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The intersegmental pulmonary vein is not always located on the intersegmental plane of the lung: Evaluation with 3-dimensional volume-rendering image reconstruction

OBJECTIVE: To clarify whether intersegmental pulmonary veins are always located on the intersegmental plane and determine the division from which blood flows into them. METHODS: We analyzed representative intersegmental veins located between the upper/lingular and superior/basal division of the lung...

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Detalles Bibliográficos
Autores principales: Mimae, Takahiro, Miyata, Yoshihiro, Kumada, Takashi, Tsutani, Yasuhiro, Okada, Morihito
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9735388/
https://www.ncbi.nlm.nih.gov/pubmed/36510548
http://dx.doi.org/10.1016/j.xjtc.2022.09.002
Descripción
Sumario:OBJECTIVE: To clarify whether intersegmental pulmonary veins are always located on the intersegmental plane and determine the division from which blood flows into them. METHODS: We analyzed representative intersegmental veins located between the upper/lingular and superior/basal division of the lungs using preoperative chest computed tomography (CT) DICOM data from 22 patients who underwent lobectomy or segmentectomy during 2020. The location and blood flow of V(3)a+b and V(6)b+c were assessed using REVORAS (Ziosoft), a novel volume-rendering 3-dimensional (3D) image reconstruction software dedicated to lung segmentectomy. RESULTS: The V(3)a+b was in the upper division and on the intersegmental plane between the upper and lingular divisions of the left lung in 11 patients (50%) each. A main root of V(3)a+b was not found in the lingular division, but some peripheral flow in the V(3)a+b was derived from it in 14 patients (64%). The V(6)b+c was found in the superior division of the right lower lobe in 13 patients (59%) and the left lower lobe in 10 patients (45%), and on the intersegmental plane between the superior and basal division of the right lower lobe in 6 patients (27%) and the left lower lobe in 10 patients (45%). A main root of V(6)b+c was imperceptible in the basal division. Some peripheral blood flow was derived from the basal division in 6 patients (27%) with V(6)b+c veins located in the right lower lobe and in 8 patients (36%) with V(6)b+c veins located in the left lower lobe. CONCLUSIONS: Precise evaluation of intersegmental veins using preoperative volume-rendering 3D reconstructed CT images provides useful anatomic information for separating intersegmental pulmonary parenchyma.