Öz
Objective: Lung fissures embryologically separate the bronchopulmonary segments from each other. We aimed to detect anatomical variations in fissures in patients who underwent thoracic computed tomography (CT).
Materials and Methods: All the patients underwent a thoracic CT examination between July 1 - July 15, 2022. The patients’ gender, lung fissures continuity, accessory fissures presence, and variation side were recorded. The frequency of fissures was compared between the genders using the chi-square test.
Results: The study included a total of 352 patients (211 men, 141 women). A total of 105 variations were detected in 95/352 (26.99%) of the patients, 61/211 (28.91%) were male, 34/141 (24.11%) were female. The right oblique fissure was incomplete in nine (2.6%), and the right horizontal fissure was incomplete in 14 (4%) patients and absent in 14 (4%). The left oblique fissure was observed to be incomplete in 16 (4.5%) patients. A total of 52 (14.8%) accessory fissures were detected.
Conclusion: In the literature, a wide variety of fissure variations have been reported. Due to this diversity, having good knowledge of the fissure anatomical architecture is essential when performing surgical procedures and interpreting radiological images to clinically identify the location of bronchopulmonary segments.
Anahtar Kelimeler
Kaynakça
- Singh V. Textbook of Anatomy: Upper Limb and Thorax. 3rd ed. eBook: Elsevier Health Sciences; 2020.
- Standring S. Gray's anatomy: The Anatomical Basis of Clinical Practice 42nd ed. eBook: Elsevier Health Sciences; 2021.
- Bayter PA, Lee GM, Grage RA, et al. Accessory and incomplete lung fissures: Clinical and histopathologic implications. J Thorac Imaging. 2021;36(4):197-207.
- Nene AR, Gajendra KS, Sarma MVR. Lung lobes and fissures: a morphological study. Anatomy. 2011;5(1):30-38.
- Kc S, Shrestha P, Shah AK, Jha AK. Variations in human pulmonary fissures and lobes: A study conducted in nepalese cadavers. Anat Cell Biol. 2018;51(2):85-92.
- Manjunath M, Sharma MV, Janso K, John PK, Anupama N, Harsha DS. Study on anatomical variations in fissures of lung by CT scan. Indian J Radiol Imaging. 2021;31(4):797-804.
- Li S, Wang Z, Zhou K, et al. Effects of degree of pulmonary fissure completeness on major in-hospital outcomes after video-assisted thoracoscopic lung cancer lobectomy: a retrospective-cohort study. Ther Clin Risk Manag. 2018;14:461-474.
- Sadler TW, Langman J. Langman's medical embryology. 9th ed. US: Lippincott Williams and Wilkins; 2004:113.
- Aziz A, Ashizawa K, Nagaoki K, Hayashi K. High resolution CT anatomy of the pulmonary fissures. J Thorac Imaging. 2004;19(3):186-191.
- Gülsün M, Arıyürek OM, Cömert RB, Karabulut N. Variability of the pulmonary oblique fissures presented by high-resolution computed tomography. Surg Radiol Anat. 2006;28(3):293-299.
- Ozmen CA, Nazaroglu H, Bayrak AH, Senturk S, Akay HO. Evaluation of interlobar and accessory pulmonary fissures on 64-row MDCT. Clin Anat. 2010;23(5):552-558.
- Koenigkam-Santos M, Puderbach M, Gompelmann D, et al. Incomplete fissures in severe emphysematous patients evaluated with MDCT: incidence and interobserver agreement among radiologists and pneumologists. Eur J Radiol. 2012;81(12):4161-4166.
- Magadum A, Dixit D, Bhimalli S. Fissures and lobes of lung-An anatomical study and its clinical significance. Int J Curr Res Rev. 2015;7(3):8.
- Jacob SM, Pillay M. Variations in the inter-lobar fissures of lungs obtained from cadavers of South Indian origin. Int J Morphol. 2013;31(2):497-499.
- Lattupalli H. Lungs lobes and fissures: a morphological study. Int J Recent Trends Sci Technol. 2014;11:122-126.
- Mamatha Y, Murthy CK, Prakash B. Study of morphological variations of fissures and lobes of lung. Int J Anat Res. 2016;4(1):1874-1877.
- Joshi A, Mittal P, Rai AM, Verma R, Bhandari B, Razdan S. Variations in pulmonary fissure: A source of collateral ventilation and its clinical significance. Cureus. 2022;14(3): e23121.
- Prakash, Bhardwaj AK, Shashirekha M, Suma HY, Krishna GG, Singh G. Lung morphology: a cadaver study in Indian population. Ital J Anat Embryol. 2010;115(3):235-240.
- Dutta S, Mandal L, Mandal SK, Biswas J, Ray A, Bandopadhyay M. Natural fissures of lung-anatomical basis of surgical techniques and imaging. Natl J Med Res. 2013;3(02):117-121.
