Anatomic Pathways of Peripancreatic Fluid Draining to Mediastinum in Recurrent Acute Pancreatitis: Visible Human Project and CT Study

Haotong Xu,Shaoxiang Zhang,Fuzhou Tian,Zhulin Luo,Yin Li,Yi Wu,Andreas Christe,Xiaoming Zhang,Lukas Ebner,Xiaoming Yang

doi:10.1371/journal.pone.0062025

Abstract

BackgroundIn past reports, researchers have seldom attached importance to achievements in transforming digital anatomy to radiological diagnosis. However, investigators have been able to illustrate communication relationships in the retroperitoneal space by drawing potential routes in computerized tomography (CT) images or a virtual anatomical atlas. We established a new imaging anatomy research method for comparisons of the communication relationships of the retroperitoneal space in combination with the Visible Human Project and CT images. Specifically, the anatomic pathways of peripancreatic fluid extension to the mediastinum that may potentially transform into fistulas were studied.MethodsWe explored potential pathways to the mediastinum based on American and Chinese Visible Human Project datasets. These drainage pathways to the mediastinum were confirmed or corrected in CT images of 51 patients with recurrent acute pancreatitis in 2011. We also investigated whether additional routes to the mediastinum were displayed in CT images that were not in Visible Human Project images.Principal FindingsAll hypothesized routes to the mediastinum displayed in Visible Human Project images, except for routes from the retromesenteric plane to the bilateral retrorenal plane across the bilateral fascial trifurcation and further to the retrocrural space via the aortic hiatus, were confirmed in CT images. In addition, route 13 via the narrow space between the left costal and crural diaphragm into the retrocrural space was demonstrated for the first time in CT images.ConclusionThis type of exploration model related to imaging anatomy may be used to support research on the communication relationships of abdominal spaces, mediastinal spaces, cervical fascial spaces and other areas of the body.

Highlights

In recent years, researchers have focused on how they could transform the scientific findings of molecular biology and neurobiology to clinical treatments [1,2]
This type of exploration model related to imaging anatomy may be used to support research on the communication relationships of abdominal spaces, mediastinal spaces, cervical fascial spaces and other areas of the body
7 Exploring additional pathways in computerized tomography (CT) vs. CVH2 images If some additional conduits to the mediastinum were manifested while observing routes via the diaphragmatic hiatuses into the mediastinum in CT images, we considered the anatomic evidence that formed these conduits in Visible Human Project images

Summary

Introduction

Researchers have focused on how they could transform the scientific findings of molecular biology and neurobiology to clinical treatments [1,2]. They have seldom paid attention to achievements in transforming digital anatomy to radiological diagnosis. Investigators have been able to illustrate communication relationships in the retroperitoneal space by drawing potential routes in computerized tomography (CT) images or a virtual anatomical atlas. We established a new imaging anatomy research method for comparisons of the communication relationships of the retroperitoneal space in combination with the Visible Human Project and CT images. The anatomic pathways of peripancreatic fluid extension to the mediastinum that may potentially transform into fistulas were studied

Methods

Results

Conclusion