Digital subtraction angiography and computed tomography angiography of predominant artery feeding pancreatic body and tail

Diabetes Technol Ther. 2011 May;13(5):537-41. doi: 10.1089/dia.2010.0173. Epub 2011 Mar 15.

Abstract

Background: Recently a considerable number of promising clinical trials have been designed to perform infusion of stem cells by pancreatic arterial intervention to improve the endocrine function of the pancreas for better diabetes control. It is necessary to investigate the pancreatic body and tail (PBT) arterial system for human islets located mostly in the PBT and identify the predominant artery or arteries. However, the arterial system in the PBT is complicated and variable. In this study we comprehensively investigated the anatomical characteristics of arteries feeding the PBT.

Research design and methods: One hundred two patients with diabetes underwent 64-slice computed tomography angiography (CTA) and digital subtraction angiography (DSA). The target artery was catheterized, and DSA was performed to show the PBT. All images were documented for later analysis.

Results: DSA demonstrated that the feeding arteries for the PBT included the dorsal pancreatic artery (DPA) alone (n = 51 [50%]), combined DPA and great pancreatic artery (GPA) (n = 22 [21.6%]), GPA alone (n = 16 [15.7%]), and transverse pancreatic artery (TPA) (n = 11 [10.8%]). DPA was observed to originate from the initial segment of the splenic artery (n = 34 [46.6%]), common hepatic artery (n = 17 [23.3%]), or superior mesenteric artery (n = 14 [19.2%]). The GPA was mostly from the middle (n = 36 [94.7%]), and only two were found to originate from the initial segment of the splenic artery. The TPA (n = 11) was from either the pancreatoduodenal artery (n = 5 [54.5%]) or the gastroduodenal artery (n = 4 [36.4%]). In most case, the predominant artery of the PBT (95.1%, 97 of 102) could be revealed by 64-slice CTA.

Conclusions: The origins and identities of the predominant artery in the PBT are variable. DSA is superior to CTA for preoperative imaging in arterial intervention therapy.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Angiography, Digital Subtraction*
  • Diabetes Mellitus / pathology*
  • Diabetes Mellitus / physiopathology*
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional
  • Islets of Langerhans / blood supply
  • Islets of Langerhans / pathology
  • Male
  • Middle Aged
  • Organ Specificity
  • Pancreas / blood supply*
  • Pancreas / pathology
  • Regional Blood Flow
  • Retrospective Studies
  • Tomography, X-Ray Computed*
  • Young Adult