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Assessment of the relationship between intraabdominal fat thickness and the aortomesenteric angle and distance using computed tomography

Year 2017, Volume: 39 Issue: 4, 675 - 682, 18.12.2017

Eda Albayrak Osman Demir

https://doi.org/10.7197/223.v39i32356.368998

Abstract

Objective: The aim of this
study is to evaluate the effect of visceral fat thickness on the distance and
angle between the superior mesenteric artery (SMA) and the aorta in the normal
population.



Method: The
aortomesenteric distance and retroperitoneal fat thickness (RFT) were measured
on an axial plane, and the aortomesenteric angle and mesenteric fat thickness
(MFT) were measured on a sagittal plane using multidetector computed tomography
(MDCT). The relationships between MFT, RFT and aortomesenteric angle and
distance were evaluated.



Results: There was a
weak/moderate, significant and positive correlation between aortomesenteric
angle and MFT and RFT (r = 0,396, p<0.001 and r = 0,494, p<0.001,
respectively). There was also a moderate, significant and positive correlation
between aortomesenteric distance and RFT and MFT (r = 0,607, p<0.001 and r =
0,633, p<0.001, respectively).



Conclusion: The
aortomesenteric distance and angle correlate with the retroperitoneal and
mesenteric fat thickness. According to the results, retroperitoneal and
mesenteric fat thickness may be used as an CT marker to help diagnose suspected
SMAS in addition to the measurements of the aortomesenteric distance and angle.

Keywords

Superior mesenteric artery multidetector computed tomography mesenteric fat retroperitoneal fat

