medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.10.24835/1607-0763-1253medvis-1253Research ArticleБРЮШНАЯ ПОЛОСТЬ И ЗАБРЮШИННОЕ ПРОСТРАНСТВОABDOMEN AND RETROPERITONEALВозможности КТ-ангиографии нижней брыжеечной артерии при планировании резекций левой половины толстой кишки у пациентов с колоректальным ракомPossibilities of CT angiography of the inferior mesenteric artery in planning resections of the left half of the colon in patients with colorectal cancerhttps://orcid.org/0000-0003-0854-3598АраблинскийА. В.ArablinskiiA. V.

Араблинский Андрей Владимирович – доктор медицинских наук, профессор кафедры лучевой диагностики и лучевой терапии Института клинической медицины им. Н.В. Склифосовского

119991 Москва, ул. Трубецкая, д. 8, стр. 2

Andrey V. Arablinskii – Doct. of Sci. (Med.), Professor, Department of Radiation Diagnostics and Radiation Therapy

8, bld. 2, Trubetskaya str., Moscow 119991

arablinskiy_a_v@staff.sechenov.ruhttps://orcid.org/0000-0001-5150-8793СеуркоК. И.SeurkoK. I.

Сеурко Кирилл Игоревич – ассистент кафедры госпитальной хирургии Института клинической медицины им. Н.В. Склифосовского

119991 Москва, ул. Трубецкая, д. 8, стр. 2

Kirill I. Seurko – Assistant, Department of Hospital Surgery

8, bld. 2, Trubetskaya str., Moscow 119991

kirill.seurko@yandex.ruhttps://orcid.org/0000-0001-6441-100XПашковскаяА. А.PashkovskaiaA. A.

Пашковская Анна Александровна – врач-рентгенолог

115446 Москва, Коломенский проезд, д. 7

Anna A. Pashkovskaia – Radiologist

7, Kolomensky pr., Moscow 115446

pashkovskaya.an@yandex.ruhttps://orcid.org/0000-0003-4761-5793ВойновскийА. Е.VoynovskiyA. E.

Войновский Александр Евгеньевич – доктор медицинских наук, профессор кафедры госпитальной хирургии Института клинической медицины им. Н.В. Склифосовского ФГАОУ ВО Первый МГМУ имени И.М. Сеченова Минздрава России (Сеченовский Университет); заведующий отделом клинико-экспертной работы ГКБ им. С.С. Юдина 

119991 Москва, ул. Трубецкая, д. 8, стр. 2; 115446 Москва, Коломенский проезд, д. 7

Aleksandr E. Voynovskiy – Doct. of Sci. (Med.), Professor, Department of Hospital Surgery, I.M. Sechenov First Moscow State Medical University (Sechenov University); Head of the Department of Clinical and Expert Work, S.S. Yudin City Clinical Hospital

8, bld. 2, Trubetskaya str., Moscow 119991; 7, Kolomensky pr., Moscow 115446

voynovskiy_a_e@staff.sechenov.ruhttps://orcid.org/0000-0001-5655-2929СтепанченкоА. П.StepanchenkoA. P.

Степанченко Андрей Петрович – кандидат медицинских наук, заведующий рентгеновского отделения 

115446 Москва, Коломенский проезд, д. 7

Andrei P. Stepanchenko – Cand. of Sci. (Med.), Head of the Radiology Department

7, Kolomensky pr., Moscow 115446

aps65@mail.ruhttps://orcid.org/0000-0003-3754-8005КосенковА. Н.KosenkovA. N.

Косенков Александр Николаевич – доктор медицинских наук, профессор кафедры госпитальной хирургии Института клинической медицины им. Н.В. Склифосовского

119991 Москва, ул. Трубецкая, д. 8, стр. 2

Aleksandr N. Kosenkov – Doct. of Sci. (Med.), Professor, Department of Hospital Surgery

