Detection Rate of Median Arcuate Ligament Syndrome in Japanese Population: Insights from Ultrasound Screening of 223 Individuals

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  • 日本人の正中弓状靭帯圧迫症候群の検出率～223名の超音波スクリーニング検査からの考察～

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<p>Purpose: This study aimed to assess the prevalence of median arcuate ligament syndrome (MALS) in the Japanese population by observing the celiac artery (CA) during abdominal ultrasound screenings. Subjects and Methods: Between January 2022 and February 2023, 532 abdominal ultrasound examinations were performed by a single sonographer at our institution. Of the 532 individuals screened, 223 Japanese patients were selected, excluding those whose examination purpose was suspicion of MALS, health check-ups, or non-Japanese individuals. The screening for MALS included: (1) observing the direction and diameter of the CA during rest expiration in a longitudinal epigastric scan, with a significant displacement of the CA axis towards the head or narrowing of the vessel being considered indicative of MALS; (2) checking for CA narrowing and turbulence, and measuring the vessel diameter and peak systolic velocity (PSV) during inhalation and exhalation at the narrowed part; and (3) if respiratory-induced changes in the CA axis, stenosis, or turbulence were noted, and if the PSV in the turbulent area exceeded 200 cm/s, or if there was a difference of more than 50 cm/s in PSV between inhalation and exhalation, MALS was suspected. Results and Discussion: MALS was suspected in 11 out of 223 individuals (4.9%). Among these, seven underwent a detailed examination with abdominal contrast-enhanced CT, and all were diagnosed with MALS (3.1%). Four patients with severe abdominal symptoms (1.3%) underwent surgery, resulting in symptom improvement for all. The average time for detailed CA observation was 6.8 ± 1.2 minutes. Conclusion: The detection rate of MALS in this study was found to be 3.1%. MALS can cause abdominal pain and visceral artery aneurysm, but surgery can improve symptoms. The diagnostic accuracy of ultrasound for MALS is high. Therefore, it is advisable to perform a detailed observation of CA, taking into account the possibility of MALS.</p>

Journal

  • Choonpa Igaku

    Choonpa Igaku 51 (4), 173-177, 2024

    The Japan Society of Ultrasonics in Medicine

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