Superior mesenteric artery stenosis

Last revised by David Luong on 15 Nov 2021

Citation, DOI, disclosures and article data

Citation:

Weerakkody Y, Luong D, Bell D, Superior mesenteric artery stenosis. Reference article, Radiopaedia.org (Accessed on 25 Apr 2024) https://doi.org/10.53347/rID-88955

DOI:

https://doi.org/10.53347/rID-88955

Permalink:

https://radiopaedia.org/articles/88955

rID:

88955

Article created:

24 Apr 2021, Yuranga Weerakkody ◉

Disclosures:

At the time the article was created Yuranga Weerakkody had no recorded disclosures.

View Yuranga Weerakkody's current disclosures

Last revised:

15 Nov 2021, David Luong ◉

Disclosures:

At the time the article was last revised David Luong had no recorded disclosures.

View David Luong's current disclosures

Revisions:

5 times, by 3 contributors - see full revision history and disclosures

Systems:

Vascular

Synonyms:

SMA stenosis
Superior mesenteric arterial stenosis
Stenosis of SMA

Superior mesenteric artery stenosis refers to any form of narrowing involving the superior mesenteric artery and may result from a number of factors. It can result in acute or chronic mesenteric ischemia.

Radiographic features

Ultrasound

Several values on doppler ultrasound have been proposed that include:

to suggest stenosis of 70% or greater: peak systolic velocity (PSV) should be ≥275 cm/s ^4,7

From a different paper:

to suggest stenosis of 50-69%⁵:
- peak systolic velocity (PSV) should be >280 cm/s
- end-diastolic velocity (EDV) >45 cm/s
- mesenteric aortic ratio (MAR) >3.6
to suggest stenosis of 70-99% ⁵:
- peak systolic velocity (PSV) should be >395 cm/s
- end-diastolic velocity (EDV) >74 cm/s
- mesenteric aortic ratio (MAR) >3.6

References

1. Nevil Ghodasara, Robert Liddell, Elliot K. Fishman, Pamela T. Johnson. High-Value Multidetector CT Angiography of the Superior Mesenteric Artery: What Emergency Medicine Physicians and Interventional Radiologists Need to Know. (2019) RadioGraphics. doi:10.1148/rg.2019180131
2. Aburahma AF, Mousa AY, Stone PA, Hass SM, Dean LS, Keiffer T. Duplex velocity criteria for native celiac/superior mesenteric artery stenosis vs in-stent stenosis. (2012) Journal of vascular surgery. 55 (3): 730-8. doi:10.1016/j.jvs.2011.10.086 - Pubmed
3. Lim HK, Lee WJ, Kim SH, Lee SJ, Choi SH, Park HS, Do YS, Choo SW, Choo IW. Splanchnic arterial stenosis or occlusion: diagnosis at Doppler US. (1999) Radiology. 211 (2): 405-10. doi:10.1148/radiology.211.2.r99ma27405 - Pubmed
3. Ming-Chen Paul Shih, Klaus D. Hagspiel. CTA and MRA in Mesenteric Ischemia: Part 1, Role in Diagnosis and Differential Diagnosis. (2012) American Journal of Roentgenology. doi:10.2214/AJR.05.1167
4. Mitchell EL, Chang EY, Landry GJ, Liem TK, Keller FS, Moneta GL. Duplex criteria for native superior mesenteric artery stenosis overestimate stenosis in stented superior mesenteric arteries. (2009) Journal of vascular surgery. 50 (2): 335-40. doi:10.1016/j.jvs.2008.12.071 - Pubmed
5. Biri S, Biri İ, Gultekin Y, Yurdakul M, Ozdemir M, Tola M. Doppler ultrasonography criteria of superior mesenteric artery stenosis. (2019) Journal of clinical ultrasound : JCU. 47 (5): 267-271. doi:10.1002/jcu.22695 - Pubmed
6. AbuRahma AF, Stone PA, Srivastava M, Dean LS, Keiffer T, Hass SM, Mousa AY. Mesenteric/celiac duplex ultrasound interpretation criteria revisited. (2012) Journal of vascular surgery. 55 (2): 428-436.e6; discussion 435-6. doi:10.1016/j.jvs.2011.08.052 - Pubmed
7. Moneta GL, Yeager RA, Dalman R, Antonovic R, Hall LD, Porter JM. Duplex ultrasound criteria for diagnosis of splanchnic artery stenosis or occlusion. (1991) Journal of vascular surgery. 14 (4): 511-8; discussion 518-20. Pubmed