8, bld. 2, Trubetskaya str., Moscow 119991

kosenkov_a_n@staff.sechenov.ruФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Минздрава России (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian FederationГБУЗ города Москвы “Городская клиническая больница имени С.С. Юдина ДЗ города Москвы”РоссияS.S. Yudin City Clinical HospitalRussian FederationФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Минздрава России (Сеченовский Университет); ГБУЗ города Москвы “Городская клиническая больница имени С.С. Юдина ДЗ города Москвы”РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University); S.S. Yudin City Clinical HospitalRussian Federation2023160320232727184Copyright © Араблинский А.В., Сеурко К.И., Пашковская А.А., Войновский А.Е., Степанченко А.П., Косенков А.Н., 20232023Араблинский А.В., Сеурко К.И., Пашковская А.А., Войновский А.Е., Степанченко А.П., Косенков А.Н.Arablinskii A.V., Seurko K.I., Pashkovskaia A.A., Voynovskiy A.E., Stepanchenko A.P., Kosenkov A.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/1253

Во время лапароскопической операции по поводу колоректального рака сосудистые структуры могут быть неправильно идентифицированы и повреждены из-за незнания вариантной анатомии нижней брыжеечной артерии (НБА), отсутствия тактильных ощущений, суженного поля зрения, что приводит к таким осложнениям, как массивное кровотечение и ишемия кишечника. Следовательно, предоперационное изучение вариантной анатомии НБА имеет первостепенное значение. Зная вариантную анатомию сосудов перед операцией, можно заранее составить план операции, что обеспечит быструю и безопасную перевязку сосудов на требуемом уровне и лимфодиссекцию.

Цель исследования

Цель исследования: разработать классификацию вариабельности НБА для практического применения при операциях по поводу колоректального рака. Оптимизировать стандартный протокол сканирования брюшной полости для повышения точности МСКТ и наилучшей визуализации НБА и ее ветвей.

Материал и методы

Материал и методы. С февраля 2013 г. по март 2022 г. проанализировано 214 компьютерных томограмм органов брюшной полости с внутривенным контрастированием. Изучили вариантную анатомию НБА. Оптимизировали протокол сканирования органов брюшной полости с использованием напряжения трубки 100 кВ, сравнили плотность контрастирования НБА и ее ветвей при использовании стандартного и оптимизированного протоколов сканирования при ретроспективном анализе 105 КТ-исследований органов брюшной полости.

Результат

Результат. Нами была предложена классификация строения НБА и ее ветвей. Данная классификация очень важна при выполнении лимфодиссекции вдоль основного ствола НБА. Тип I – несколько толстокишечных ветвей отходили от НБА отдельными стволами (54%); тип II – все толстокишечные ветви отходят от НБА из одной точки в виде “гусиной лапки” (25%); тип III – от НБА отходит единственный ствол, который на своем протяжении делится на толстокишечные ветви (21%).

Точность МСКТ органов брюшной полости с внутривенным контрастированием, которая определялась путем сравнения результатов исследований с интраоперационными данными, составила 97,9%, чувствительность метода – 95,8%, специфичность – 100%.

Использование протокола сканирования с напряжением трубки 100 кВ позволяет упростить и ускорить определение анатомического типа строения, улучшить визуализацию НБА и ее ветвей.

Заключение

Заключение. КТ с 3D-реконструкцией сосудов позволяет хирургу выполнить расширенную лимфодиссекцию при колоректальном раке с минимальным риском осложнений.

During laparoscopic surgery for colorectal cancer, vascular structures may be incorrectly identified and damaged due to ignorance of the variant anatomy of the inferior mesenteric artery (IMA), lack of tactile sensations, narrowed field of vision, which leads to complications such as massive bleeding and intestinal ischemia. Therefore, the preoperative study of the variant anatomy of the IMA is of paramount importance. Knowing the variant anatomy of the vessels before surgery, you can make an operation plan in advance, which will ensure fast and safe vascular ligation at the required level and lymph dissection.

Aim

Aim: To develop a classification of IMA variability for practical use in operations for colorectal cancer. Optimize the standard abdominal scanning protocol to improve the accuracy of MSCT and the best visualization of the IMA and its branches.

Material and methods

Material and methods. From February 2013 to March 2022, 214 computed tomograms (CT) of abdominal organs with intravenous contrast were analyzed. We studied the variant anatomy of the IMA. The abdominal cavity scanning protocol was optimized using a 100 kV tube voltage, the contrast density of the NBA and its branches was compared using standard and optimized scanning protocols during a retrospective analysis of 105 CT studies of abdominal organs.

Results

Results. We proposed the classification of structure of the IMA and its branches. This is especially important when the safe lymph node dissection along the IMA is necessary. I type – several colonic branches derivate from the IMA by independent trunks (54%); II type – all colon branches derivate from the IMA in one point like a “goose paw” (25%); III type – one colon branch departs from the IMA by a single trunk; then it divides into colonic branches (21%).

