基于腹部CTA腹腔干正中弓状韧带压迫的影像解剖学研究

doi:10.13418/j.issn.1001-165x.2024.4.11

Abstract

Abstract: Objective　The epidemiologic and anatomic features of the median arcuate ligament (MAL) causing celiac artery (CA) compression were retrospectively investigated.　Methods　The starting position and distance of MAL and CA, the degree of compression of the celiac trunk, the angle of emergence (AE) and the fold angle (FA) of CA were measured. The anatomical and baseline characteristics of the compression of the CA caused by the MAL wereanalyzed.　Results　The levels of MAL and CA vertebral body initiation were negatively correlated with BMI. There were statistical differences in BMI, MAL and CA vertebral body initiation between the MAL/CA overlap group and non-overlap group. Abdominal trunk AE and FA were correlated with BMI. MAL caused abdominal trunk compression in 9.7% of cases, which was consistent with MALS in 4.6% of cases. There were statistical differences in BMI, AE, and FA angles between the abdominal trunk compression group and the non-compression group.　Conclusions　This study provides basis for the study of anatomy, pathology and clinical diagnosis and treatment of median arcuate ligament syndrome (MALS).

Key words: Median arcuate ligament syndrome;　Celiac artery compression;　Abdominal CTA, Imaging Anatomy

CLC Number:

R445.3

Li Jingjing, Gong Shenchu, Yin Jianbing . Radiographic anatomical study of median arcuate ligament compression in the celiac artery based on abdominal CTA[J]. Chinese Journal of Clinical Anatomy, 2024, 42(4): 424-428.

References

[1] Okobi OE, Afuda BA, Boms M, et al. Median arcuate ligament syndrome: management and literature review[J]. Cureus, 2022, 14(9): e28889. DOI: 10.7759/cureus.28889.
[2] Goodall R, Langridge B, Onida S, et al. Median arcuate ligament syndrome[J]. J Vasc Surg, 2020, 71(6): 2170-2176. DOI: 10.1016/j.jvs.2019.11.012.
[3] Kim JE, Kang M, Jeong OS, et al. A Median arcuate ligament syndrome could be retermed as a nutcracker celiac ganglion abdominal pain syndrome[J]. J Neurogastroenterol,2023,29(2): 200-207. DOI: 10.5056/ jnm22158.
[4] Iqbal S, Chaudhary M. Median arcuate ligament syndrome (Dunbar syndrome)[J]. Cardiovasc Diagn Ther, 2021, 11(5): 1172-1176. DOI: 10.21037/cdt-20-846.
[5] Kazmi SSH, Safi N, Berge ST, et al. Laparoscopic surgery for median arcuate ligament syndrome (mals): a prospective cohort of 52 patients[J]. Vasc Health Risk Manag, 2022, 18(null): 139-151. DOI: 10.2147/VHRM.S350841.
[6] Kaszczewski P, Leszczyński J, Elwertowski M, et al. Combined treatment of multiple splanchnic artery aneurysms secondary to median arcuate ligament syndrome: a case study and review of the literature[J]. Am J Case Rep, 2020,21(null): e926074. DOI: 10.12659/AJCR. 926074.
[7] Dyches RP, Eaton KJ, Smith HF. The roles of celiac trunk angle and vertebral origin in median arcuate ligament syndrome[J]. Diagnostics (Basel), 2020, 10(2): 76. DOI: 10.3390/diagnostics10020076.
[8] Metz FM, Blauw JTM, Brusse-Keizer M, et al. Systematic review of the efficacy of treatment for median arcuate ligament syndrome[J]. Eur J Vasc Endovasc,2022, 64(6): 720-732. DOI: 10.1016/j.ejvs. 2022. 08.033.
[9] Lawton J, Touma J, Sénémaud J, et al. Computer-assisted study of the axial orientation and distances between renovisceral arteries ostia[J]. Surg Radiol Anat, 2017, 39(2): 149-160. DOI: 10.1007/s00276-016-1718-6.
[10]Petnys A, Puech-Leão P, Zerati AE, et al. Prevalence of signs of celiac axis compression by the median arcuate ligament on computed tomography angiography in asymptomatic patients[J]. J Vasc Surg, 2018, 68(6): 1782-1787. DOI: 10.1016/j.jvs.2018.04.044.
[11]Khrucharoen U, Juo YY, Sanaiha Y, et al. Factors associated with symptomology of celiac artery compression and outcomes following median arcuate ligament release[J]. Ann Vasc Surg, 2020, 62(null): 248-257. DOI: 10.1016/j.avsg.2019.06.025.
[12]Gümüş H, Gümüş M, Tekbaş G, et al. Clinical and multidetector computed tomography findings of patients with median arcuate ligament syndrome[J]. Clin Imag, 2012, 36(5): 522-525. DOI: 10.1016/j.clinimag.2011.11.031.
[13] Chan SM, Weininger G, Kozhimala M, et al. Utility of hook sign in the diagnosis of median arcuate ligament syndrome[J]. Ann Vasc Surg, 2023, 94(null): 165-171. DOI: 10.1016/j.avsg.2023.03.018.
[14] 何杰, 牛忠锋, 胡红杰. CT与数字减影血管造影诊断正中弓状韧带压迫腹腔动脉的对比研究[J]. 中国医学影像学杂志, 2018, 26(10): 763-766, 771. DOI: 10.3969/j.issn.1005-5185.2018.10.010.

Radiographic anatomical study of median arcuate ligament compression in the celiac artery based on abdominal CTA

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