Detection of superior mesenteric and coeliac artery stenosis with colour flow Duplex imaging

Measurements of blood velocity in the coeliac axis (CA) and the superior mesenteric artery (SMA) before and after a standard meal in normal people have been studied by several authors. However, information about the ability to detect stenotic lesions is lacking. The aim of our study was to determine the accuracy of Duplex scanning in detecting angiographically proven lesions. Twenty normal volunteers (13 males and seven females) and 24 patients (19 males and five females) with visceral artery stenosis on angiography were examined in the supine position (angle of insonation 60.5) with colour flow Duplex imaging (CFDI) (3.5MHz probe), in the fasting state and after a standard meal at 15, 40, 60 and 90 min. Peak systolic velocity (PSV) and end diastolic velocity (EDV) were determined in both CA and SMA. The PSV was the best indicator of stenosis. After the meal, there was an increase in both PSV and EDV but neither of the postprandial measurements improved the accuracy of the test. The results indicate that CFDI can detect the presence of significant stenosis (>50%) in the CA and SMA with a sensitivity and specificity of >80%.