Ct Findings In Abdominopelvic Vascular Compression Syndromes

Abstract

Abdominopelvic vascular compression syndromes (AVCS) comprise a group of uncommon conditions caused by extrinsic compression of vessels or hollow viscera by adjacent anatomical structures. These include nutcracker syndrome, superior mesenteric artery syndrome, median arcuate ligament syndrome, and May–Thurner syndrome. Contrast-enhanced computed tomography (CT) is central to diagnosis, enabling visualization of direct vessel narrowing, secondary changes such as collateral formation, and precise quantitative measurements. Advanced techniques, including multiphasic CT angiography, dual-energy CT, respiratory phase imaging, and 3D reconstructions, enhance detection and surgical planning. Accurate interpretation requires correlation with clinical presentation to distinguish true pathological compression from incidental anatomical variants. This review synthesizes current literature on CT findings in AVCS, detailing characteristic signs, diagnostic measurement thresholds, indirect indicators, and the role of advanced imaging strategies. Awareness of CT features and potential pitfalls can improve diagnostic confidence, facilitate timely treatment, and potentially prevent complications.