed in 8.3% of cases. This was followed by Type 3 variation, where the left vertebral artery arises directly from the aortic arch, seen in 4.1% of cases. The third most common variation was Type 4, observed in 1.3% of cases, which involves both the Type 2 branching pattern and the left vertebral artery originating directly from the aortic arch. Type 6 variation, defined as an aberrant right subclavian artery, was seen in 0.8% of cases, while Type 7 (mirror image) variation was observed in 0.1%. Type 5 variation was not detected in any case. Apart from these classifications, a variation in which the left inferior thyroid artery originated directly from the aortic arch was detected in one female patient. CONCLUSION: There was no statistically significant difference between sexes in the distribution of aortic arch branching pattern variations (p = 0.067). Patients with aortic arch variations are at increased risk of bleeding and ischemia during thoracic surgery. Awareness of aortic arch variations is particularly important in patients scheduled for thoracic surgery or interventional radiological procedures, as it helps reduce potential risks.
The retrocochlear recess: radiomorphometric investigation of an anatomical novelty in children under five.
Wojciechowski T, Szeliga S, Skadorwa T
Surg Radiol Anat · 2026 Jan · PMID 41514059 · Publisher ↗
PURPOSE: To evaluate the presence and measure the depth of newly found air space located posteriorly to the basal turn of the cochlea-retrocochlear recess (RCR). METHOD: The area of subtympanic sinus was explored bilater...
PURPOSE: To evaluate the presence and measure the depth of newly found air space located posteriorly to the basal turn of the cochlea-retrocochlear recess (RCR). METHOD: The area of subtympanic sinus was explored bilaterally using multi-planar reconstruction tools in 280 temporal bone computed tomography scans. We searched for RCR and measured its depth whenever present. We evaluated the presence of subcochlear canaliculus and the position of the jugular fossa bordering the RCR. RESULTS: The RCR in 192 out of 280 evaluated temporal bones (69%), more commonly in children under 2 years old than aged three to five (p < 0.001). The mean depth of the RCR for the whole studied group measured from posterior pillar of the round window niche was 3.9 ± 1.8 mm, and from promontory - 6.6 ± 1.8 mm. The influence of the jugular fossa on the shape of the RCR was confirmed in 88 out of 192 temporal bones with RCR present (46%), more commonly on the right side (p < 0.001). We found subcochlear canaliculus in only 7.5% of examined bones. CONCLUSION: The RCR is a commonly found anatomical space in the vicinity of subtympanic sinus. Its final shape may be affected by the jugular fossa, especially on the right side. The RCR may play role in preoperative evaluation for cholesteatoma surgery or cochlear implantation.
Unilateral arcuate foramen with a posteriorly projecting vertebral artery loop between C1-C2: a rare anatomical variation.
Zeng Y, Hu B, Sun G … +3 more , Yuan C, Lin Y, Chang D
Surg Radiol Anat · 2026 Jan · PMID 41511524 · Publisher ↗
PURPOSE: To describe the morphological features of this rare anatomical variation and to evaluate its significance in relation to embryological development, potential pathological consequences, and surgical consideration...
PURPOSE: To describe the morphological features of this rare anatomical variation and to evaluate its significance in relation to embryological development, potential pathological consequences, and surgical considerations. METHODS: A detailed anatomical dissection of the craniovertebral junction was conducted. Morphometric analysis was conducted to document the characteristics of the arcuate foramen and the course of the vertebral artery, with emphasis on osseous bridging and vascular loop. RESULTS: On the right side, two osseous bridges (ponticulus posticus and ponticulus lateralis) were identified between the lateral mass of the atlas and both its posterior arch and transverse process. The ipsilateral vertebral artery demonstrated a pronounced posterior loop-like tortuosity in its course between the transverse foramen of the axis and that of the atlas. CONCLUSION: This first reported case of a concurrent arcuate foramen and posterior vertebral artery loop at C1-C2 level significant challenges for surgical planning and procedures. It emphasizes that recognizing such complex variations through careful imaging is essential for safe intervention at the craniovertebral junction.
