ANOMALOUS INSERTION OF MEDIAN ARCUATE LIGAMENT IN ASYMPTOMATIC INDIVIDUALS ON MULTIDETECTOR COMPUTED TOMOGRAPHY

Awais Ahmed, Rashed Nazir, Khalid Shakeel Babar, Umar Amin

Abstract


Background: Median arcuate ligament syndrome is a controversial entity because anomalous insertion of median arcuate ligament can be seen in asymptomatic individuals. Multidetector CT scanners, along with multiplanar reformats have greatly improved the visualization of this ligament. This study was conducted to determine the presence of anomalous insertion of median arcuate ligament on CT in asymptomatic individuals.
Material& Methods: This was a record base cross-sectional study conducted at the Department of Radiology, Shifa International Hospital, Islamabad, Pakistan from February 05, 2015 to May 15, 2015. It included case records of post-contrast CT scan abdomen of 852 asymptomatic (without median arcuate ligament syndrome) individuals carried out from July 2011 to June 2013. Cases were reviewed for identification of anomalous median arcuate ligament insertion on MDCT. Postsurgical cases and those with vascular thrombosis and arteriovenous malformation were excluded. The CT images were reviewed on workstation after image post processing.
Results: A sample of 852 persons was studied with male to female ratio of 1:2. Out of 852 cases, the anomalous insertion of MAL was identified in 133 (15.60%) cases. These included 46 (5.39%) males and 87 (10.21 %) females with a male to female ratio of 1:1.89.
Conclusion: A significant number of asymptomatic persons have anomalous insertion of median arcuate ligament. It is important to correlate the radiologic findings with clinical symptoms to identify the subset of patients who will benefit from treatment.

Keywords


Celiac Artery Stenosis from Compression by Median Arcuate Ligament of Diaphragm; Median arcuate ligament; Median arcuate ligament syndrome; Computed tomographic angiography; Arteriovenous malformations; Celiac artery; Multidetector Computed Tomography

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