Vascular compression syndromes in the abdomen and pelvis: what should we know?

Abstract

Introduction. Because abdominal cavity organs are arranged in confined anatomic space, various anatomical structures can compress blood vessels, or arteries of harder consistency can compress internal organs. Abdominal vascular compression syndromes are uncommon and can be a diagnostic challenge for attending physician, because they present with nonspecific symptoms. However, their imaging findings are characteristic and must be recognized by radiologists. Aims and Objectives. To evaluate prevalence rate of superior mesenteric artery syndrome in CT imaging research carried out in The Hospital of Lithuanian University of Health Sciences Kauno Klinikos radiology clinic. Materials and methods. Evaluation of 330 patients abdomen CTs. Program Advantage Workstation 4.2P. was used for multiplanar reconstruction. Statistical analysis was performed with SPSS v. 23.0. Results. Superior mesenteric artery syndrome risk factors were identified: small aortomesenteric angle and decreased aortomesenteric distance with prevalence of 18,2 pct. and 14,3 pct. of cases, respectively. At least one risk factor was prevalent in 25,6 pct., both in 6,7 pct. of patients. Low origin of SMA was observed in 6,7 pct. cases. Compression of the left renal vein between the SMA and aorta in 24,0 pct. cases: 7,0 pct. of them had radiology signs compatible with Nutcracker syndrome. Identified lower than 10 mm cut-off value with 73 pct. sensitivity and 81 pct. specificity of the distance between SMA and abdominal aorta at the level of left renal vein. Conclusions: 1. The prevalence rate of SMA syndrome risk factors indentified: SMA angle less than 28° - 18,2 pct, distance between SMA and AA less than 10 mm - 14,3 pct, low SMA branching position from the abdominal aorta - 6,7 pct patients. 2. 7,0 pct of patients had radiology signs compatible with NS. 3. Identified lower than 10 mm cut-off value with 73 pct sensitivity and 81 pct specificity of th.[...].