Morphometric Analysis of the Inferior Vena Cava Related to Lumbar Vertebra and the Aortic Bifurcation on Multidetector Computed Tomography (MDCT)

Abstract

SALBACAK, A.; AKIN, D.; KABAKCI, A. D. A.; YILMAZ, M. T.; CICEKCIBASI, A. E. & OZBEK, O.Morphometric analysis of the inferior vena cava related to the lumbar vertebra and the aortic bifurcation on multidetector computed tomography (MDCT). Int. J. Morphol., 34(2):620-627, 2016. SUMMARY:Vascular structures are in greater danger during lumbar surgery. The purpose of this study is to describe the morphology of the inferior vena cava (IVC) related to the lumbar vertebra and aortic bifurcation (AB) and assessing the role of demographic values in these relations to decrease the risk of complications in the surgical interventions. The study was performed on Multidetector Computed Tomography (MDCT) images of 100 male and 100 female cases with an age range from 50 to 84 years. The morphometric values of the IVC obtained from the coronal, sagittal and the axial reformatted images were measured and compared with the demographic values. The distance from the IVC to the 1 st lumbar vertebra (L1) and 2 nd lumbar vertebra (L2) were measured as (26.5 mm and 18.1 mm) in males and (21.1 mm and 14.2 mm) in females with a high level of significance between genders; the distance from the IVC to the iliocaval confluence (IC), 3 rd lumbar vertebra (L3) and 4 rd lumbar vertebra (L4) were measured as (6.5 mm, 10.5 mm and 6.9 mm) in males and (4.9 mm, 9.1 mm and 5.5 mm) in females with significance between genders. The level of the IC was detected 46 % of males, 39 % of females at the level of lower third of L4. The vertical distance between the IC and the AB was measured and negative correlation between genders based on age was detected. Demographic values are important to consider the relationship of the IVC, the lumbar vertebra and the AB. The IVC was located further from the lumbar vertebra in males compared to females. Age increase played role in the approaching of the AB and the IC to each other in both gender and the IC to the promontory level in males.

Case series and a systematic review concerning the level of the aortic bifurcation

“…All details regarding the selection of eligible studies are presented in Figure 4 (PRISMA flow diagram). Eventually 31 articles were found eligible and were [11,15], 1 multidetector computed tomography (MDCT) study [20], 1 was angiographic study [38] and 1 was based on pelvic arteriograms [25]. Mean age or age range where included when available.…”

Morphometric analysis of the lumbar vertebrae and intervertebral discs in relation to abdominal aorta: CT-based study

“…Those works are mainly analyzing the levels of bifurcation of the aorta, iliac veins, confluence with the inferior vena cava (IVC), and relations between those structures. What’s more, veins not only occur in great variability in lumbar location [ 4 , 6 , 7 , 16 ], but also the measurements of venous structures are imprecise because of variations in blood flow and diameter associated with respiration [ 11 ]. That is why we decided to base our study on the relation between spinal column and arterial vessels.…”

“…Cadaver study by Panagouli et al [ 21 ] also confirmed our findings—mean level of bifurcation was the lower third of the L4 vertebral body. As aforementioned, there is variability of venous structures in the lumbar region that lead to discrepancies in different studies [ 4 , 6 , 7 , 15 , 16 ]. Some authors reported aorta bifurcation 1–2 segments above the IVC confluence [ 15 ].…”

“…As aforementioned, there is variability of venous structures in the lumbar region that lead to discrepancies in different studies [4,6,7,15,16]. Some authors reported aorta bifurcation 1-2 segments above the IVC confluence [15].…”

Is there Effect of Intervertebral Disc Herniation on the Lumbar Spine in Early Period? A Morphometric and Stereological Study

“…Where t is the section thickness, SU the scale unit of the printed film, d the distance between the test points of the grid, SL the measured length of the scale printed on the film and ∑p is the total number of points hitting the sectioned cut surface areas of the structure (Mahato, 2013;Wang et al, 2015;Azu et al;Keskinoz et al, 2016). According to this volumetric technique, a square grid of test points was positioned on each MRI, and all points hitting the structure were counted (Fig.…”