Median arcuate ligament syndrome: multidetector computed tomography findings.
OBJECTIVE
We aimed to describe the clinical and multidetector computed tomography (MDCT) angiography findings of celiac, mesenteric, and renal artery entrapment by the median arcuate ligament.


METHODS
Patients (n = 453) who underwent MDCT abdominal aorta angiography in a period of 3 years were retrospectively reviewed for vascular compression by median arcuate ligament known as median arcuate ligament syndrome. The MDCT examinations were performed with 16-slice (n = 292) and 64-slice scanners (n = 161). The median arcuate ligament itself and adjacent vascular branches of abdominal aorta were assessed for compression by 2 different radiologists who are experienced on MDCT angiography more than 3 years. Both axial, multiplanar reformatted images and 3-dimensional angiographies were used for interpretation.


RESULTS
Twelve patients were found to have clinically significant vessel entrapments by median arcuate ligament; 6 of them with celiac artery, 4 of them with renal artery, and 2 of them with both celiac and mesenteric artery involvement. Patients with celiac and mesenteric vessel entrapments presented with epigastric pain. All patients with renal artery entrapment had resistant hypertension. The MDCT showed the proximal narrowing caused by compression of median arcuate ligament. The proximal portions of renal arteries pulled down and in toward the aorta, with mild to moderate narrowing.


CONCLUSIONS
The MDCT exanimation with multiplanar images and 3-dimensional angiography is a noninvasive imaging technique that can be used with high accuracy in the diagnosis of median arcuate ligament syndrome.
Ilica
Ahmet Turan
AT
Department of Radiology, Gulhane Military Medical School, Ankara, Turkey. aturca2002@yahoo.com
Kocaoglu
Murat
M
Bilici
Aslan
A
Ors
Fatih
F
Bukte
Yasar
Y
Senol
Ayhan
A
Ucoz
Taner
T
Somuncu
Ibrahim
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging*; D002445:Celiac Artery; D003287:Contrast Media; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007472:Iohexol / Q000031:analogs & derivatives; D008022:Ligaments; D008297:Male; D017538:Mesenteric Artery, Superior; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging*; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D013577:Syndrome; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide