TY - JOUR
T1 - Segmental arterial mediolysis
T2 - Abdominal imaging of and disease course in 111 patients
AU - Naidu, Sailen G.
AU - Menias, Christine O.
AU - Oklu, Rahmi
AU - Hines, Robert S.
AU - Alhalabi, Kinan
AU - Makar, Gerges
AU - Shamoun, Fadi E.
AU - Henkin, Stanislav
AU - McBane, Robert D.
N1 - Publisher Copyright:
© American Roentgen Ray Society.
PY - 2018/4
Y1 - 2018/4
N2 - OBJECTIVE. The purpose of this study is to identify the imaging characteristics of segmental arterial mediolysis (SAM) at presentation and establish the longitudinal course of disease. MATERIALS AND METHODS. We retrospectively identifed patients with SAM at a single institution from 2000 through 2015. Diagnosis was based on published guidelines with multidisciplinary consensus. Imaging studies obtained at initial evaluation were reviewed to evaluate imaging fndings and vascular territory distribution. All subsequent follow-up imaging studies were reviewed to assess for progression, stability, or regression. RESULTS. We identifed 111 patients (79 men and 32 women; median age, 51 years) who met the diagnostic criteria for SAM. Abdominal pain was the most common presentation (74%), followed by flank pain (21%). SAM most commonly affected the renal arteries (47%), superior mesenteric artery (46%), celiac trunk (46%), hepatic artery (23%), iliac arteries (18%), and splenic artery (14%). The most common imaging fndings were dissection (86%), aneurysm (57%), beading or webs (28%), occlusion (19%), and a rind or wall thickening (15%). The 247 available follow-up imaging studies for 97 patients (median follow-up, 12 months) showed progression in 19 patients (20%), with either stability or regression observed in the remaining patients. CONCLUSION. SAM most commonly affects the renal arteries, superior mesenteric artery, and celiac artery. Dissections and aneurysms are the most common imaging fndings. Follow-up imaging studies show stability or regression in most patients.
AB - OBJECTIVE. The purpose of this study is to identify the imaging characteristics of segmental arterial mediolysis (SAM) at presentation and establish the longitudinal course of disease. MATERIALS AND METHODS. We retrospectively identifed patients with SAM at a single institution from 2000 through 2015. Diagnosis was based on published guidelines with multidisciplinary consensus. Imaging studies obtained at initial evaluation were reviewed to evaluate imaging fndings and vascular territory distribution. All subsequent follow-up imaging studies were reviewed to assess for progression, stability, or regression. RESULTS. We identifed 111 patients (79 men and 32 women; median age, 51 years) who met the diagnostic criteria for SAM. Abdominal pain was the most common presentation (74%), followed by flank pain (21%). SAM most commonly affected the renal arteries (47%), superior mesenteric artery (46%), celiac trunk (46%), hepatic artery (23%), iliac arteries (18%), and splenic artery (14%). The most common imaging fndings were dissection (86%), aneurysm (57%), beading or webs (28%), occlusion (19%), and a rind or wall thickening (15%). The 247 available follow-up imaging studies for 97 patients (median follow-up, 12 months) showed progression in 19 patients (20%), with either stability or regression observed in the remaining patients. CONCLUSION. SAM most commonly affects the renal arteries, superior mesenteric artery, and celiac artery. Dissections and aneurysms are the most common imaging fndings. Follow-up imaging studies show stability or regression in most patients.
KW - Aneurysm
KW - Dissection
KW - Hemorrhage
KW - Segmental arterial mediolysis
KW - Vasculopathy
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U2 - 10.2214/AJR.17.18309
DO - 10.2214/AJR.17.18309
M3 - Article
C2 - 29446669
AN - SCOPUS:85044529904
SN - 0361-803X
VL - 210
SP - 899
EP - 905
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 4
ER -