Ultrasound findings in Median Arcuate Ligament Syndrome

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Question 1 of 5

1. Question
Median arcuate ligament syndrome(MALS)compresses the following vessel
- a) Celiac artery
- b) Splenic artery
- c) Hepatic artery
- d) Superior mesenteric artery
Question 2 of 5

2. Question
To confirm median arcuate ligament syndrome diagnosis on Ultrasound
1. At deep expiration, celiac axis is tortuous with a 130° trunk deflection
2. At deep expiration Peak systolic velocity (PSV) is> 200cm/s with post stenotic flow turbulence
3. On deep inspiration, the celiac axis straightens, PSV decreases < 200cm/s and turbulence disappears
4. On deep inspiration, the celiac axis straightens, PSV decreases > 200cm/s and turbulence appears
Correct responses are:
- a) 1 & 2
- b) 1, 2 & 3
- c) All of the above
- d) none of the above
Question 3 of 5

3. Question
Post stenotic turbulence demonstrated on deep expiration on median arcuate ligament syndrome will be demonstrated on spectral wave form as
- a) Low resistance flow
- b) High resistance flow
- c) Tardus parvus waveform
- d) Spectral broadening of the waveform
Question 4 of 5

4. Question
The Ultrasound findings in MEDIAN ARCUATE LIGAMENT SYNDROME show
- a) Elevated PSV of > 10 cm/S, deflection angle > 10° and a retrograde common hepatic artery flow
- b) Elevated PSV of > 50 cm/S, deflection angle > 20° and a antegrade common hepatic artery flow
- c) Elevated PSV of > 100 cm/S, deflection angle > 40° and a antegrade common hepatic artery flow
- d) Elevated PSV of > 200 cm/S, deflection angle > 50° and a retrograde common hepatic artery flow
Question 5 of 5

5. Question
In the case of median arcuate ligament syndrome diagnosis on ultrasound the celiac axis should show
- a) Geometric significant changes on expiration
- b) Hemodynamically significant changes on both inspiration
- c) Both geometric and hemodynamically significant changes on both inspiration & expiration
- d) None of the above

CJMS Volume 10 – Issue 1, Quiz 4

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