- Ariyürek OM, Gülsün M, Demirkazik FB. Accessory fissures of the lung: evaluation by high-resolution computed tomography. Eur Radiol. 2001;11(12):2449-2453.
- Nune GKR, Patra M, Rao K. Variation in the lobar pattern of the right & left lungs: a case report seen in 3 cadaveric lungs. IOSR J Dent Sci. 2015;3(14):1-5.
- Mutua V, Cheruiyot I, Bundi B, Mong'are N, Kipkorir V, Othieno E. Variations in the human pulmonary fissures and lobes: A cadaveric study. Open Access Library Journal. 2021;8(8):1-13.
- Yildiz A, Gölpinar F, Calikoğlu M, Duce MN, Ozer C, Apaydin FD. HRCT evaluation of the accessory fissures of the lung. Eur J Radiol. 2004;49(3):245-249.
- Watanabe K. Lungs. IN: Tubbs Shane R, Shoja MM, Loukas M, ed. Bergman’s Comprehensive Encyclopedia of Human Anatomic Variation. 1st ed. eBook: John Wiley & Sons; 2016:1217-1233.
- Deve M. Les lobes surnumeraires du poumon. Bull Mem Soc Anat Paris. 1900;75:341-367.
- Langlois SL, Henderson DW. Variant pulmonary location. Australas Radiol. 1980;24(3):255-261.
- Mpolokeng K, Madolo M, Louw G, Gunston G. Anatomical variations in lung fissures leading to supernumerary lobes in the lungs. Transl Res Anat. 2022;28:100209.
- Jariwala P, Maturu VN, Christopher J, Jadhav KP. Congenital isolated unilateral agenesis of pulmonary arteries in adults: case series and review. Indian J Thorac Cardiovasc Surg. 2021;37:144-154.
- Yaginuma H. Investigation of displaced bronchi using multidetector computed tomography: associated abnormalities of lung lobulations, pulmonary arteries and veins. Gen Thorac Cardiovasc Surg. 2020;68(4):342-349.
Öz
Amaç: Akciğer fissürleri embriyolojik olarak bronkopulmoner segmentleri birbirinden ayırırlar. Bu nedenle biz de toraks bilgisayarlı tomografi (BT) çekilen hastalarda fissürlerdeki anatomik varyasyonları bulmayı amaçladık.
Materyal ve Metod: Çalışmamıza 01 -15 Temmuz 2022 tarihleri arasında toraks BT tetkiki çektiren tüm hastalar dahil edilmiştir. Hastaların cinsiyetleri, akciğer fissürlerinin devamlılık durumu, aksesuar fissür varlığı ve varyasyonun tarafı kaydedildi. Cinsiyetler arası fissür sıklığı ki-kare testi kullanılarak değerlendirilmiştir.
Bulgular: Çalışmamıza toplamda 352 hasta (211 erkek, 141 kadın) dahil edildi. hastaların 95/352 (%26,99) tanesinde 105 varyasyon tespit edildi bunların 61/211’i (%28,91) erkek, 34/141’i (%24,11) kadındı. Sağ oblik fissür dokuz (%2,6) hastada inkomplet; sağ horizontal fissür 14 (%4) hastada inkomplet, 14 (%4) hastada ise yoktu. Sol oblik fissür 16 (%4,5) hastada inkomplet olarak izlendi. Toplamda 52 (%14,8) aksesuar fissür tespit edildi.
Sonuç: Literatürde çeşitli fissür varyasyon sıklığı bildirilmiştir. Bu çeşitlilik nedeniyle, cerrahi işlemler yapılırken ve radyolojik görüntüleri klinik olarak yorumlarken bronkopulmoner segmentlerin yerini tespit etmek için fissür anatomik yapısını iyi bilmek önemlidir.
Anahtar Kelimeler
Kaynakça
- Singh V. Textbook of Anatomy: Upper Limb and Thorax. 3rd ed. eBook: Elsevier Health Sciences; 2020.
- Standring S. Gray's anatomy: The Anatomical Basis of Clinical Practice 42nd ed. eBook: Elsevier Health Sciences; 2021.
- Bayter PA, Lee GM, Grage RA, et al. Accessory and incomplete lung fissures: Clinical and histopathologic implications. J Thorac Imaging. 2021;36(4):197-207.
- Nene AR, Gajendra KS, Sarma MVR. Lung lobes and fissures: a morphological study. Anatomy. 2011;5(1):30-38.
- Kc S, Shrestha P, Shah AK, Jha AK. Variations in human pulmonary fissures and lobes: A study conducted in nepalese cadavers. Anat Cell Biol. 2018;51(2):85-92.
- Manjunath M, Sharma MV, Janso K, John PK, Anupama N, Harsha DS. Study on anatomical variations in fissures of lung by CT scan. Indian J Radiol Imaging. 2021;31(4):797-804.