Anatomical variations and clinical significance of interconnections between flexor hallucis longus and flexor digitorum longus tendons in Chinese population.
Ren JY, Zhang XH, Xing Z … +4 more , Jin RX, Ren LN, Wang PY, Li J
Surg Radiol Anat · 2026 Jan · PMID 41507522 · Publisher ↗
PURPOSE: Tendons of the flexor hallucis longus (FHL) and flexor digitalis longus (FDL) are used in reconstructive foot surgery in general and have important clinical significance. These tendons intersect at the plantar s...
PURPOSE: Tendons of the flexor hallucis longus (FHL) and flexor digitalis longus (FDL) are used in reconstructive foot surgery in general and have important clinical significance. These tendons intersect at the plantar surface and exhibit different interconnections, complicating the tendon acquisition process. The aim of this study was to establish a comprehensive understanding of these interconnections through an improved classification system and to identify anatomical characteristics based on the data. METHODS: 100 embalmed feet were dissected to observe plantar cross-linking sites. The improved classification system was used to classify the interconnections and the relevant data of the interconnections were measured. RESULTS: Four types of interconnections between the FHL and FDL tendons were classified. Type Ⅰ, a proximal to distal interconnection of the FHL to the FDL was observed in 92 cases; Type Ⅱ, a proximal to distal interconnection of the FHL to the FDL, accompanied by an additional proximal-to-distal interconnection from the FDL to the FHL, was noted in 4 cases; Type Ⅲ, two parallel proximal to distal interconnections of FHL to FDL were detected in 3 cases; Type Ⅳ, a thin fascial interconnection rather than a fibrous one between the FHL and the FDL was found in 1 case. The mean length and width of the interconnections were (16.59 ± 4.93) mm and (2.91 ± 0.77) mm respectively. CONCLUSION: In the present study, the classification of the FHL to FDL interconnection serves as a complement to the existing body of literature. Knowledge of the anatomical variations in these interconnections is critical to preserve the blood vessels and nerves during foot reconstructions.
Shape variation of the human peritoneal cavity: a principal component analysis using computed tomography.
O'Hagan LA, Yassaie S, Fernandez J … +1 more , Mirjalili SA
Surg Radiol Anat · 2026 Jan · PMID 41507412 · Publisher ↗
PURPOSE: The peritoneal cavity is a complex area of human anatomy. Although the general anatomy and subdivisions of the cavity have long been understood, no studies have investigated its overall morphology and individual...
PURPOSE: The peritoneal cavity is a complex area of human anatomy. Although the general anatomy and subdivisions of the cavity have long been understood, no studies have investigated its overall morphology and individual variability. This study aimed to create a three-dimensional (3D) model of the peritoneal cavity and perform a principal component analysis (PCA) to determine its average shape and individual variability. Methods: Thirty archival abdominopelvic computed tomography (CT) scans were used to create 3D models of the peritoneal cavity. A PCA was performed to determine areas of variation. Results: An average 3D model of the peritoneal cavity was created. There was a high degree of both intra- and inter-observer reliability. The main area of variation between individuals was a change in width in the coronal plane and thickness in the sagittal plane. Differences between males and females were also investigated, as well as in high vs low BMI individuals. Conclusion: The peritoneal cavity exhibits consistent patterns of shape variation that are quantifiable in three dimensions. Our findings lay the groundwork for future anatomically informed tools in surgical planning, education, and device design.
Atrial septal pouch: a comprehensive morphologic and morphometric evaluation with clinical relevance.
Sumalatha S, Prabhath S, Thaker S … +3 more , Shetty A, Lalani K, Bhat NP
Surg Radiol Anat · 2026 Jan · PMID 41498945 · Publisher ↗
PURPOSE: The septal pouch is an anatomical variant resulting from incomplete fusion between the septum primum and the septum secundum at the interatrial septum. This partial fusion creates a conical pouch, which is poten...