References

  • 1. Gustafsson L, Falk A, Lukes PJ, Gamklou R. Diagnosis and treatment of superior mesenteric artery syndrome. Br J Surg. 1984; 71: 499-501.
  • 2. Alsulaimy M, Tashiro J, Perez EA, Sola JE. Laparoscopic Ladd’s procedure for superior mesenteric artery syndrome. J Pediatr Surg. 2014; 49: 1533-35.
  • 3. Applegate GR, Cohen AJ. Dynamic CT in superior mesenteric artery syndrome. J Comput Assist Tomogr 1988; 12: 976-80
  • 4. Ahmed AR, Taylor I. Superior mesenteric artery syndrome. Postgrad Med 1997; 73:776-8.
  • 5. Baltazar U, Dunn J, Floresguerra C, Schmidt L, Browder W. Superior mesenteric artery syndrome: an uncommon cause of intestinal obstruction. South Med J 2000; 93: 606-8.
  • 6. Cohen LB, Field SP, Sachar DB. The superior mesenteric artery syndrome: the disease that isn’t or is it? J Clin Gastroenterol 1985; 7: 113-6.
  • 7. Jani PG. Superior mesenteric artery syndrome: case report. East Afr Med J 2003; 80: 334-6.
  • 8. Matheus CO, Waisberg J, Toledo Zewer MH, Godoy AC. Syndrome of duodenal compression by the superior mesenteric artery following restorative proctocolectomy. A case report and review of literature. Sao Paulo Med J 2005; 123: 151-3.
  • 9. Roy A, Gisel JJ, Roy V, Bouras EP. Superior mesenteric artery (Wilkie’s) syndrome as a result of cardiac cachexia. J Gen Intern Med 2005; 20: C3-4
  • 10. Ozbulbul N, Yurdakul M, Dedeoglu H, Tola M, Olcer T. Evaluation of the effect of visceral fat area on the distance and angle between the superior mesenteric artery and the aorta. Surg Radiol Anat. 2009; 31: 545-9.
  • 11. Ozkurt H, Cenker MM, Bas N, Erturk SM, Basak M. Measurement of the distance and angle between the aorta and superior mesenteric artery: normal values in different BMI categories. Surg Radiol Anat. 2007; 29: 595-9.
  • 12. Bhagirath Desai A, Sandeep Shah D, Jagat Bhatt C, Umesh Vaishnav K, Salvi B. Measurement of the Distance and Angle Between the Aorta and Superior Mesenteric Artery on CT Scan: Values in Indian Population in Different BMI Categories. Indian J Surg. 2015; 77: 614-7.
  • 13. Schneider HJ, Glaesmer H, Klotsche J, Böhler S, Lehnert H, Zeiher AM, März W, Pittrow D, Stalla GK, Wittchen HU; DETECT Study Group. Accuracy of anthropometric indicators of obesity to predict cardiovascular risk. J Clin Endocrinol Metab. 2007; 92: 589-94.
  • 14. Svendsen OL, Hassager C, Bergmann I, Christiansen C. Measurement of abdominal and intra-abdominal fat in postmenopausal women by dual energy X-ray absorptiometry and anthropometry: comparison with computerized tomography. Int J Obes Relat Metab Disord 1993; 17: 45-51.
  • 15. Unal B, Aktas A, Kemal G. Bilgili Y, Güliter S, Daphan C, Aydinuraz K. Superior mesenteric artery syndrome: CT and ultrasonography endings. Diagn Interv Radiol 2005; 11: 90-5.
  • 16. Yang L, Kuper H, Weiderpass E. Anthropometric characteristics as predictors of coronary heart disease in women. J Intern Med 2008; 264: 39-49.
  • 17. Canoy D, Boekholdt SM, Wareham N, Luben R, Welch A, Bingham S, Buchan I, Day N, Khaw KT. Body fat distribution and risk of coronary heart disease in men and women in the European Prospective Investigation into Cancer and Nutrition in Norfolk cohort: a population-based prospective study. Circulation. 2007; 116: 2933-43.
  • 18. Canoy D. Distribution of body fat and risk of coronary heart disease in men and women. Curr Opin Cardiol 2008; 23: 591-8.
  • 19. Goodpaster BH, Krishnaswami S, Harris TB. Katsiaras A, Kritchevsky SB, Simonsick EM, Nevitt M, Holvoet P, Newman AB. Obesity, regional body fat distribution and the metabolic syndrome in older men and women. Arch Intern Med 2005; 165: 777-83.
  • 20. Goodpaster BH, Krishnaswami S, Resnick H, Resnick H, Kelley DE, Haggerty C, Harris TB, Schwartz AV, Kritchevsky S, Newman AB. Association between regional adipose tissue distribution and both type 2 diabetes and impaired glucose tolerance in elderly men and women. Diabetes Care 2003; 26: 372-9.
  • 21. Gillum RF. The association of body fat distribution with hypertension, hypertensive heart disease, coronary heart disease, diabetes and cardiovascular risk factors in men and women aged 18–79 years. J Chronic Dis 1987; 40: 421-8.
  • 22. Uysal E, Paksoy Y, Koplay M, Nayman A, Gumus S. Effects of body mass index, mesenteric and abdominal subcutaneous adipose tissue on the spinopelvic parameters. Wien Klin Wochenschr 2015;127: 935-41.
  • 23. Biswas A, Babu AA, Neelakantan S, Sarkar PS. Superior mesenteric artery syndrome: CT findings. BMJ Case Rep 2016 Jun 28 doi: 10.1136/bcr-2016-215885.
  • 24. Kaur A, Pawar NC, Singla S, Mohi JK, Sharma S. Superior mesentric artery syndrome in a patient with subacute intestinal obstruction: a case report, J Clin Diagn Res 2016; TD03-5.
  • 25. Sherry Scovell M, Allen Hamdan M. Superior Mesenteric Artery Syndrome, 2015, Available at: E:\SMA syndrome report\6-Superior mesenteric arterysyndrome. Uptodate.html. Accessed 08/2016, 2016.
  • 26. Zaraket V, Deeb L. Wilkie’s syndrome or superior mesenteric artery syndrome: fact or fantasy? Case Rep Gastroenterol 2015; 9: 194-9.
  • 27. Merrett N.D, Wilson R.B, Cosman P, Biankin A.V. Superior mesenteric artery syndrome: diagnosis and treatment strategies, J. Gastrointest Surg 2009; 13: 287-92.
  • 28. Shiu J.R, Chao H.C, Luo C.C, Lai M.W, Kong M.S, Chen S.Y. Clinical and nutritional outcomes in children with idiopathic superior mesenteric artery syndrome. J Pediatr Gastroenterol Nutr 2010; 51: 177-82.
  • 29. Welsch T, Buchler M.W, Kienle P. Recalling superior mesenteric artery syndrome. Dig Surg 2007; 24: 149-56.
  • 30. Agrawal GA, Johnson PT, Fishman EK. Multidetector row CT of superior mesenteric artery syndrome. J Clin Gastroenterol 2007; 41: 62-5.
  • 31. Hirooka M, Kumagi T, Kurose K, Nakanishi S, Michitaka K, Matsuura B, Horiike N, Onji M. A technique for the measurement of visceral fat by ultrasonography: comparison of measurements by ultrasonography and computed tomography. Intern Med 2005; 44; 794-9.
  • 32. Yoshizumi T, Nakamura T, Yamane M. Islam AH, Menju M, Yamasaki K, Arai T, Kotani K, Funahashi T, Yamashita S, Matsuzawa Y. Abdominal fat: standartized technique for measurement at CT. Radiology 1999; 211: 283-6.

