Diagnostic Accuracy of Doppler Ultrasound versus CT Angiography in Superior Mesenteric Artery Syndrome
DOI:
https://doi.org/10.32792/jmed.2025.29.41Keywords:
superior syndrome Doppler US CTAAbstract
Background: Superior mesenteric artery syndrome (SMAS) is a rare vascularcompression phenomenon causing duodenal obstruction. CT angiography (CTA)
is the test of choice; ultrasound Doppler offers a noninvasive alternative. Aim:
to verify the diagnostic accuracy of both tests to verify an evidence-based
pathway in SMAS diagnosis.
Methods: A total of 48 patients suspected as SMAS were enrolled in this
prospective multicenter study. All patients had a standard ultrasound Doppler
and CTA protocol scan. Validity measures were based on the consensus
clinical diagnosis reference standard.
Results: Ultrasound sensitivity was 87.5% (95% CI 71.0–96.5) and the
specificity was 81.3% (95% CI 54.4–96.0) versus CTA specificity of 100%.
Patients who were obese (BMI >30; OR 6.7, p=0.003) and patients with bowel
gas (OR 8.2, p=0.001) showed high discordance rates by each definition. The
mean aortomesenteric angle difference between modalities was 2.3° (95% LoA:
−5.1°‐9.7°).
Conclusion: Ultrasound Doppler can be a valuable method for the primary
screening of SMAS, and high-BMI or surgical patients should receive CTA
examination for diagnosis verification of SMAS.
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