The accuracy of MSCT of the abdominal organs with intravenous contrast, which was determined by comparing the results of studies with intraoperative data, was 97.9%. The sensitivity of the method is 95.8%, the specificity of the method is 100%.

The use of a scanning protocol with a tube voltage of 100 kV makes it possible to simplify and speed up the determination of the anatomical type of structure, improve the visualization of the IMA and its branches.

Conclusion

Conclusion. CT with 3D-reconstruction of vessels allows the surgeon to perform an extended LND for colorectal cancer with a minimal risk of complications.

КТ-ангиографиянижняя брыжеечная артерияанатомиялапароскопияCT angiographyinferior mesenteric arteryanatomylaparoscopyReferencesTrastulli S., Cirocchi R., Listorti C. et al. Laparoscopic vs open resection for rectal cancer: ameta-analysis of randomized clinical trials. Colorectal Dis. 2012; 14 (6): e277–96. https://doi.org/10.1111/j.1463-1318.2012.02985.xTrastulli S., Cirocchi R., Listorti C. et al. Laparoscopic vs open resection for rectal cancer: ameta-analysis of randomized clinical trials. Colorectal Dis. 2012; 14 (6): e277–96. https://doi.org/10.1111/j.1463-1318.2012.02985.xKellokumpu I.H., Kairaluoma M.I., Nuorva K.P. et al. Short- and long-term outcome following laparoscopic versus open resection for carcinoma of the rectum in the multimodal setting. Dis. Colon. Rectum. 2012; 55 (8): 854–863. https://doi.org/10.1097/DCR.0b013e31825b9052Kellokumpu I.H., Kairaluoma M.I., Nuorva K.P. et al. Short- and long-term outcome following laparoscopic versus open resection for carcinoma of the rectum in the multimodal setting. Dis. Colon. Rectum. 2012; 55 (8): 854–863. https://doi.org/10.1097/DCR.0b013e31825b9052McKay G.D., Morgan M.J., Wong S.K. et al.; South Western Sydney Colorectal Tumor Group. Improved short-term outcomes of laparoscopic versus open resection for colon and rectal cancer in an area health service: a multicenter study. Dis. Colon Rectum. 2014; 55 (1): 42–50. https://doi.org/10.1097/DCR.0b013e318239341fMcKay G.D., Morgan M.J., Wong S.K. et al.; South Western Sydney Colorectal Tumor Group. Improved short-term outcomes of laparoscopic versus open resection for colon and rectal cancer in an area health service: a multicenter study. Dis. Colon Rectum. 2014; 55 (1): 42–50. https://doi.org/10.1097/DCR.0b013e318239341fZeng S., Wu W., Zhang X. et al. The significance of anatomical variation of the inferior mesenteric artery and its branches for laparoscopic radical resection of colorectal cancer: a review. Wld J. Surg. Oncol. 2022; 20 (1): 290. https://doi.org/10.1186/s12957-022-02744-6Zeng S., Wu W., Zhang X. et al. The significance of anatomical variation of the inferior mesenteric artery and its branches for laparoscopic radical resection of colorectal cancer: a review. Wld J. Surg. Oncol. 2022; 20 (1): 290. https://doi.org/10.1186/s12957-022-02744-6Chen J., Wang M., Chen Y. et al. A clinical study of inferior mesenteric artery typing in laparoscopic radical resections with left colonic artery preservation of rectal cancer. Wld J. Surg. Oncol. 2022; 20 (1): 292. https://doi.org/10.1186/s12957-022-02762-4Chen J., Wang M., Chen Y. et al. A clinical study of inferior mesenteric artery typing in laparoscopic radical resections with left colonic artery preservation of rectal cancer. Wld J. Surg. Oncol. 