Ultrasound findings in Median Arcuate Ligament Syndrome

Median arcuate ligament syndrome(MALS)compresses the following vessel

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:

Post stenotic turbulence demonstrated on deep expiration on median arcuate ligament syndrome will be demonstrated on spectral wave form as

The Ultrasound findings in MEDIAN ARCUATE LIGAMENT SYNDROME show

In the case of median arcuate ligament syndrome diagnosis on ultrasound the celiac axis should show