Fetal median sacral artery anatomy study by micro-CT imaging

Area of Science:

• Embryology
• Human Anatomy
• Vascular Biology

Background:

• The median sacral artery (MSA) originates from the dorsal aorta and is vital for pelvic vascularization.
• Its development involves complex regression and remodeling during embryonic and fetal stages.
• Knowledge of MSA embryogenesis, anastomosis, and variations is incomplete, impacting surgical safety in pelvic procedures.

Purpose of the Study:

• To investigate the developmental stages of the median sacral artery (MSA) in human fetal development.
• To elucidate the formation of anastomoses involving the MSA and its contribution to pelvic vascularization.
• To understand anatomical variations of the MSA for improved clinical practice.

Main Methods:

• Micro-computed tomography (micro-CT) imaging was employed to study a human fetus at 22 weeks of gestation.
• Arterial segmentation and 3D visualization techniques were utilized for detailed analysis.

Main Results:

• At 22 weeks gestation, the MSA was a prominent, straight artery anterior to the sacrum, exceeding the abdominal aorta in length.
• Anastomoses were identified between the MSA and the internal pudendal and superior rectal arteries.
• No evidence of a coccygeal glomus with arteriovenous anastomosis was observed.

Conclusions:

• Micro-CT imaging and 3D visualization confirmed the central role of the MSA in pelvic vascularization via the ilio-aortic anastomotic system.
• Understanding the MSA's anastomotic network is critical for managing conditions like sacrococcygeal teratomas and parasitic twin gestations.
• Detailed anatomical knowledge of the MSA is essential for surgical planning and treating related pathological conditions.