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Related Experiment Video

Updated: Dec 14, 2025

Point of Care Transcranial Color-Coded Duplex Ultrasound of the Middle Cerebral Artery
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Assessment of celiac artery compression using color-coded duplex sonography.

Claudia Römer1, Thomas Fischer2, Oliver Haase3

  • 1Department of Emergency Medicine (CVK, CCM) and Department of Cardiology (CVK), Charité Universitiy Medicine, Berlin, Germany.

Clinical Hemorheology and Microcirculation
|July 18, 2020
PubMed
Summary

Doppler ultrasonography can help diagnose median arcuate ligament syndrome (MALS). Elevated celiac artery (CA) peak systolic velocity (PSV) during breathing maneuvers is a key indicator for MALS diagnosis.

Keywords:
Dunbar syndromeMALSMedian arcuate ligament syndromecoeliac artery compression syndromecolor-coded duplex sonography

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Area of Science:

  • Vascular Surgery
  • Diagnostic Imaging
  • Gastroenterology

Background:

  • Median arcuate ligament syndrome (MALS) is a rare condition caused by celiac artery (CA) compression.
  • Ultrasonography (US) is a first-line test for abdominal pain, but its diagnostic performance in MALS is not well-established.

Purpose of the Study:

  • To evaluate the diagnostic utility of CA peak systolic velocity (PSV) in patients with suspected MALS.

Main Methods:

  • Retrospective analysis of patients diagnosed with MALS between 2009-2019.
  • Comparison of B-mode US findings and CA PSV during respiratory states between MALS and non-MALS groups.
  • Diagnosis confirmation via surgery or cross-sectional imaging.

Main Results:

  • Patients with MALS showed significantly higher median CA PSV during inspiratory and expiratory breath-holds compared to controls.
  • CA PSV during both maneuvers demonstrated diagnostic value (AUC 0.88-0.89).
  • A combined formula (CA PSVexpiration + 2.4 * PSVinspiration > 550 cm/s) achieved 100% sensitivity and 80% specificity.

Conclusions:

  • CA PSV measurements during breathing maneuvers are valuable for MALS diagnosis.
  • Combining PSV values from different respiratory states may improve diagnostic accuracy for MALS.