2022; 20 (1): 292. https://doi.org/10.1186/s12957-022-02762-4Park M.G., Hur H., Min B.S. et al. Colonic ischemia following surgery for sigmoid colon and rectal cancer: a study of 10 cases and a review of the literature. Int. J. Colorectal Dis. 2012; 27: 671–675. https://doi.org/10.1007/s00384-011-1372-8.Park M.G., Hur H., Min B.S. et al. Colonic ischemia following surgery for sigmoid colon and rectal cancer: a study of 10 cases and a review of the literature. Int. J. Colorectal Dis. 2012; 27: 671–675. https://doi.org/10.1007/s00384-011-1372-8.Tsujinaka S., Kawamura Y.J., Tan K.Y. et al. Proximal bowel necrosis after high ligation of the inferior mesenteric artery in colorectal surgery. Scand. J. Surg. 2012; 101 (1): 21–25. https://doi.org/10.1177/145749691210100105Tsujinaka S., Kawamura Y.J., Tan K.Y. et al. Proximal bowel necrosis after high ligation of the inferior mesenteric artery in colorectal surgery. Scand. J. Surg. 2012; 101 (1): 21–25. https://doi.org/10.1177/145749691210100105Jinshui Zeng and Guoqiang Su. High ligation of the inferior mesentericartery during sigmoid colon and rectal cancer surgery increases the risk of anastomotic leakage: a meta-analysis. Wld J. Surg. Oncol. 2018; 16 (1): 157. https://doi.org/10.1186/s12957-018-1458-7Jinshui Zeng and Guoqiang Su. High ligation of the inferior mesentericartery during sigmoid colon and rectal cancer surgery increases the risk of anastomotic leakage: a meta-analysis. Wld J. Surg. Oncol. 2018; 16 (1): 157. https://doi.org/10.1186/s12957-018-1458-7Zhang W., Yuan W.T., Song J.M. Ileum interposition for low rectal anastomosis in rectal cancer surgery: is it a remedial option? Dis. Colon Rectum. 2015; 58: 708–709. https://doi.org/10.1097/DCR.0000000000000377Zhang W., Yuan W.T., Song J.M. Ileum interposition for low rectal anastomosis in rectal cancer surgery: is it a remedial option? Dis. Colon Rectum. 2015; 58: 708–709. https://doi.org/10.1097/DCR.0000000000000377Fan Y.C., Ning F.L., Zhang C.D., Dai D.Q. Preservation versus non-preservation of left colic artery in sigmoid and rectal cancer surgery: a meta-analysis. Int. J. Surg. 2018; 52: 269–277. https://doi.org/10.1016/j.ijsu.2018.02.054Fan Y.C., Ning F.L., Zhang C.D., Dai D.Q. Preservation versus non-preservation of left colic artery in sigmoid and rectal cancer surgery: a meta-analysis. Int. J. Surg. 2018; 52: 269–277. https://doi.org/10.1016/j.ijsu.2018.02.054Miyamoto R., Nagai K., Kemmochi A. et al. Three-dimensional reconstruction of the vascular arrangement including the inferior mesenteric artery and left colic artery in laparoscope-assisted colorectal surgery. Surg. Endosc. 2016; 30 (10): 4400–4404. https://doi.org/10.1007/s00464-016-4758-4Miyamoto R., Nagai K., Kemmochi A. et al. Three-dimensional reconstruction of the vascular arrangement including the inferior mesenteric artery and left colic artery in laparoscope-assisted colorectal surgery. Surg. Endosc. 2016; 30 (10): 4400–4404. https://doi.org/10.1007/s00464-016-4758-4Malakorn S., Sammour T., Bednarski B. et al. Three different approaches to the inferior mesenteric artery during robotic D3 lymphadenectomy for rectal cancer. Ann. Surg. Oncol. 2017; 24 (7): 1923. https://doi.org/10.1245/s10434-017-5792-8Malakorn S., Sammour T., Bednarski B. et al. Three different approaches to the inferior mesenteric artery during robotic D3 lymphadenectomy for rectal cancer. Ann. Surg. Oncol. 2017; 24 (7): 1923. https://doi.org/10.1245/s10434-017-5792-8Yasuda K., Kawai K., Ishihara S. et al. Level of arterial ligation in sigmoid colon and rectal cancer surgery. Wld. J. Surg. Oncol. 2016; 14: 99. https://doi.org/10.1186/s12957-016-0819-3Yasuda K., Kawai K., Ishihara S. et al. Level of arterial ligation in sigmoid colon and rectal cancer surgery. Wld. J. Surg. Oncol. 