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

中国临床解剖学杂志 ›› 2024, Vol. 42 ›› Issue (4): 424-428.doi: 10.13418/j.issn.1001-165x.2024.4.11

基于腹部CTA腹腔干正中弓状韧带压迫的影像解剖学研究

李晶晶^1，2，龚沈初¹*，尹剑兵¹

1.南通大学第二附属医院影像科，江苏南通 226006； 2.南通大学杏林学院附属如东医院影像科，江苏南通 226400

收稿日期:2023-12-02 出版日期:2024-07-25 发布日期:2024-08-27
作者简介:李晶晶（1992-），女，江苏南通人，主治医师，南通大学医学院在读在职研究生，研究方向：腹部影像诊断，E-mail：2272456632@qq.com

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

Li Jingjing^1，2, Gong Shenchu¹*, Yin Jianbing¹

1. Department of Radiology, the Second Affiliated Hospital of Nantong University, Nantong 226006, Jiangsu Province, China; 2. Department of Radiology, Affiliated Rudong Hospital of Xinglin College，Nantong University, Nantong 226400, Jiangsu Province, China

Received:2023-12-02 Online:2024-07-25 Published:2024-08-27

摘要/Abstract

摘要： 目的　回顾性研究正中弓状韧带（median arcuate ligament，MAL）引起腹腔干（celiac artery，CA）压迫的流行病学、解剖学特征。方法　测量MAL和CA起始位置及两者距离；CA受压程度，腹腔干主动脉角（angle of emergence，AE）及腹腔干折角（fold angle，FA）。分析MAL引起CA压迫的解剖学特征与基线特征。结果 MAL和CA椎体起始水平与BMI呈负相关。MAL/CA重叠组与非重叠组在BMI、MAL、CA椎体起始位置等方面的差异有统计学意义。AE、FA与BMI相关。MAL引起CA压迫占9.7%，其中符合正中弓状韧带综合征（median arcuate ligament syndrome，MALS）占4.6%。BMI、AE、FA的差异在腹腔干压迫组与非压迫组间有统计学意义。结论　本研究为MALS的解剖学、病理学及临床诊治研究提供依据。

关键词: 正中弓状韧带综合征, 　腹腔干压迫, 　腹部CTA, 　影像解剖

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

中图分类号:

R445.3

李晶晶, 龚沈初, 尹剑兵. 基于腹部CTA腹腔干正中弓状韧带压迫的影像解剖学研究[J]. 中国临床解剖学杂志, 2024, 42(4): 424-428.

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.

参考文献

[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.

基于腹部CTA腹腔干正中弓状韧带压迫的影像解剖学研究

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

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 6

Metrics

本文评价

推荐阅读 0

[1]	孙克, 周广文, 蒋智烨, 王洪岗. 横突根部入路经皮椎弓根螺钉的解剖基础研究[J]. 中国临床解剖学杂志, 2024, 42(3): 246-250.
[2]	肖平, 李杨涛, 言羿文, 侯德淼, 张坤木, 徐准, 李义凯. 不同年龄正常人群骶髂关节间隙的CT影像解剖学观测[J]. 中国临床解剖学杂志, 2022, 40(2): 143-149.
[3]	周雪明, 黄桂武, 刘彬, 谢荏棠, 邬培慧, 吴润柏. 臼杯边缘与髋臼骨性边缘位置关系影像解剖学研究[J]. 中国临床解剖学杂志, 2021, 39(3): 297-301.
[4]	余琴琴, 陈焱君, 张晓东, 周全, 杨洋, 钟世镇, 黄文华. 三种3D序列显示腰骶丛神经及影像解剖的比较[J]. 中国临床解剖学杂志, 2020, 38(4): 385-390.
[5]	张少群,冯梓誉,陈燕萍,张磊,祁冀,李义凯. 成年人正常骶髂关节间隙的CT影像解剖学观测及其临床意义[J]. 中国临床解剖学杂志, 2019, 37(1): 14-19.
[6]	李晓燕,吕发金,周永霞,张翱,胡良波,刘丹. 肾上腺静脉MSCT影像解剖研究[J]. 中国临床解剖学杂志, 2015, 33(3): 278-283.