İntraabdominal yağ doku kalınlığı ile aortomezenterik açı ve uzaklık değerleri arasındaki ilişkinin bilgisayarlı tomografi ile değerlendirilmesi

Year 2017, Volume: 39 Issue: 4, 675 - 682, 18.12.2017

Eda Albayrak Osman Demir

https://doi.org/10.7197/223.v39i32356.368998

Abstract

Amaç: Çalışmamızın amacı, normal populasyonda, visseral yağ
doku kalınlığının, superior mezenterik arter (SMA) ile aorta arasındaki açıya
ve uzaklığa olan etkisini araştırmaktır.

Yöntem:
Ölçümler çok kesitli bilgisayarlı tomografi (ÇKBT) cihazı
kullanılarak gerçekleştirildi. Aortomezenterik uzaklık ve retroperitoneal yağ
doku kalınlığı (RYK) aksiyal kesitlerde, aortomezenterik açı ve mezenterik yağ
doku kalınlığı (MYK) sagital kesitlerde ölçüldü. MYK ve RYK ile aortomezenterik
açı ve uzaklık arasındaki ilişki araştırıldı.

Bulgular:
Aortomezenterik açı ile MYK ve RYK arasında sırasıyla zayıf/orta
düzeyde pozitif yönlü ilişki tespit edilmiştir (r = 0,396, p<0.001 ve r = 0,494, p<0.001). Aortomezenterik
uzaklık ile RYK ve MYK arasında  ise orta
düzeyde pozitif yönlü bir ilişki tespit edilmiştir (r = 0,607, p<0.001 ve r = 0,633, p<0.001).







Sonuç: Aortomesenterik açı
ve uzaklık ile visceral yağ doku kalınlıkları arasında pozitif yönlü anlamlı
bir ilişki vardır. Bu sonuçlara göre ÇKBT ile ölçülen, retroperitoneal ve
mezenterik yağ doku kalınlıkları klinik olarak SMA sendromu düşünülen şüpheli vakaların tanısında
aortomezenterik uzaklık ve açı ölçümlerine ek olarak bir BT belirteci olarak
kullanılabilir.

