Abstract

Because the stomach in situ has few distinctive surface features and changes shape dramatically with food intake, we have used micro-CT imaging combined with two distinct contrast agents to (1) characterize the pattern of arteries, potential landmarks, on the stomach wall and (2) evaluate how meal-related shape changes affect the size of the different regions. Images generated with a contrast agent injected directly into the heart during perfusion enabled a thorough look at the organizational features of the stomach angioarchitecture. The stomach receives its blood supply primarily from two pairs of vessels, the gastric and gastroepiploic arteries. Each of the three regions of the stomach is delineated by a distinctive combination of arterial fields: the corpus, consistent with its dynamic secretory activity and extensive mucosa, is supplied by extensive arterial trees formed by the left and right gastric arteries, travelling, respectively, on the ventral and dorsal stomach surfaces. These major arteries course circularly from the lesser towards the greater curvature, distally along both left (or ventral) and right (or dorsal) walls of the corpus, and branch rostrally to supply the region. The muscular antrum is characterized by smaller arterial branches arising primarily from the right gastroepiploic artery that follows the distal greater curvature and secondarily from small, distally directed arteries supplied by the large vessels of the left and right gastric arteries. The forestomach, essentially devoid of mucosal tissue and separated from the corpus by the limiting ridge, is vascularized predominantly by a network of small arteries issued from the left gastroepiploic artery coursing around the proximal greater curvature, as well as from higher order and smaller branches issued by the gastric and celiac arteries. These distinctive arterial fields appear to distinguish the major gastric regions, irrespective of the degree of fill of the stomach. Volume assessments of stomach compartments were made from images of iodine-stained stomachs. By varying the delay time between eating and perfusion, we were able to probe the emptying behavior of the stomach and demonstrate that the regions of the stomach empty at different rates, thus changing the relative dimensions of the organ regions. Notably, and despite these shape changes, the gastric arteries appear to form a regular, particularly recognizable, and lateralized pattern corresponding to the corpus that should be of use in guiding surgical and experimental interventions.

Full Text
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