title: Analysis of variation in bronchovascular pattern of the right middle and lower lobes of the lung using three-dimensional CT angiography and bronchography.
abstract: OBJECTIVE
  General thoracic surgeons must be familiar with anatomical variation in the pulmonary vessels and bronchi. Here, we analyzed the bronchovascular pattern of the right middle lobe (RML) and right lower lobe (RLL) of the lung using three-dimensional CT angiography and bronchography (3DCTAB).
  
  
  METHODS
  We reviewed the anatomical patterns of the pulmonary vessels and bronchi in 270 patients using 3DCTAB images.
  
  
  RESULTS
  The branching patterns of vessels and bronchi of RML and S6were classified according to the number of stems. The single-stem type was the most common, except in the artery of the RML, for which the two-stem type was the most common. The artery and bronchus of S*, which is an independent segment between S6and S10, were observed in 20.4% of cases. The branching pattern of A7(B7) was classified into four types. The A7a (B7a) type was observed in 74.8% of cases, and was the most common. The branching pattern of the artery and bronchus of S8-10was classified into five and three types, respectively. The A8and A9+ A10type, and the B8and B9+ B10type, were observed in 68.1 and 80.4% of cases, respectively, and were the most common types. The branching pattern of V8-10was more complex than that of A8-10and B8-10.
  
  
  CONCLUSIONS
  We explored the bronchovascular patterns of RML and RLL and their frequencies using a large number of 3DCTAB images. Our data can be used by thoracic surgeons to perform safe and precise lung resections.
authors.affiliation: Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Toshiteru
authors.initials: T
authors.lastname: Nagashima
authors.affiliation: Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan. kmshimizu@gmail.com.
authors.forename: Kimihiro
authors.identifier: http://orcid.org/0000-0003-4076-5174
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ohtaki
authors.affiliation: Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Kai
authors.initials: K
authors.lastname: Obayashi
authors.affiliation: Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Seshiru
authors.initials: S
authors.lastname: Nakazawa
authors.affiliation: Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Mogi
authors.affiliation: Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D001980:Bronchi / Q000098:blood supply* / Q000000981:diagnostic imaging; D001995:Bronchography / Q000379:methods*; D000072226:Computed Tomography Angiography / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008168:Lung / Q000098:blood supply* / Q000000981:diagnostic imaging
keywords: Lung anatomy; Lung cancer surgery; Segmentectomy; Three-dimensional CT