Modern aspects of superior mesenteric artery morphometry: Results of computed tomographic angiography study

Introduction. In modern clinical practice, precise and detailed knowledge of the normal and variant anatomy of the superior mesenteric artery (SMA) has ceased to be the exclusive domain of fundamental science and has become a necessary condition for ensuring the safety and effectiveness of a number of surgical interventions.

Aim. To perform a comprehensive morphometric analysis of the superior mesenteric artery (SMA) using multispiral computed tomographic angiography (MSCTA) and to evaluate the influence of sex and age on its anatomical parameters.

Materials and мethods. A single-center retrospective study was conducted, including data from 615 patients (245 men, 370 women) aged 20–89 years who underwent MSCTA of the abdomen. The following parameters were assessed: thelevel of SMA origin relative to the vertebral bodies, the angle of origin,linear distances to adjacent arteries (the celiac trunk and the renal arteries), SMA diameter at threelevels (ostium,level of middle colic artery origin,level of ileocolic artery origin), and the number of the small intestine arteries. Statistical analysis was performed using IBM SPSS Statistics 26. Pearson's χ² test, Student's t-test (or Mann–Whitney U-test), and one-way analysis of variance (ANOVA) with Tukey's post-hoc test (or Kruskal–Wallis test) were used to compare groups.

Results. Statistically significant gender differences were found: women more often had the superior mesenteric artery originating at the level of Th12 (30.3% versus 8.6% in men), a smaller origin angle (25–50° in 68.6% of cases), and a smaller orifice diameter (6.24 ± 1.25 mm versus 8.28 ± 1.36 mm in men). A strong positive correlation was found between age, the origin angle (r = 0.747), and the diameter of the superior mesenteric artery (r = 0.802–0.884). The number of small intestinal arteries did not depend on gender or age

Conclusion. Sex and age significantly influence the morphometry of the superior mesenteric artery. These factors should be considered in preoperative planning, endovascular interventions, and diagnostic imaging.

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