2016; 14: 99. https://doi.org/10.1186/s12957-016-0819-3Guo Y., Wang D., He L. et al. Marginal artery stump pressure in left colic artery-preserving rectal cancer surgery: a clinical trial. ANZ J. Surg. 2017; 87: 576–581. https://doi.org/10.1111/ans.13032Guo Y., Wang D., He L. et al. Marginal artery stump pressure in left colic artery-preserving rectal cancer surgery: a clinical trial. ANZ J. Surg. 2017; 87: 576–581. https://doi.org/10.1111/ans.13032Goh N., Fong S.S., How K.Y. et al. Apical lymph node dissection of the inferior mesenteric artery. Colorectal Dis. 2016; 18: O206–209. https://doi.org/10.1111/codi.13299Goh N., Fong S.S., How K.Y. et al. Apical lymph node dissection of the inferior mesenteric artery. Colorectal Dis. 2016; 18: O206–209. https://doi.org/10.1111/codi.13299Sekimoto M., Takemasa I., Mizushima T. et al. Laparoscopic lymph node dissection around the inferior mesenteric artery with preservation of the left colic artery. Surg. Endosc. 2016; 25:861–866. https://doi.org/10.1007/s00464-010-1284-7Sekimoto M., Takemasa I., Mizushima T. et al. Laparoscopic lymph node dissection around the inferior mesenteric artery with preservation of the left colic artery. Surg. Endosc. 2016; 25:861–866. https://doi.org/10.1007/s00464-010-1284-7Ke J., Cai J., Wen X. et al. Anatomic variations of inferior mesenteric artery and left colic artery evaluated by 3-dimensional CT angiography: insights into rectal cancer surgery–a retrospective observational study. Int. J. Surg. 2017; 1 (41): 106–111. https://doi.org/10.1016/j.ijsu.2017.03.012Ke J., Cai J., Wen X. et al. Anatomic variations of inferior mesenteric artery and left colic artery evaluated by 3-dimensional CT angiography: insights into rectal cancer surgery–a retrospective observational study. Int. J. Surg. 2017; 1 (41): 106–111. https://doi.org/10.1016/j.ijsu.2017.03.012Zhang W., Yuan W.T., Wang G.X., Song J.M. Anatomical study of the left colic artery in laparoscopic-assisted colorectal surgery. Surg. Endosc. 2019; 13: 1–7. https://doi.org/10.1007/s00464-019-07320-wZhang W., Yuan W.T., Wang G.X., Song J.M. Anatomical study of the left colic artery in laparoscopic-assisted colorectal surgery. Surg. Endosc. 2019; 13: 1–7. https://doi.org/10.1007/s00464-019-07320-wCirocchi R., Randolph J., Cheruiyot I. et al. Systematic review and meta-analysis of the anatomical variants of the left colic artery. Colorectal Dis. 2020; 22 (7): 768–778. https://doi.org/10.1111/codi.14891Cirocchi R., Randolph J., Cheruiyot I. et al. Systematic review and meta-analysis of the anatomical variants of the left colic artery. Colorectal Dis. 2020; 22 (7): 768–778. https://doi.org/10.1111/codi.14891Войновский А.Е., Башанкаев Б.Н., Сеурко К.И., Винокуров И.А. Новый взгляд на вариантную анатомию нижней брыжеечной артерии у пациентов с колоректальным раком. Клиническая и экспериментальная хирургия. Журнал имени академика Б.В. Петровского. 2021; 9 (3): 44–50. https://doi.org/10.33029/2308-1198-2021-9-3-44-50Voynovskiy A.E., Bashankaev B.N., Seurko K.I., Vinokurov I.A. A novel view on the variant anatomy of the inferior mesenteric artery in patients with colorectal cancer. Clinical and Experimental Surgery. Petrovsky Journal. 2021; 9 (3): 44–50. https://doi.org/10.33029/2308-1198-2021-9-3-44-50 (In Russian)Войновский А.Е., Сеурко К.И. Роль вариантной анатомии левой ободочной артерии и нижней брыжеечной вены при планировании резекций левой половины толстой кишки по поводу колоректального рака. Вестник Национального медико-хирургического центра им. Н.И. Пирогова. 2022; 17 (1): 36–40. https://doi.org/10.25881/20728255_2022_17_1_36Voynovskiy A.E., Seurko K.I. The role of variant anatomy of the left colon artery and inferior mesenteric vein in planning resections of the left colon for colorectal cancer. Bulletin of Pirogov National Medical & Surgical Center. 