Question

You are performing an abdominal Doppler study and suspect the presence of median arcuate ligament syndrome. To rule out this condition, which of the following should be done?

A) Obtain baseline Doppler values, give the patient a fatty meal and rescan at 10, 20 & 30 min following the meal

B) Obtain Doppler readings during both inspiration & expiration & in both supine and upright positions

C) Obtain Doppler readings at an angle of 45 degrees and then repeat at an angle of 60 & 90 degrees

D) Obtain baseline Doppler readings & then have the patient return in about two weeks for a comparison study

E) Obtain Doppler readings from the proximal, mid and distal aspect of the artery

Answer 1

To rule out median arcuate ligament syndrome during an abdominal Doppler study, obtain Doppler readings during inspiration and expiration, and in both supine and upright positions. This differentiates the condition by showing changes in the celiac artery compression with respiratory movements and positioning.

Step-by-step explanation:

When performing an abdominal Doppler study and suspect the presence of median arcuate ligament syndrome, to rule out this condition, the correct procedure is to obtain Doppler readings during both inspiration and expiration, and in both supine and upright positions. This answer corresponds with option B. This method helps determine if the compression of the celiac artery by the median arcuate ligament changes with respiratory phases or body positioning, which are characteristic findings in median arcuate ligament syndrome. In the context of Doppler ultrasound studies, when there is a partial constriction of an artery, you would expect the blood speed to be greatest at or after the constriction point due to the necessity to maintain the flow rate. The two distinct causes of higher resistance in the constriction are the narrowing of the vessel's lumen and the onset of turbulence as the blood flow speed increases.