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Correlation of Riolan’s arch diameter to treatment choice in patients with isolated superior mesenteric artery dissection

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Objective

To investigate the diameter changes of Riolan’s arch in patients with isolated superior mesenteric artery dissection (ISMAD) and to evaluate the implication for treatment selection.

Methods

Ninety-five patients with CT angiography (CTA) confirmed ISMAD were retrospectively included, and another 95 cases with no positive findings on abdominal CTA were included as controls. According to the treatment methods, the patients were subsequently divided into conservative treatment (n = 68) or invasive treatment (n = 27) subgroups. According to the initial CTA images, the prevalence of Riolan’s arch as well as its diameter (DR) were determined in each subject, and compared between ISMAD and control cases, as well as between patients with different treatments. In patients with ISMAD, dissections were classified according to the Li classification.

Results

Riolan’s arch prevalence and DR were significantly elevated in the ISMAD group compared with the control group (83.16% vs. 35.79%, P < 0.001; 2.63 ± 0.56 mm vs. 2.12 ± 0.39 mm, P < 0.001). Patients with invasive treatment had significantly higher baseline DR (2.93 ± 0.57 mm vs. 1.89 ± 1.14 mm, P < 0.001), and higher proportion of high-risk dissection (P < 0.001) than those administered conservative treatment. Binary logistic regression revealed DR (OR = 2.771, 95% CI 1.157–6.638, P = 0.022) and Li classification (OR = 0.107, 95% CI 0.019–0.586, P = 0.010) were independent risk factors for treatment selection. With cutoff of 2.635 mm, the area under the curve, sensitivity, and specificity were 0.805, 0.778 and 0.794, respectively.

Conclusion

Dilation of Riolan’s arch is common in patients with ISMAD, and Riolan’s arch diameter could be a convenient indicator of disease severity and inform subsequent treatment.

Graphical Abstract

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Data availability

Data generated or analyzed during the study are available from the corresponding author by request.

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Acknowledgements

We thank Ms. Weiwei Deng, Philips [China] Investment Co., Ltd, for her support in postprocessing work. We thank Dr. Yuanxian YANG, Department of obstetrics and gynecology, the Eighth Hospital of Wuhan, for her encouragement that let us never give up.

Funding

No funding was provided for any component of the submitted work.

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Author notes

  1. Yang Peng and Ruixi Li have contributed equally to this work and are co-first authors.

Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshanerlu Road, Guangzhou, Guangdong, People’s Republic of China

    Yang Peng, Ruixi Li, Guanglei Tang, Ke Wang, Mengya Sun & Jian Guan

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  1. Yang Peng
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  2. Ruixi Li
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  3. Guanglei Tang
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Correspondence to Jian Guan.

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There are no conflicts of interest or competing interests to disclose. The authors declare they have no financial interests or non-financial interests.

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Study protocol approval by Clinical Research Ethics Committee of the first affiliated Hospital, Sun Yat- sen University (code 2021/258, approval date April 6, 2021).

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Peng, Y., Li, R., Tang, G. et al. Correlation of Riolan’s arch diameter to treatment choice in patients with isolated superior mesenteric artery dissection. Abdom Radiol 47, 3628–3637 (2022). https://doi.org/10.1007/s00261-022-03622-1

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  • DOI: https://doi.org/10.1007/s00261-022-03622-1

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