2022; 17 (1): 36–40. https://doi.org/10.25881/20728255_2022_17_1_36 (In Russian)Hiroishi A., Yamada T., Morimoto T. et al. Three-dimensional computed tomographic angiography with computed tomographic colonography for laparoscopic colorectal surgery. Jpn. J. Radiol. 2018; 36 (12): 698–705. https://doi.org/10.1007/s11604-018-0775-7Hiroishi A., Yamada T., Morimoto T. et al. Three-dimensional computed tomographic angiography with computed tomographic colonography for laparoscopic colorectal surgery. Jpn. J. Radiol. 2018; 36 (12): 698–705. https://doi.org/10.1007/s11604-018-0775-7Canedo-Antelo M., García-Figueiras R., Quintero-Rivera J.C. et al. Usefulness of computed tomography angiography in the preoperative workup of patients with colorectal cancer. J. Comput. Assist. Tomogr. 2022; 46 (3): 349–354. https://doi.org/10.1097/RCT.0000000000001288Canedo-Antelo M., García-Figueiras R., Quintero-Rivera J.C. et al. Usefulness of computed tomography angiography in the preoperative workup of patients with colorectal cancer. J. Comput. Assist. Tomogr. 2022; 46 (3): 349–354. https://doi.org/10.1097/RCT.0000000000001288Zebrowski W., Augustyniak E., Zajac S. Variation of origin and branches of the inferior mesenteric artery and its anastomoses. Folia Morphol. (Warsz.). 1971; 30: 510–517.Zebrowski W., Augustyniak E., Zajac S. Variation of origin and branches of the inferior mesenteric artery and its anastomoses. Folia Morphol. (Warsz.). 1971; 30: 510–517.Wang Y., Shu W., Ouyang A. et al. The New Concept of Physiological “Riolan's Arch” and the Reconstruction Mechanism of Pathological Riolan's Arch After High Ligation of the Inferior Mesenteric Artery by CT Angiography-Based Small Vessel Imaging. Front. Physiol. 2021; 12: 641290. https://doi.org/10.3389/fphys.2021.641290Wang Y., Shu W., Ouyang A. et al. The New Concept of Physiological “Riolan's Arch” and the Reconstruction Mechanism of Pathological Riolan's Arch After High Ligation of the Inferior Mesenteric Artery by CT Angiography-Based Small Vessel Imaging. Front. Physiol. 2021; 12: 641290. https://doi.org/10.3389/fphys.2021.641290Selvaraj L., Sundaramurthi I. Study of Normal Branching Pattern of the Coeliac Trunk and its Variations Using CT Angiography. J. Clin. Diagn. Res. 2015; 9 (9): AC01-4. https://doi.org/10.7860/JCDR/2015/12593.6523Selvaraj L., Sundaramurthi I. Study of Normal Branching Pattern of the Coeliac Trunk and its Variations Using CT Angiography. J. Clin. Diagn. Res. 2015; 9 (9): AC01-4. https://doi.org/10.7860/JCDR/2015/12593.6523Ke J., Cai J., Wen X. et al. Anatomic variations of inferior mesenteric artery and left colic artery evaluated by 3-dimensional CT angiography: Insights into rectal cancer surgery – A retrospective observational study. Int. J. Surg. 2017; 41: 106–111. https://doi.org/10.1016/j.ijsu.2017.03.012Ke J., Cai J., Wen X. et al. Anatomic variations of inferior mesenteric artery and left colic artery evaluated by 3-dimensional CT angiography: Insights into rectal cancer surgery – A retrospective observational study. Int. J. Surg. 2017; 41: 106–111. https://doi.org/10.1016/j.ijsu.2017.03.012Hounsfield G.N. Computerized transverse axial scanning (tomography): I. Description of systems. Br. J. Radiol. 1973; 46, 1016–1022. https://doi.org/10.1259/0007-1285-46-552-1016Hounsfield G.N. Computerized transverse axial scanning (tomography): I. Description of systems. Br. J. Radiol. 1973; 46, 1016–1022. https://doi.org/10.1259/0007-1285-46-552-1016Кригер А.Г., Пронин Н.А., Двухжилов М.В., Горин Д.С., Павлов А.В., Кармазановский Г.Г. Хирургический взгляд на артериальную анатомию поджелудочной железы. Анналы хирургической гепатологии. 