title: Multidetector CT of vascular compression syndromes in the abdomen and pelvis.
abstract: Certain abdominopelvic vascular structures may be compressed by adjacent anatomic structures or may cause compression of adjacent hollow viscera. Such compressions may be asymptomatic; when symptomatic, however, they can lead to a variety of uncommon syndromes in the abdomen and pelvis, including median arcuate ligament syndrome, May-Thurner syndrome, nutcracker syndrome, superior mesenteric artery syndrome, ureteropelvic junction obstruction, ovarian vein syndrome, and other forms of ureteral compression. These syndromes, the pathogenesis of some of which remains controversial, can result in nonspecific symptoms of epigastric or flank pain, weight loss, nausea and vomiting, hematuria, or urinary tract infection. Direct venography or duplex ultrasonography can provide hemodynamic information in cases of vascular compression. However, multidetector computed tomography is particularly useful in that it allows a comprehensive single-study evaluation of the anatomy and resultant morphologic changes. Anatomic findings that can predispose to these syndromes may be encountered in patients who are undergoing imaging for unrelated reasons. However, the diagnosis of these syndromes should not be made on the basis of imaging findings alone. Severely symptomatic patients require treatment, which is generally surgical, although endovascular techniques are increasingly being used to treat venous compressions.
authors.affiliation: From the Department of Radiology, University of California, Davis Health System, 4860 Y St, Suite 3100, Sacramento, CA 95817 (R.L., D.T.T., S.S., J.P.M., M.T.C.); and Department of Radiology, University of California, Irvine Medical Center, Irvine, Calif (C.G.L).
authors.forename: Ramit
authors.initials: R
authors.lastname: Lamba
authors.forename: Dawn T
authors.initials: DT
authors.lastname: Tanner
authors.forename: Simran
authors.initials: S
authors.lastname: Sekhon
authors.forename: John P
authors.initials: JP
authors.lastname: McGahan
authors.forename: Michael T
authors.initials: MT
authors.lastname: Corwin
authors.forename: Chandana G
authors.initials: CG
authors.lastname: Lall
mesh_terms: D000328:Adult; D000368:Aged; D003251:Constriction, Pathologic / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D010388:Pelvis / Q000000981:diagnostic imaging*; D016491:Peripheral Vascular Diseases / Q000145:classification / Q000175:diagnosis*; D011856:Radiographic Image Enhancement / Q000379:methods; D011860:Radiography, Abdominal / Q000379:methods*; D013577:Syndrome; D055815:Young Adult