PURPOSE: The septal pouch is an anatomical variant resulting from incomplete fusion between the septum primum and the septum secundum at the interatrial septum. This partial fusion creates a conical pouch, which is potentially predisposed to thrombus formation, increasing the degree of thromboembolic risk. This cadaveric study aimed to evaluate the prevalence, morphology, and morphometry of septal pouches and their associations with other septal defects. METHODOLOGY: The interatrial septa of 60 human hearts were examined for septal pouches. Characteristics such as pouch type, apex and base orientation, base width, depth, and morphological variants were documented. RESULTS: Atrial septal pouches (ASPs) were identified in 22/60 (37%) specimens. Right atrial septal pouches (RSPs) were predominant (30%), whereas left atrial septal pouches (LSPs) were found in 7% of the patients. Most RSPs exhibited a thin, membranous, flattened morphology, although some were thick and muscular. All LSPs were thin and flattened, with a superiorly directed ostium and an inferiorly directed apex. Histologically, the pouches demonstrated a trilaminar arrangement, comprising the myocardium sandwiched between two endocardial layers, with collagen-rich connective tissue beneath. CONCLUSION: This study highlights important anatomical insights regarding septal pouches, emphasizing the higher prevalence and varied morphometry of RSPs. Given their potential clinical significance in thromboembolic phenomena, further investigation into septal pouch involvement in cardiovascular diseases is warranted.
Unveiling sex- and side-specific variations in genicular nerve targeting: implications for precision in nerve ablation therapy.
Fodjeu G, Fonkoué L, Cornu O … +1 more , Behets C
Surg Radiol Anat · 2026 Jan · PMID 41491043 · Publisher ↗
BACKGROUND: Genicular nerve radiofrequency denervation, blocks, and neurolysis are effective techniques for pain from knee osteoarthritis (OA) by targeting specific sensory nerves. However, anatomical variability related...
BACKGROUND: Genicular nerve radiofrequency denervation, blocks, and neurolysis are effective techniques for pain from knee osteoarthritis (OA) by targeting specific sensory nerves. However, anatomical variability related to laterality and sex may influence targeting accuracy. This study systematically evaluated these factors to optimise procedural precision. METHODS: Twenty-seven frozen lower limbs (10 bilateral: 6 females and 4 males; 7 unilateral: 5 males and 2 females; mean age 84.5 ± 10.8 years) were dissected from the proximal thigh to the knee following colored latex injection. Nerve diameters and distances from genicular nerves to relevant bony landmarks were measured and compared by sex and side using standard statistical tests (p < 0.05). RESULTS: No significant differences were observed in the distances from the target points to the bony landmarks between either men and women or left and right sides. These were larger, on average, in males than in females, except for the distance from the superomedial genicular nerve (SMGN) to the medial condyle. The inferomedial genicular nerve (IMGN) measured diameter at the target point was statistically larger in females than in males [p = 0.04(CI; -0.39–0.05)]. Interestingly, 44.4% of the superolateral genicular nerve (SLGN) showed no proximity to vascular supply at the target point, which is necessary for ultrasound-assisted targeting. CONCLUSION: Although minor dimensional differences exist, sex- and laterality-based anatomical variations do not significantly influence genicular nerve targeting for pain interventions. These findings support the applicability of current targeting protocols across sexes and sides for effective knee OA pain management.
Anatomic parameters for diagnosing congenital cervical stenosis via computed tomography.
Shin D, Shin B, Im D … +15 more , Tang T, Dinh C, Cummings C, Brandt Z, Nguyen K, Carter D, Carter M, Razzouk J, Taka TM, Harianja G, Yacoubian V, Abd-El-Barr M, Wycliffe N, Cheng W, Danisa O
Surg Radiol Anat · 2026 Jan · PMID 41491029 · Full text
PURPOSE: To establish parameters for congenital cervical stenosis (CCS) using computed tomography (CT), assessing influences of patient sex, race, and ethnicity. METHODS: Measurements were collected of anteroposterior di...