2021; 26 (3): 112–122. https://doi.org/10.16931/1995-5464.2021-3-112-122Kriger A.G., Pronin N.A., Dvukhzhilov M.V., Gorin D.S., Pavlov A.V., Karmazonovsky G.G. Surgical glance at pancreatic arterial anatomy. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2021; 26 (3): 112–122. https://doi.org/10.16931/1995-5464.2021-3-112-122 (In Russian)Рубцова Н.А., Федулеев М.Н., Нерестюк Я.И., Хамидов Д.Х., Сидоров Д.В., Ложкин М.В., Каприн А.Д. Артериальное кровоснабжение печени, целиако-мезентериальный бассейн (литературный обзор). Медицинская визуализация. 2021; 25 (2): 74–83. https://doi.org/10.24835/1607-0763-928Rubtsova N.A., Pheduleev M.N., Nerestyuk Y.I., Khamidov D.K., Sidorov D.V., Lozhkin M.V., Kaprin A.D. Arterial blood supply to the liver, celiac and mesenteric pool (literature review). Medical Visualization. 2021; 25 (2): 74–83. https://doi.org/10.24835/1607-0763-928 (In Russian)Старостина Н.С., Кармазановский Г.Г., Петров Р.В., Егоров В.И. Феномен включения непостоянных предсуществующих артериальных коллатералей брюшной полости по данным МСКТ как признак нерезектабельности рака поджелудочной железы. Медицинская визуализация. 2015; 6: 66–84.Starostina N.S., Karmazanovskiy G.G., Petrov R.V., Egorov V.I. Circulatory Engagement of Abdominal Inconstant Preexisting Arterial Collaterals, as Revealed by MSCT Angiography, Indicates Unresectability of Pancreatic Cancer. Medical Visualization. 2015; 6: 66–84. (In Russian)Ян Цинь, Бурякина С.А., Кармазановский Г.Г., Ручкин Д.В. Ангиоархитектоника тощей кишки на опыте 30 гастропластических операций и возможности МСКТ-диагностики в предоперационном планировании объемного имплантата. Медицинская визуализация. 2014; 4: 22–31.Yang Qin, Buryakina S.A., Karmazanovsky G.G., Ruchkin D.V. Angioarchitectonics of Jejunum on the Experience of 30 Jejunal Interposition After Gastrectomy and Possibilities of MSCT-Diagnostics in Preoperative Planning of a Volume Implant. Medical Visualization. 2014; 4: 22–31. (In Russian)Wintersperger B., Jakobs T., Herzog P. et al. Aorto-iliac multidetector-row CT angiography with low kV settings: improved vessel enhancement and simultaneous reduction of radiation dose. Eur. Radiol. 2005; 15: 334–341. https://doi.org/10.1007/s00330-004-2575-yWintersperger B., Jakobs T., Herzog P. et al. Aorto-iliac multidetector-row CT angiography with low kV settings: improved vessel enhancement and simultaneous reduction of radiation dose. Eur. Radiol. 2005; 15: 334–341. https://doi.org/10.1007/s00330-004-2575-yYu L., Fletcher J.G., Grant K.L. et al. Automatic selection of tube potential for radiation dose reduction in vascular and contrast-enhanced abdominopelvic CT. Am. J. Roentgenol. 2013; 201 (2): W297–306. https://doi.org/10.2214/AJR.12.9610.Yu L., Fletcher J.G., Grant K.L. et al. Automatic selection of tube potential for radiation dose reduction in vascular and contrast-enhanced abdominopelvic CT. Am. J. Roentgenol. 2013; 201 (2): W297–306. https://doi.org/10.2214/AJR.12.9610.Hough D.M., Fletcher J.G., Grant K.L. et al. Lowering kilovoltage to reduce radiation dose in contrast-enhanced abdominal CT: initial assessment of a prototype automated kilovoltage selection tool. Am. J. Roentgenol. 2012; 199 (5): 1070–1077. https://doi.org/10.2214/AJR.12.8637Hough D.M., Fletcher J.G., Grant K.L. et al. Lowering kilovoltage to reduce radiation dose in contrast-enhanced abdominal CT: initial assessment of a prototype automated kilovoltage selection tool. Am. J. Roentgenol. 2012; 199 (5): 1070–1077. https://doi.org/10.2214/AJR.12.8637

The authors declare that there are no conflicts of interest present.