Differential growth patterns of the abdominal aorta and vertebrae during childhood

The adult vertebral level of the splanchnic branches of the abdominal aorta relies on a complex series of fusion and regression steps during embryological development, such that variation is common. Little is known however regarding the anatomy of the abdominal aorta in children. This study aimed to investigate the spatial relationship between the abdominal aorta and the vertebral column during childhood development to inform clinical management of pediatric patients. Retrospective multislice computed tomography abdominopelvic angiograms of children aged neonate to 19 years (n = 232) were used to examine vertebral levels of the celiac trunk (CoT), superior mesenteric artery (SMA), inferior mesenteric artery (IMA), and aortic bifurcation (AB) using multiplanar formatting views in OsiriX. The abdominal aorta length, AB angle, and displacement of the aorta from the midline were quantified with the effect of age and sex analyzed using multinomial logistic regression and general linear models. The most frequent origins of CoT, SMA, IMA, and AB were T12, L1, L3, and L4, respectively, with significant variation in vertebral level for each vessel. SMA level was significantly more proximal with age, and CoT and AB demonstrated marked sex differences in vertebral level. As the age of the child increased, AB angle decreased, aortic displacement increased, and the length of the abdominal aorta increased at a slower velocity to the vertebral column (P < 0.001). Our study highlights the variation of the location and geometry of the abdominal aorta in children; this knowledge will positively impact pediatric surgical approaches and endovascular procedures. Clin. Anat. 32:783-793, 2019. © 2019 Wiley Periodicals, Inc.