Keywords

Superior mesenterik arter çok kesitli bilgisayarlı tomografi mesenterik yağ dokusu retroperitoneal yağ dokusu

References

  • 1. Gustafsson L, Falk A, Lukes PJ, Gamklou R. Diagnosis and treatment of superior mesenteric artery syndrome. Br J Surg. 1984; 71: 499-501.
  • 2. Alsulaimy M, Tashiro J, Perez EA, Sola JE. Laparoscopic Ladd’s procedure for superior mesenteric artery syndrome. J Pediatr Surg. 2014; 49: 1533-35.
  • 3. Applegate GR, Cohen AJ. Dynamic CT in superior mesenteric artery syndrome. J Comput Assist Tomogr 1988; 12: 976-80
  • 4. Ahmed AR, Taylor I. Superior mesenteric artery syndrome. Postgrad Med 1997; 73:776-8.
  • 5. Baltazar U, Dunn J, Floresguerra C, Schmidt L, Browder W. Superior mesenteric artery syndrome: an uncommon cause of intestinal obstruction. South Med J 2000; 93: 606-8.
  • 6. Cohen LB, Field SP, Sachar DB. The superior mesenteric artery syndrome: the disease that isn’t or is it? J Clin Gastroenterol 1985; 7: 113-6.
  • 7. Jani PG. Superior mesenteric artery syndrome: case report. East Afr Med J 2003; 80: 334-6.
  • 8. Matheus CO, Waisberg J, Toledo Zewer MH, Godoy AC. Syndrome of duodenal compression by the superior mesenteric artery following restorative proctocolectomy. A case report and review of literature. Sao Paulo Med J 2005; 123: 151-3.
  • 9. Roy A, Gisel JJ, Roy V, Bouras EP. Superior mesenteric artery (Wilkie’s) syndrome as a result of cardiac cachexia. J Gen Intern Med 2005; 20: C3-4
  • 10. Ozbulbul N, Yurdakul M, Dedeoglu H, Tola M, Olcer T. Evaluation of the effect of visceral fat area on the distance and angle between the superior mesenteric artery and the aorta. Surg Radiol Anat. 2009; 31: 545-9.
  • 11. Ozkurt H, Cenker MM, Bas N, Erturk SM, Basak M. Measurement of the distance and angle between the aorta and superior mesenteric artery: normal values in different BMI categories. Surg Radiol Anat. 2007; 29: 595-9.
  • 12. Bhagirath Desai A, Sandeep Shah D, Jagat Bhatt C, Umesh Vaishnav K, Salvi B. Measurement of the Distance and Angle Between the Aorta and Superior Mesenteric Artery on CT Scan: Values in Indian Population in Different BMI Categories. Indian J Surg. 2015; 77: 614-7.
  • 13. Schneider HJ, Glaesmer H, Klotsche J, Böhler S, Lehnert H, Zeiher AM, März W, Pittrow D, Stalla GK, Wittchen HU; DETECT Study Group. Accuracy of anthropometric indicators of obesity to predict cardiovascular risk. J Clin Endocrinol Metab. 2007; 92: 589-94.
  • 14. Svendsen OL, Hassager C, Bergmann I, Christiansen C. Measurement of abdominal and intra-abdominal fat in postmenopausal women by dual energy X-ray absorptiometry and anthropometry: comparison with computerized tomography. Int J Obes Relat Metab Disord 1993; 17: 45-51.
  • 15. Unal B, Aktas A, Kemal G. Bilgili Y, Güliter S, Daphan C, Aydinuraz K. Superior mesenteric artery syndrome: CT and ultrasonography endings. Diagn Interv Radiol 2005; 11: 90-5.
  • 16. Yang L, Kuper H, Weiderpass E. Anthropometric characteristics as predictors of coronary heart disease in women. J Intern Med 2008; 264: 39-49.
  • 17. Canoy D, Boekholdt SM, Wareham N, Luben R, Welch A, Bingham S, Buchan I, Day N, Khaw KT. Body fat distribution and risk of coronary heart disease in men and women in the European Prospective Investigation into Cancer and Nutrition in Norfolk cohort: a population-based prospective study. Circulation. 2007; 116: 2933-43.