PURPOSE: To establish parameters for congenital cervical stenosis (CCS) using computed tomography (CT), assessing influences of patient sex, race, and ethnicity. METHODS: Measurements were collected of anteroposterior diameter (APD), interpedicular distance (IPD) and cervical intervertebral foramen dimensions (CIFD) from 1000 patients between 18 and 35 years of age without spinal pathology. CCS was determined as two standard deviations below the mean of the collected measurements. RESULTS: Irrespective of vertebral level, mean anatomic APD, CIFD and IPD measurements were as follows: 14.94 ± 1.99 mm for APD, 6.58 ± 1.45 mm and 6.68 ± 1.45 mm for left and right widths, of 9.30 ± 2.30 mm and 9.25 ± 2.80 mm for left and right heights, 57.0 ± 19.2 mm2 and 59.5 ± 20.3 mm2 for left and right areas, and 25.4 ± 1.78 mm for IPD. Irrespective of vertebral level, threshold values for CCS were 10.96 mm for APD, 3.68 mm and 3.78 mm for left and right widths, of 4.70 mm and 3.65 mm for left and right heights, 20.6 mm2 and 19 mm2 for left and right areas, and 21.8 mm for IPD. Males demonstrated larger CCS threshold values than females for left and right CIFD area and APD. African American patients had smaller CIFDs and APD, and subsequent CCS thresholds compared to White patients. CONCLUSIONS: This study reports measurements of CIFD, IPD, and APD to establish quantitative thresholds for diagnosis of CCS. CCS thresholds were significantly influenced by patient sex, race, and ethnicity.
Anatomical patterns and collateral pathways in congenital aplasia, atresia, and hypoplasia of iliac and lower extremity veins: a retrospective cohort study.
Sun P, Wang H, Xu W … +6 more , Li X, Xie C, Lin W, Wang P, Yang W, Guo Z
Surg Radiol Anat · 2025 Dec · PMID 41430505 · Publisher ↗
PURPOSE: Congenital aplasia, atresia, and hypoplasia of the iliac and lower extremity veins are rare vascular anomalies characterized by disrupted venous drainage and compensatory collateralization. Despite the clinical...
PURPOSE: Congenital aplasia, atresia, and hypoplasia of the iliac and lower extremity veins are rare vascular anomalies characterized by disrupted venous drainage and compensatory collateralization. Despite the clinical significance of these anomalies, their embryological origins, anatomical patterns, and hemodynamic consequences remain understudied. This study aimed to elucidate the anatomical variability, collateral pathways, and clinical implications of these anomalies through a single-center retrospective analysis. METHODS: Chinese patients with lower extremity congenital capillary-venous malformations and deep venous aplasia/atresia/hypoplasia were included. Imaging protocols included color Doppler ultrasound in all cases, supplemented by magnetic resonance and/or computed tomography venography in selected cases. RESULTS: An evaluation of the patient demographics demonstrated a male predominance (male:female, 40:24), mean age of 6.9 ± 6.7 years (2 months to 33 years), and 59.4% of cases in childhood (2-12 years) at referral. Anatomical patterns included left-sided iliac vein aplasia (36 left and 31 right cases) with frequent multi-segment defects (58%). Severe cases included deep vein aplasia (12%) and saphenous system anomalies (22%). Five key collateral pathways were identified: 1) superficial cross-pubic, great saphenous vein (GSV) → pudendal veins → contralateral GSV; 2) deep pelvic, internal pudendal → obturator → internal iliac veins; 3) ascending trunk, thoracoepigastric → axillary veins; 4) marginal systems, gluteal-external vertebral networks; and 5) reflux-driven collaterals mimicking post-thrombotic syndrome. CONCLUSION: Congenital iliac and lower extremity venous anomalies demonstrated left-sided and male predominance and complex collateralization. The observed anatomical patterns, including the persistence of embryonic veins, provide a practical framework for distinguishing compensatory collaterals from pathological vessels.
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