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A new comprehensive ultrasonic diagnostic method for celiac artery compression syndrome that hybridizes “arterial compression hook sign” and peak systolic velocity

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Abstract

Purpose

Diagnosing celiac artery compression syndrome (CACS) is based on an imaging finding of celiac artery compression (CAC), but the diagnostic criteria are inconsistent. The study aim was to devise an ultrasonographic screening method to effectively diagnose CAC in occult CACS.

Methods

The subjects were 61 patients with suspected CACS who underwent ultrasonography at our hospital from May 2017 to December 2019 and were divided into the following two groups: the “arterial compression hook sign”-positive group (n = 15, mean age: 26.6 ± 16.4 years, six males, nine females) and -negative group (n = 41, mean age: 32.5 ± 18.6 years, 12 males, 34 females). We used B-mode and advanced dynamic flow to detect arterial compression hook sign and pulse Doppler to measure expiration peak systolic velocity (EPSV) and inspiration PSV (IPSV).

Results

The EPSV was significantly higher in the arterial compression hook sign-positive group (304.7 ± 47.4 cm/s) than in the -negative groups (158.2 ± 38.7 cm/s), (p < 0.001). Receiver operating characteristic curve analysis was performed to calculate the EPSV cutoff value for presence of CAC, which was 226 cm/s (sensitivity: 0.957, specificity: 1.000, AUC: 0.997, 95% confidence interval: 0.99–1). The IPSV was lower in the positive group than in the negative group in all cases (EPSV − IPSV range: 68–199 cm/s).

Conclusion

Our results showed that if arterial compression hook sign determined by B-mode ultrasound, EPSV > 226 cm/s, and IPSV decreases by ≥ 68 cm/s, then CAC can be detected with high specificity.

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Data availability

The data sets generated and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank Enago (www.enago.jp) for the English language review.

Funding

No financial support was received.

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Authors and Affiliations

  1. Department of Clinical Laboratory, Fukuoka Tokushukai Hospital, 4-5 Sugu Kita, Kasuga-shi, Fukuoka, 816-0864, Japan

    Daisuke Miura, Rino Hiwatashi & Mitsuto Sakita

  2. Department of Laboratory Medicine, Fukuoka Tokushukai Hospital, 4-5 Sugu Kita, Kasuga-shi, Fukuoka, 816-0864, Japan

    Tomoko Sakata

Authors
  1. Daisuke Miura
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  2. Rino Hiwatashi
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  3. Mitsuto Sakita
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  4. Tomoko Sakata
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Contributions

DM: data collection and analysis, manuscript writing, RH: data collection, MS: data collection, YH: diagnosis and treatment, TS: check and proofread.

Corresponding author

Correspondence to Daisuke Miura.

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The authors have no competing interests to declare.

Research involving human participants and/or animals

This research was approved by the medical ethics committee of the Fukuoka Tokushukai Hospital (No.200302).

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Informed consent was obtained from all individual participants included in the study.

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Miura, D., Hiwatashi, R., Sakita, M. et al. A new comprehensive ultrasonic diagnostic method for celiac artery compression syndrome that hybridizes “arterial compression hook sign” and peak systolic velocity. J Ultrasound 24, 289–295 (2021). https://doi.org/10.1007/s40477-020-00519-x

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  • DOI: https://doi.org/10.1007/s40477-020-00519-x

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