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Exploring celiac trunk parameters in median arcuate ligament syndrome: A CT study

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Abstract

Purpose

To assess anatomical variations in the celiac trunk (Ct) in patients with Median Arcuate Ligament Syndrome (MALS) using computed tomography (CT). The primary objectives were to investigate the celiac trunk angle (CtA), origin level, length (CtL), and their relationships with the superior mesenteric artery (SMA) in MALS patients. Additionally, the study intended to evaluate gender differences in these parameters and explore correlations between variables.

Methods

Retrospectively, reports of abdominal CT scans taken between January 2018, and Sepmtember 2021, in the hospital image archive were screened vey two observers independently for MALS diagnosis. Parameters such as CtA, CtL, Ct-SMA distance, SMA angle (SMAA), and median arcuate ligament thickness (MALT) were measured. Statistical analyses were conducted using SPSS software.

Results

Among the 81 patients (25 females, 56 males), significant differences were observed in MALT between genders (p = 0.001). CtA showed a negative correlation with CtL and Ct-SMA (p < 0.001), and a positive correlation was found between CtL and Ct-SMA (p = 0.002). CtL was measured as 25 mm for the all group. Origin levels of Ct and SMA were evaluated in comparison to vertebral levels. Ct-SMA distance was relatively shorter (9.19 mm) compared to the literature. SMAA findings were consistent with normal population values.

Conclusion

This study provided valuable insights into the anatomical parameters of the Ct ans SMA in MALS patients. Despite some differences compared to normal population parameters, no evidence supported the hypothesis of a superiorly placed Ct contributing to MALS.

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Data availability

There are ethical restrictions on sharing an original anonymized data set, because the data contain potentially identifying patient information. Contact the corresponding author upon reasonable request.

Abbreviations

Ct:

celiac trunk

CT:

computed tomography

CtA:

celiac trunk angle

CtL:

celiac trunk length

Ct-SMA:

the distance between SMA and Ct

MAL:

median arcuate ligament

MALS:

median arcuate ligament syndrome

MALT:

median arcuate ligament thickness

SMA:

superior mesenteric artery

SMAA:

superior mesenteric artery angle

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Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey

    Emre Emekli & Elif Gündoğdu

  2. Department of Radiology, Karadeniz Ereğli State Hospital, Zonguldak, Turkey

    Fatma Didem Bayav

Authors
  1. Emre Emekli
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  2. Fatma Didem Bayav
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  3. Elif Gündoğdu
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Contributions

EE: Conception and design of the study, Acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be submitted FDB: Conception and design of the study, Acquisition of data, Final approval of the version to be submitted. EG: Conception and design of the study, Analysis and interpretation of data, Final approval of the version to be submitted.

Corresponding author

Correspondence to Emre Emekli.

Ethics declarations

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committe of Eskişehir Osmangazi University (Date XXX/No. XXX).

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Not applicable.

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Approval from the Institutional Review Board was obtained and in keeping with the policies for a retrospective review, informed consent was not required.

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The authors declare no competing interests.

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Emekli, E., Bayav, F.D. & Gündoğdu, E. Exploring celiac trunk parameters in median arcuate ligament syndrome: A CT study. Surg Radiol Anat (2024). https://doi.org/10.1007/s00276-024-03352-7

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