  • 18. Canoy D. Distribution of body fat and risk of coronary heart disease in men and women. Curr Opin Cardiol 2008; 23: 591-8.
  • 19. Goodpaster BH, Krishnaswami S, Harris TB. Katsiaras A, Kritchevsky SB, Simonsick EM, Nevitt M, Holvoet P, Newman AB. Obesity, regional body fat distribution and the metabolic syndrome in older men and women. Arch Intern Med 2005; 165: 777-83.
  • 20. Goodpaster BH, Krishnaswami S, Resnick H, Resnick H, Kelley DE, Haggerty C, Harris TB, Schwartz AV, Kritchevsky S, Newman AB. Association between regional adipose tissue distribution and both type 2 diabetes and impaired glucose tolerance in elderly men and women. Diabetes Care 2003; 26: 372-9.
  • 21. Gillum RF. The association of body fat distribution with hypertension, hypertensive heart disease, coronary heart disease, diabetes and cardiovascular risk factors in men and women aged 18–79 years. J Chronic Dis 1987; 40: 421-8.
  • 22. Uysal E, Paksoy Y, Koplay M, Nayman A, Gumus S. Effects of body mass index, mesenteric and abdominal subcutaneous adipose tissue on the spinopelvic parameters. Wien Klin Wochenschr 2015;127: 935-41.
  • 23. Biswas A, Babu AA, Neelakantan S, Sarkar PS. Superior mesenteric artery syndrome: CT findings. BMJ Case Rep 2016 Jun 28 doi: 10.1136/bcr-2016-215885.
  • 24. Kaur A, Pawar NC, Singla S, Mohi JK, Sharma S. Superior mesentric artery syndrome in a patient with subacute intestinal obstruction: a case report, J Clin Diagn Res 2016; TD03-5.
  • 25. Sherry Scovell M, Allen Hamdan M. Superior Mesenteric Artery Syndrome, 2015, Available at: E:\SMA syndrome report\6-Superior mesenteric arterysyndrome. Uptodate.html. Accessed 08/2016, 2016.
  • 26. Zaraket V, Deeb L. Wilkie’s syndrome or superior mesenteric artery syndrome: fact or fantasy? Case Rep Gastroenterol 2015; 9: 194-9.
  • 27. Merrett N.D, Wilson R.B, Cosman P, Biankin A.V. Superior mesenteric artery syndrome: diagnosis and treatment strategies, J. Gastrointest Surg 2009; 13: 287-92.
  • 28. Shiu J.R, Chao H.C, Luo C.C, Lai M.W, Kong M.S, Chen S.Y. Clinical and nutritional outcomes in children with idiopathic superior mesenteric artery syndrome. J Pediatr Gastroenterol Nutr 2010; 51: 177-82.
  • 29. Welsch T, Buchler M.W, Kienle P. Recalling superior mesenteric artery syndrome. Dig Surg 2007; 24: 149-56.
  • 30. Agrawal GA, Johnson PT, Fishman EK. Multidetector row CT of superior mesenteric artery syndrome. J Clin Gastroenterol 2007; 41: 62-5.
  • 31. Hirooka M, Kumagi T, Kurose K, Nakanishi S, Michitaka K, Matsuura B, Horiike N, Onji M. A technique for the measurement of visceral fat by ultrasonography: comparison of measurements by ultrasonography and computed tomography. Intern Med 2005; 44; 794-9.
  • 32. Yoshizumi T, Nakamura T, Yamane M. Islam AH, Menju M, Yamasaki K, Arai T, Kotani K, Funahashi T, Yamashita S, Matsuzawa Y. Abdominal fat: standartized technique for measurement at CT. Radiology 1999; 211: 283-6.
There are 32 citations in total.

Details

Subjects Health Care Administration
Journal Section Medical Science Research Articles
Authors

Eda Albayrak

Osman Demir

Publication Date December 18, 2017
Acceptance Date December 4, 2017
Published in Issue Year 2017Volume: 39 Issue: 4

Cite

AMA Albayrak E, Demir O. Assessment of the relationship between intraabdominal fat thickness and the aortomesenteric angle and distance using computed tomography. CMJ. December 2017;39(4):675-682. doi:10.7197/223.v39i32356.368998