Abstract：Objective To investigate the occurrence and the diameter of Riolan's arch in patients with isolated superior mesenteric artery dissection (ISMAD) . Methods The retrospective case-control study was conducted. Seventy-six cases (69 males and 7 females) of ISMAD (case group) with complete clinical and abdominal CT angiography (CTA) data were obtained from the Department of Radiology of the First Affiliated Hospital of Sun Yat-Sen University from January 2015 to January 2020 and included as the case group. A total of 150 subjects who underwent abdominal CTA without abnormal findings were selected from July 2020 to July 2021 as the control group. The occurrence and diameter of Riolan's arch were evaluated and compared on CTA images. The case group was divided into four subgroups according to Yun classification, and the occurrence and diameter of Riolan's arch were compared. Results The ages of patients in the case and control groups were (55.0±8.6) years and (54.2±13.2) years, respectively, and no significant difference was found between the two groups (t=0.55, P=0.585). Male accounted for 90.8% (69/76) in the case group, which was higher than that in the control group (60.7%, 91/150), and the difference was statistically significant (χ2=22.14, P<0.001). The incidence rates of Riolan's arch were 84.21% (64/76) in the case group and 31.33% (47/150) in the control group as well as 85.51% (59/69) and 34.07% (31/91) in the male group, and 5/7 and 27.12% (16/59) in the female group, respectively. Statistically significant differences were found among all groups (all P values <0.05), but no statistically significant differences were detected between genders within the group (all P values >0.05). The diameter of Riolan's arch was (2.61±0.58) mm in the case group and (2.14±0.35)mm in control group, and the differences was statistically significant (t=6.49, P<0.001). The occurrence and average diameter of the Riolan's arch in each subgroup were as follows: 75%(18/24) and (2.35±0.44) mm (Type Ⅰ), 76.92% (20/26) and 2.40±0.33 mm (Type Ⅱa), 19/19 and (2.86±0.65) mm (Type Ⅱb), and 7/7 and (3.2±0.66) mm (Type Ⅲ). Statistically significant difference in the occurrence of Riolan's arch was found in each subgroup (P=0.043), and significant differences in the diameter of Riolan's were detected (P<0.001). Conclusion The occurrence of Riolan's arch in patients of ISMAD was higher than that in the control group, and the caliber obviously dilated. These findings indirectly verify the compensation in ISMAD. Hence, Riolan's arch can easily evaluate the classification of ISMAD.
李瑞希, 彭洋, 唐广磊, 王珂, 关键, 杨建勇. 基于CT血管成像的孤立性肠系膜上动脉夹层患者Riolan弓的影像解剖学观察[J]. 中华解剖与临床杂志, 2022, 27(6): 373-378.
Li Ruixi, Peng Yang, Tang Guanglei, Wang Ke, Guan Jian, Yang Jianyong. Imaging anatomy of Riolan's arch in patients with isolated superior mesenteric artery dissection based on CT angiography. Chinese Journal of Anatomy and Clinics, 2022, 27(6): 373-378.
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2022, Vol. 27 
