title: Median arcuate ligament syndrome: Predictor of ischemic complications?
abstract: Median arcuate ligament syndrome (MALS) is a pathologic entity that can affect the celiac axis. Due to the extensive collateral network of mesenteric circulation, stenosis of one mesenteric artery does not lead to significant symptoms. The purpose of this study was to describe multidetector computed tomography (MDCT) angiography findings of celiac artery entrapment by the median arcuate ligament and determine those patients with high risks of ischemic complications. From January 2012 to March 2016, 103 patients with celiac artery (CA) compression by median arcuate ligament were detected. In 23 patients collateral circulation was developed. In order to investigate the problem, we managed to estimate the correlation between range of stenosis of CA and presence of collateral circulation between the celiac artery (CA) and superior mesenteric artery (SMA). A statistically significant correlation was found between range of CA stenosis and collateral circulation presence (Spearman's correlation coefficient 0.339, P < 0.0001). In conclusions, based on our observations, we hypothesize that ischemia as a result of mesenteric vessel narrowing by the median arcuate ligament may occur more often than indicated by clinical symptoms and described in literature. Clin. Anat. 29:1025-1030, 2016. © 2016 Wiley Periodicals, Inc.
authors: Department of Radiology, Medical University of Łódź, Kopcińskiego 22, Łódź, 90-153, Poland.
authors: Agata
authors: A
authors: Arazińska
authors: Department of Angiology, Medical University of Łódź, Narutowicza 60, Łódź, 90-136, Poland. michal.polguj@umed.lodz.pl.
authors: Michał
authors: M
authors: Polguj
authors: Department of Radiology, Medical University of Łódź, Kopcińskiego 22, Łódź, 90-153, Poland.
authors: Andrzej
authors: A
authors: Wojciechowski
authors: Department of Radiology, Medical University of Łódź, Kopcińskiego 22, Łódź, 90-153, Poland.
authors: Łukasz
authors: Ł
authors: Trębiński
authors: Department of Radiology, Medical University of Łódź, Kopcińskiego 22, Łódź, 90-153, Poland.
authors: Ludomir
authors: L
authors: Stefańczyk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002445:Celiac Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D003097:Collateral Circulation; D000072226:Computed Tomography Angiography; D003251:Constriction, Pathologic / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology*; D008297:Male; D000074742:Median Arcuate Ligament Syndrome; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012189:Retrospective Studies; D055815:Young Adult
keywords: MDCT angiography; celiac artery; celiac artery compression syndrome; collateral circulation; constriction; ischemia; median arcuate ligament syndrome; splanchnic circulation; superior mesenteric artery