Anatomic characteristics of left pulmonary lingual segment artery analyzed by CT three-dimensional reconstruction_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Xiaofeng ¹ , JIA Shouqin ² , DONG Guowei ² , LI Ming ¹ ,  LIU Jingliang ¹

1. Department of Thoracic Surgery, Shandong Public Health Clinical Center, Jinan, 250013, P. R. China;
2. Department of Radiology, Shandong Public Health Clinical Center, Jinan, 250013, P. R. China;

Corresponding author：

LIU Jingliang, Email: Liujl865@126.com

Keywords：

Three-dimensional reconstruction; lingual artery; mediastinal lingual artery; interlobar lingual artery

DOI：

10.7507/1007-4848.202011022

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To further understand the anatomical characteristics and rules of left upper lingual pulmonary artery.Methods CT data of 120 patients (82 males, 38 females, median age of 65 years ranging 36-78 years) with pulmonary nodules from December 2018 to August 2020 in our hospital were retrospectively analyzed. The anatomic characteristics of the lingual segment of the upper left lung were analyzed by three-dimensional reconstruction. Results Mediastinal lingual artery appeared in 34 of the 120 patients, accounting for 28.4%. There were 26 patientsof mixed mediastinal/interlobar type, 8 patients of pure mediastinal lingual artery, and 92.3% (24/26) mixed mediastinal/interlobar type blood vessel contained A4b. Fifty-eight (58/120, 48.3%) patients had interlobar type A4+5 type, the rest were two-branches type. And 22 patients of A4 and A5 type accounted for the most two-branches type (22/28, 78.6%). The single-branch type was located at the distal end of A6 in 54 (54/58, 93.1%) patients, originated from the proximal end of A6 in 4 patients, and originated from the basilar artery in 6 patients. The two-branches type was at the distal end of A6 accounting for 50.0% (14/28).Conclusion Mediastinal lingual artery is more common than expected, accounting for 28.4%, among which mixed lingual artery is more prevalent, usually located in the first pulmonary trunk, and mostly follows the principle of proximity to supply relevant lung tissues. The location of the interlobar branches in the pulmonary trunk can be at the distal or proximal end of A6, care should be taken to avoid damaging adjacent structures.

Citation： LI Xiaofeng, JIA Shouqin, DONG Guowei, LI Ming, LIU Jingliang. Anatomic characteristics of left pulmonary lingual segment artery analyzed by CT three-dimensional reconstruction. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(6): 698-702. doi: 10.7507/1007-4848.202011022 Copy

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2.	Nagata T, Nakamura Y, Kariatsumari K, et al. Potentially overlooked branches of the left pulmonary artery. Asian Cardiovasc Thorac Ann, 2016, 24(7): 676-680.
3.	Hagiwara M, Shimada Y, Kato Y, et al. High-quality 3-dimensional image simulation for pulmonary lobectomy and segmentectomy: Results of preoperative assessment of pulmonary vessels and short-term surgical outcomes in consecutive patients undergoing video-assisted thoracic surgery. Eur J Cardiothorac Surg, 2014, 46(6): e120-e126.
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6.	Fourdrain A, De Dominicis F, Blanchard C, et al. Three-dimensional CT angiography of anatomic variations in the pulmonary arterial tree. Surg Radiol Anat, 2018, 40(1): 45-53.
7.	Kandathil A, Chamarthy M. Pulmonary vascular anatomy & anatomical variants. Cardiovasc Diagn Ther, 2018, 8(3): 201-207.
8.	Cory RA, Valentine EJ. Varying patterns of the lobar branches of the pulmonary artery. A study of 524 lungs and lobes seen at operation of 426 patients. Thorax, 1959, 14(4): 267-280.
9.	Matsumoto K, Yamasaki N, Tsuchiya T, et al. Three-dimensional computed tomography for a mediastinal basal pulmonary artery. Ann Thorac Surg, 2012, 94(5): e115-e116.
10.	Yatsuyanagi E, Yasuda S. Wedge bronchoplastic left upper lobectomy for lung cancer patient with abnormal mediastinal left basal pulmonary artery. Kyobu Geka, 2018, 71(8): 573-577.
11.	Akiba T. Utility of three-dimensional computed tomography in general thoracic surgery. Gen Thorac Cardiovasc Surg, 2013, 61(12): 676-684.
12.	Yao F, Wang J, Yao J, et al. Three-dimensional image reconstruction with free open-source OsiriX software in video-assisted thoracoscopic lobectomy and segmentectomy. Int J Surg, 2017, 39: 16-22.
13.	Nakano T, Ishikawa S, Sohara Y, et al. Composite resection of the left upper lobe and superior segment (S6) of the lower lobe for lung cancer with a mediastinal lingular and basal pulmonary artery. Surg Case Rep, 2018, 4(1): 39.
14.	Fukuhara K, Akashi A, Nakane S, et al. Preoperative assessment of the pulmonary artery by three-dimensional computed tomography before video-assisted thoracic surgery lobectomy. Eur J Cardiothorac Surg, 2008, 34(4): 875-877.
15.	Watanabe S, Arai K, Watanabe T, et al. Use of three-dimensional computed tomographic angiography of pulmonary vessels for lung resections. Ann Thorac Surg, 2003, 75(2): 388-392.
16.	Sardari Nia P, Olsthoorn JR, Heuts S, et al. Interactive 3D reconstruction of pulmonary anatomy for preoperative planning, virtual simulation, and intraoperative guiding in video-assisted thoracoscopic lung surgery. Innovations (Phila), 2019, 14(1): 17-26.
17.	Zhang C, Zhang H, Wu W, et al. Prophylactic octreotide does not reduce the incidence of postoperative chylothorax following lobectomy: Results from a retrospective study. Medicine (Baltimore), 2019, 98(29): e16599.

