{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:05:02Z","timestamp":1777496702576,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CH"],"published-print":{"date-parts":[[2020,12,22]]},"abstract":"<jats:p>BACKGROUND: Median arcuate ligament syndrome (MALS) is a rare condition due to compression of the celiac artery (CA) by an anatomically abnormal median arcuate ligament. With ultrasonography (US) as first-line diagnostic modality in patients with unclear abdominal pain, there is limited data on its diagnostic performance in MALS. OBJECTIVE: To investigate the value of CA peak systolic velocity (PSV) in the workup of patients with suspected MALS. METHODS: Patients with diagnosis of MALS between 2009 and 2019 were referred by Department of Visceral Surgery after clinical and gastroenterological workup. Diagnosis was confirmed by surgery or further cross-sectional imaging. B-mode US findings and PSV in the CA during various respiratory states were compared between patients with a final MALS diagnosis and patients not meeting the diagnostic criteria. RESULTS: Patients with proven MALS (n\u200a=\u200a10) had higher median CA PSV during normal inspiratory breath-hold (239 [IQR, 159\u2013327] vs. 138 [IQR, 116\u2013152] cm\/s; p\u200a&lt;\u200a#x003C;&lt;\u200a#x200A;0.001), and expiratory breath-hold (287 [IQR, 191\u2013412] vs. 133 [IQR, 115\u2013194] cm\/s; p\u200a&lt;\u200a#x003C;&lt;\u200a#x200A;0.001) compared to patients without MALS (n\u200a=\u200a26). CA PSV in both inspiratory breath-hold (AUC 0.88, 95% CI 0.77\u20131.00) and expiratory breath-hold (AUC 0.89, 95% CI 0.78\u20131.00) was of diagnostic value for confirming MALS. The best diagnostic performance (100% sensitivity, 80% specificity) was found for the combination of CA PSVexpiration\u00a0+\u00a02.4\u00a0\u00b7\u00a0PSVinspiration\u00a0&gt;\u00a0550\u00a0cm\/s\u2002. CONCLUSIONS: Since results on optimal cutoff values are inconsistent, a combination of CA PSVs during breathing maneuvers may help to diagnose or rule out MALS.<\/jats:p>","DOI":"10.3233\/ch-200903","type":"journal-article","created":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T11:37:45Z","timestamp":1594899465000},"page":"413-423","source":"Crossref","is-referenced-by-count":9,"title":["Assessment of celiac artery compression using color-coded duplex sonography"],"prefix":"10.1177","volume":"76","author":[{"given":"Claudia","family":"R\u00f6mer","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine (CVK, CCM) and Department of Cardiology (CVK), Charit\u00e9 Universitiy Medicine, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Radiology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Haase","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"M\u00f6ckel","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine (CVK, CCM) and Department of Cardiology (CVK), Charit\u00e9 Universitiy Medicine, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernd","family":"Hamm","sequence":"additional","affiliation":[{"name":"Department of Radiology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus Herbert","family":"Lerchbaumer","sequence":"additional","affiliation":[{"name":"Department of Radiology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"key":"10.3233\/CH-200903_ref1","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1002\/ca.20473","article-title":"Clinical anatomy of celiac artery compression syndrome: A review","volume":"20","author":"Loukas","year":"2007","journal-title":"Clin Anat"},{"key":"10.3233\/CH-200903_ref2","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1177\/1531003507305263","article-title":"Treatment of Celiac Artery Compression Syndrome: Does It Really Exist?","volume":"19","author":"Gloviczki","year":"2007","journal-title":"Perspect Vasc Surg Endovasc Ther"},{"key":"10.3233\/CH-200903_ref3","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1001\/jamasurg.2016.0002","article-title":"Median Arcuate Ligament Syndrome-Review of This Rare Disease","volume":"151","author":"Kim","year":"2016","journal-title":"JAMA Surg"},{"key":"10.3233\/CH-200903_ref4","first-page":"547","article-title":"A rare obstruction of the coeliac artery","volume":"52","author":"Harjola","year":"1963","journal-title":"Report of a case. 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