Horton Karen M, Talamini Mark A, Fishman Elliot K
Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, 601 N Caroline St, JHOC 3253, Baltimore, MD 21287, USA.
Radiographics. 2005 Sep-Oct;25(5):1177-82. doi: 10.1148/rg.255055001.
The median arcuate ligament is a fibrous arch that unites the diaphragmatic crura on either side of the aortic hiatus. The ligament usually passes superior to the origin of the celiac axis. However, in some people, the ligament inserts low and thus crosses the proximal portion of the celiac axis, causing compression and sometimes resulting in abdominal pain. The diagnosis of clinically significant celiac axis compression, referred to as median arcuate ligament syndrome, is traditionally made with conventional angiography; however, the condition can now be diagnosed with three-dimensional computed tomographic (CT) angiography. In patients with median arcuate ligament syndrome, CT angiograms demonstrate a characteristic focal narrowing in the proximal celiac axis. The focal narrowing has a characteristic hooked appearance, which can help distinguish this condition from other causes of celiac artery narrowing, such as atherosclerotic disease. Once the disorder has been diagnosed, surgery can be performed to relieve the compression. In some patients, the ligamentous constriction of the celiac axis causes vascular damage, which may require vascular reconstruction. CT angiography can play a role in the diagnosis of median arcuate ligament syndrome by demonstrating the characteristic focal narrowing of the celiac artery in patients presenting with the appropriate clinical symptoms.
正中弓状韧带是一个纤维性弓，连接主动脉裂孔两侧的膈脚。该韧带通常位于腹腔干起始部的上方。然而，在一些人身上，韧带附着位置较低，从而跨过腹腔干的近端部分，导致压迫，有时会引起腹痛。具有临床意义的腹腔干压迫的诊断，即正中弓状韧带综合征，传统上通过传统血管造影术进行；然而，现在这种情况可以通过三维计算机断层扫描（CT）血管造影术来诊断。在正中弓状韧带综合征患者中，CT血管造影显示腹腔干近端有特征性的局灶性狭窄。这种局灶性狭窄具有特征性的钩状外观，这有助于将这种情况与腹腔动脉狭窄的其他原因，如动脉粥样硬化疾病区分开来。一旦确诊，可进行手术以缓解压迫。在一些患者中，腹腔干的韧带性狭窄会导致血管损伤，这可能需要进行血管重建。CT血管造影通过显示出现适当临床症状患者腹腔动脉的特征性局灶性狭窄，可在正中弓状韧带综合征的诊断中发挥作用。