- Li S, Wang Z, Zhou K, et al. Effects of degree of pulmonary fissure completeness on major in-hospital outcomes after video-assisted thoracoscopic lung cancer lobectomy: a retrospective-cohort study. Ther Clin Risk Manag. 2018;14:461-474.
- Sadler TW, Langman J. Langman's medical embryology. 9th ed. US: Lippincott Williams and Wilkins; 2004:113.
- Aziz A, Ashizawa K, Nagaoki K, Hayashi K. High resolution CT anatomy of the pulmonary fissures. J Thorac Imaging. 2004;19(3):186-191.
- Gülsün M, Arıyürek OM, Cömert RB, Karabulut N. Variability of the pulmonary oblique fissures presented by high-resolution computed tomography. Surg Radiol Anat. 2006;28(3):293-299.
- Ozmen CA, Nazaroglu H, Bayrak AH, Senturk S, Akay HO. Evaluation of interlobar and accessory pulmonary fissures on 64-row MDCT. Clin Anat. 2010;23(5):552-558.
- Koenigkam-Santos M, Puderbach M, Gompelmann D, et al. Incomplete fissures in severe emphysematous patients evaluated with MDCT: incidence and interobserver agreement among radiologists and pneumologists. Eur J Radiol. 2012;81(12):4161-4166.
- Magadum A, Dixit D, Bhimalli S. Fissures and lobes of lung-An anatomical study and its clinical significance. Int J Curr Res Rev. 2015;7(3):8.
- Jacob SM, Pillay M. Variations in the inter-lobar fissures of lungs obtained from cadavers of South Indian origin. Int J Morphol. 2013;31(2):497-499.
- Lattupalli H. Lungs lobes and fissures: a morphological study. Int J Recent Trends Sci Technol. 2014;11:122-126.
- Mamatha Y, Murthy CK, Prakash B. Study of morphological variations of fissures and lobes of lung. Int J Anat Res. 2016;4(1):1874-1877.
- Joshi A, Mittal P, Rai AM, Verma R, Bhandari B, Razdan S. Variations in pulmonary fissure: A source of collateral ventilation and its clinical significance. Cureus. 2022;14(3): e23121.
- Prakash, Bhardwaj AK, Shashirekha M, Suma HY, Krishna GG, Singh G. Lung morphology: a cadaver study in Indian population. Ital J Anat Embryol. 2010;115(3):235-240.
- Dutta S, Mandal L, Mandal SK, Biswas J, Ray A, Bandopadhyay M. Natural fissures of lung-anatomical basis of surgical techniques and imaging. Natl J Med Res. 2013;3(02):117-121.
- Ariyürek OM, Gülsün M, Demirkazik FB. Accessory fissures of the lung: evaluation by high-resolution computed tomography. Eur Radiol. 2001;11(12):2449-2453.
- Nune GKR, Patra M, Rao K. Variation in the lobar pattern of the right & left lungs: a case report seen in 3 cadaveric lungs. IOSR J Dent Sci. 2015;3(14):1-5.
- Mutua V, Cheruiyot I, Bundi B, Mong'are N, Kipkorir V, Othieno E. Variations in the human pulmonary fissures and lobes: A cadaveric study. Open Access Library Journal. 2021;8(8):1-13.
- Yildiz A, Gölpinar F, Calikoğlu M, Duce MN, Ozer C, Apaydin FD. HRCT evaluation of the accessory fissures of the lung. Eur J Radiol. 2004;49(3):245-249.
- Watanabe K. Lungs. IN: Tubbs Shane R, Shoja MM, Loukas M, ed. Bergman’s Comprehensive Encyclopedia of Human Anatomic Variation. 1st ed. eBook: John Wiley & Sons; 2016:1217-1233.
- Deve M. Les lobes surnumeraires du poumon. Bull Mem Soc Anat Paris. 1900;75:341-367.
- Langlois SL, Henderson DW. Variant pulmonary location. Australas Radiol. 1980;24(3):255-261.
- Mpolokeng K, Madolo M, Louw G, Gunston G. Anatomical variations in lung fissures leading to supernumerary lobes in the lungs. Transl Res Anat. 2022;28:100209.
- Jariwala P, Maturu VN, Christopher J, Jadhav KP. Congenital isolated unilateral agenesis of pulmonary arteries in adults: case series and review. Indian J Thorac Cardiovasc Surg. 2021;37:144-154.
- Yaginuma H. Investigation of displaced bronchi using multidetector computed tomography: associated abnormalities of lung lobulations, pulmonary arteries and veins. Gen Thorac Cardiovasc Surg. 2020;68(4):342-349.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Radyoloji ve Organ Görüntüleme |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Erken Görünüm Tarihi | 13 Aralık 2023 |
| Yayımlanma Tarihi | 18 Aralık 2023 |
| Gönderilme Tarihi | 19 Haziran 2023 |
| Kabul Tarihi | 17 Eylül 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 8 Sayı: 4 |
