Baskan Ozdil, Kaya Emre, Gungoren Fatma Zeynep, Erol Cengiz
Istanbul Medipol University, Department of Radiology, Istanbul, Turkey.
Istanbul Medipol University, Department of Radiology, Istanbul, Turkey.
Can Assoc Radiol J. 2015 Aug;66(3):272-6. doi: 10.1016/j.carj.2015.01.001. Epub 2015 Apr 17.
The prevalence of the celiac artery stenosis caused by median arcuate ligament (MAL) compression and its multidetector computed tomography (MDCT) characteristics were evaluated in patients who underwent abdominal MDCT procedures, retrospectively.
Totally 1121 patients who had abdominal MDCT with arterial phase or MDCT angiography of the abdominal aorta for various indications were analyzed for celiac artery compression by the MAL.
Fifty (ie, 4.6%) patients showed typical MDCT features of MAL compression. Focal narrowing of the proximal celiac artery, a characteristic hooked appearance of the narrowed segment without calcification and atherosclerotic changes were diagnostic. Poststenotic dilatation was detected in 22 (44%) patients with MAL compression. The ratio of the stenosis of the celiac artery was between 35%-50% in 15 patients and 51%-80% in 35 patients. The gastroduodenal artery diameter of these patients was not significantly different from the asymptomatic control group.
MALS is an uncommon entity but it should be kept in mind in the presence of unexplained gastrointestinal symptoms. MDCT is a minimally invasive and plays a dominant role in the diagnosis of MAL compression especially with reformatted and 3-D reconstructed images.
回顾性评估接受腹部多层螺旋计算机断层扫描（MDCT）检查的患者中，由正中弓状韧带（MAL）压迫导致的腹腔干狭窄的患病率及其MDCT特征。
对总共1121例因各种适应证接受腹部MDCT动脉期扫描或腹主动脉MDCT血管造影的患者进行分析，以确定是否存在MAL对腹腔干的压迫。
50例（即4.6%）患者表现出典型的MAL压迫MDCT特征。腹腔干近端局灶性狭窄、狭窄段特征性的钩状外观且无钙化和动脉粥样硬化改变具有诊断意义。在22例（44%）MAL压迫患者中检测到狭窄后扩张。15例患者腹腔干狭窄比例在35% - 50%之间，35例患者在51% - 80%之间。这些患者的胃十二指肠动脉直径与无症状对照组无显著差异。
MAL压迫综合征（MALS）是一种罕见疾病，但在存在无法解释的胃肠道症状时应予以考虑。MDCT是一种微创检查，在MAL压迫的诊断中起主导作用，尤其是通过重组图像和三维重建图像。
