Abstract
Pulmonary vessels have numerous variation and aberrant branching patterns. Mediastinal lingular artery (MLA), the most common aberrant branch, might contribute to greater blood flow to lingular division. Hence, we investigated a correlation between lingular division volume and MLA using three-dimensional CT volumetry. We included 199 consecutive patients who underwent surveillance chest CT to detect possible malignancies in April 2015. We measured lingular division volume and cross-sectional area of lingular arteries using three-dimensional CT volumetry. MLA was identified in 58 cases (29.1%). The MLA group had significantly greater lingular division volume (median ± quartile deviation: 378.3 ± 75.5 mL vs. 330.0 ± 87.5 mL; p = 0.021) and percentage lingular division to left lung volume (19.0 ± 2.62% vs. 16.6 ± 2.39%; p < 0.001) than the non-MLA group. Total cross-sectional area of lingular arteries of the MLA group was significantly larger than that of the non-MLA group (46.1 ± 9.46 vs. 40.2 ± 5.76 mm2; p = 0.003). The total cross-sectional area of the lingular arteries strongly correlated to the percentage of lingular division to left lung volume (r = 0.689, p < 0.001). This is the first report demonstrating a positive correlation between branching pattern of pulmonary artery and lung volume.
Highlights
Complex lung architecture is often compared to a tree, which has intricate cellular structure generated by extremely elaborate process
The prevalence of the variant and aberrant branching is higher in left lung and it is well known that the most common variation is a mediastinal lingular artery (MLA)[2,3,4]
Three-dimensional computed tomography (3D-CT) combined with computer-aided diagnosis (CAD) has become widely used that can provide us accurate identification of peripheral branches of pulmonary vessels including intersegmental veins for simulation of surgery including segmentectomy[5]
Summary
Complex lung architecture is often compared to a tree, which has intricate cellular structure generated by extremely elaborate process. The prevalence of the variant and aberrant branching is higher in left lung and it is well known that the most common variation is a mediastinal lingular artery (MLA)[2,3,4]. Three-dimensional computed tomography (3D-CT) combined with computer-aided diagnosis (CAD) has become widely used that can provide us accurate identification of peripheral branches of pulmonary vessels including intersegmental veins for simulation of surgery including segmentectomy[5]. This allows us to identify intersegmental plane as well as to calculate lung segment volume with automated algorithm. We aimed to investigate relationship between lingular division volume and MLA using 3D-CT with CAD
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