title: Superior mesenteric artery syndrome: CT and ultrasonography findings.
abstract: OBJECTIVE
  The purpose of the study was to describe computed tomography (CT) and ultrasonography findings in superior mesenteric artery syndrome (SMAS).
  
  
  METHODS
  The study was performed on 89 CT examinations. Ultrasonography was performed on 32 and barium study was performed on four of these subjects. Group A consisted of cases with one or more of the following complaints: postprandial epigastric pain, weight loss and vomiting. Group B consisted of the remaining cases. Cases who had all of the above-mentioned clinical findings and duodenal dilatation, to-and-fro barium movement and SMA indentation in barium study were diagnosed as having SMAS. Body mass index (BMI, kg/m2) was calculated. The distance between SMA and aorta, at the location where the duodenum passes from, was measured on CT and ultrasonography. The angle between SMA and aorta was measured on ultrasonography images. Group and gender differences were analyzed with t-test, the relationship between clinical and CT findings was analyzed with Mann Whitney U test and the relations between BMI-CT and CT-ultrasonography measurements were analyzed with Pearson coefficients.
  
  
  RESULTS
  Of 13 cases in Group A, 3 were diagnosed as SMAS. Eight of the cases showed gastric and/or duodenal dilatation. In 6 cases, antrum had an abnormally high location at portal hilus. In Group A, the SMA-aorta distance was 6.6 +/- 1.5 mm and the SMA-aorta angle was 18.7 +/- 10.7 degrees . In Group B, these values were 16.0 +/- 5.6 mm and 50.9 +/- 25.4 degrees , respectively (p < 0.001). Cut-off values between SMAS and Group B were 8 mm (100% sensitivity and specificity), and 22 degrees (42.8% sensitivity, 100 % specificity). CT and ultrasonography measurements (p < 0.001) and SMA-aorta distance and BMI (p=0.004) were significantly correlated. The SMA-aorta distance was significantly shorter in females (p=0.036).
  
  
  CONCLUSIONS
  Gastric and/or duodenal dilatation and a diminished SMA-aorta distance have a significant correlation with clinical symptoms of SMAS that include postprandial pain, vomiting and weight loss.
authors.affiliation: Department of Radiology, Kirikkale University School of Medicine, Kirikkale, Turkey. birsenunal@hotmail.com
authors.forename: Birsen
authors.initials: B
authors.lastname: Unal
authors.forename: Aykut
authors.initials: A
authors.lastname: Aktaş
authors.forename: Gökhan
authors.initials: G
authors.lastname: Kemal
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Bilgili
authors.forename: Sefa
authors.initials: S
authors.lastname: Güliter
authors.forename: Cağatay
authors.initials: C
authors.lastname: Daphan
authors.forename: Kuzey
authors.initials: K
authors.lastname: Aydinuraz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013478:Superior Mesenteric Artery Syndrome / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014421:Turkey / Q000453:epidemiology; D014463:Ultrasonography; D014839:Vomiting / Q000209:etiology; D015431:Weight Loss