1. Subotich D, Mandarich D, Milisavljevich M, et al. Variations of pulmonary vessels: Some practical implications for lung resections. Clin Anat, 2009, 22(6): 698-705.
2. Nagata T, Nakamura Y, Kariatsumari K, et al. Potentially overlooked branches of the left pulmonary artery. Asian Cardiovasc Thorac Ann, 2016, 24(7): 676-680.
3. Hagiwara M, Shimada Y, Kato Y, et al. High-quality 3-dimensional image simulation for pulmonary lobectomy and segmentectomy: Results of preoperative assessment of pulmonary vessels and short-term surgical outcomes in consecutive patients undergoing video-assisted thoracic surgery. Eur J Cardiothorac Surg, 2014, 46(6): e120-e126.
4. Nomori H, Okada M. Illustrated Anatomical Segmentectomy for Lung Cancer. Tokyo: Bunkodo Co, Ltd, 2011. 3-7.
5. Dejima H, Takahashi Y, Hato T, et al. Mediastinal pulmonary artery is associated with greater artery diameter and lingular division volume. Sci Rep, 2017, 7(1): 1273.
6. Fourdrain A, De Dominicis F, Blanchard C, et al. Three-dimensional CT angiography of anatomic variations in the pulmonary arterial tree. Surg Radiol Anat, 2018, 40(1): 45-53.
7. Kandathil A, Chamarthy M. Pulmonary vascular anatomy & anatomical variants. Cardiovasc Diagn Ther, 2018, 8(3): 201-207.
8. Cory RA, Valentine EJ. Varying patterns of the lobar branches of the pulmonary artery. A study of 524 lungs and lobes seen at operation of 426 patients. Thorax, 1959, 14(4): 267-280.
9. Matsumoto K, Yamasaki N, Tsuchiya T, et al. Three-dimensional computed tomography for a mediastinal basal pulmonary artery. Ann Thorac Surg, 2012, 94(5): e115-e116.
10. Yatsuyanagi E, Yasuda S. Wedge bronchoplastic left upper lobectomy for lung cancer patient with abnormal mediastinal left basal pulmonary artery. Kyobu Geka, 2018, 71(8): 573-577.
11. Akiba T. Utility of three-dimensional computed tomography in general thoracic surgery. Gen Thorac Cardiovasc Surg, 2013, 61(12): 676-684.
12. Yao F, Wang J, Yao J, et al. Three-dimensional image reconstruction with free open-source OsiriX software in video-assisted thoracoscopic lobectomy and segmentectomy. Int J Surg, 2017, 39: 16-22.
13. Nakano T, Ishikawa S, Sohara Y, et al. Composite resection of the left upper lobe and superior segment (S6) of the lower lobe for lung cancer with a mediastinal lingular and basal pulmonary artery. Surg Case Rep, 2018, 4(1): 39.
14. Fukuhara K, Akashi A, Nakane S, et al. Preoperative assessment of the pulmonary artery by three-dimensional computed tomography before video-assisted thoracic surgery lobectomy. Eur J Cardiothorac Surg, 2008, 34(4): 875-877.
15. Watanabe S, Arai K, Watanabe T, et al. Use of three-dimensional computed tomographic angiography of pulmonary vessels for lung resections. Ann Thorac Surg, 2003, 75(2): 388-392.
16. Sardari Nia P, Olsthoorn JR, Heuts S, et al. Interactive 3D reconstruction of pulmonary anatomy for preoperative planning, virtual simulation, and intraoperative guiding in video-assisted thoracoscopic lung surgery. Innovations (Phila), 2019, 14(1): 17-26.
17. Zhang C, Zhang H, Wu W, et al. Prophylactic octreotide does not reduce the incidence of postoperative chylothorax following lobectomy: Results from a retrospective study. Medicine (Baltimore), 2019, 98(29): e16599.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Anatomic characteristics of left pulmonary lingual segment artery analyzed by CT three-dimensional reconstruction

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