mvjrМедицинский вестник Юга РоссииMedical Herald of the South of Russia2219-80752618-7876The Rostov State Medical University10.21886/2219-8075-2021-12-4-34-45mvjr-1461Research ArticleВНУТРЕННИЕ БОЛЕЗНИINTERNAL DISEASESСосудистые аномалии, визуализированные при мультиспиральной компьютерной томографии органов брюшной полости, - случайные находки или непосредственные причины возникновения болевого синдрома? (тематический обзор)Vascular abnormalities visualized by multislice computed tomography of the abdomen: accidental findings or immediate causes of pain syndrome? (topic review)https://orcid.org/0000-0002-0965-4145АрутюноваН. К.ArutiunovaN. K.

Арутюнова Нина Кимовна, врач консультативного отдела

Ростов-на-Дону

Nina K. Arutiunova, doctor of the Consultative Department

Rostov-on-Don

ninamezugok@yandex.ruhttps://orcid.org/0000-0003-0760-3624АраслановаЛ. В.AraslanovaL. V.

Арасланова Лариса Вакильевна, кандидат медицинских наук, заведующая отделением лучевой диагностики Областной консультативно-диагностический центр; доцент кафедры персонализированной и трансляционной медицины, Ростовский государственный медицинский университет

Ростов-на-Дону

SPIN-код 4859-0178

Larisa V. Araslanova, Cand. Sci. (Med.), Head of the Department of Diagnostic Radiology, Regional Consultative and Diagnostic Center; Associate Professor of the Department of Personalized and Translational Medicine, Rostov State Medical University

Rostov-on-Don

larisa.araslanova@gmail.comhttps://orcid.org/0000-0001-9597-1536РябченкоВ. А.RiabchenkoV. A.

Рябченко Виктория Александровна, кандидат медицинских наук, врач отделения лучевой диагностики, Областной консультативнодиагностический центр; ассистент кафедры персонализированной и трансляционной медицины, Ростовский государственный медицинский университет

Ростов-на-Дону

SPIN-код 6558-8773

Victoria A. Riabchenko, Cand. Sci. (Med.), doctor of the Department of Diagnostic Radiology, Regional Consultative and Diagnostic Center; Assistant of the Department of Personalized and Translational Medicine, Rostov State Medical University

Rostov-on-Don

vic.koreneva@gmail.comhttps://orcid.org/0000-0003-4999-0001ПисаренкоЕ. А.PisarenkoE. A.

Писаренко Елена Алексеевна, врач отделения лучевой диагностики

Ростов-на-Дону

Elena A. Pisarenko, doctor of the Department of Diagnostic Radiology

Rostov-on-Don

pisarenko73@gmail.comhttps://orcid.org/0000-0002-5418-8163Тер-АнаньянцЕ. И.Ter-AnaniantsE. I.

Tер-Ананьянц Елена Ильинична, врач отделения лучевой диагностики

Ростов-на-Дону

Elena I. Ter-Ananiantc, doctor of the Department of Radiation Diagnostics

Rostov-on-Don

terrochka161@gmail.comОбластной консультативно-диагностический центрРоссияRegional Consultative and Diagnostic CenterRussian FederationОбластной консультативно-диагностический центр; Ростовский государственный медицинский университетРоссияRegional Consultative and Diagnostic Center; Rostov State Medical UniversityRussian Federation2021251220211243445Copyright © Арутюнова Н.К., Арасланова Л.В., Рябченко В.А., Писаренко Е.А., Тер-Ананьянц Е.И., 20212021Арутюнова Н.К., Арасланова Л.В., Рябченко В.А., Писаренко Е.А., Тер-Ананьянц Е.И.Arutiunova N.K., Araslanova L.V., Riabchenko V.A., Pisarenko E.A., Ter-Ananiants E.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medicalherald.ru/jour/article/view/1461

Патология ветвей брюшной аорты может вызывать абдоминальную ишемию, прогрессирующие патологические изменения органов брюшной полости на этом фоне и хронический болевой синдром. Причины возникновения хронического абдоминального синдрома ишемического характера можно разделить на атеросклеротические и «неатеросклеротические». Атеросклероз непарных ветвей брюшной аорты подразумевает стеноз или окклюзию артериального сосуда. Другие причины включают фиброзно-мышечную дисплазию, васкулиты (Такаясу, сегментарный артериальный медиолиз) и синдром внешней компрессии чревного ствола. Эти синдромы (патогенез некоторых из них остается спорным) приводят к возникновению неспецифических жалоб, таких как боли в животе, потеря веса и т.д. Цифровая субтракционная ангиография или дуплексное ультразвуковое исследование могут предоставить гемодинамическую информацию в случаях сосудистой патологии этой области. Однако спиральная компьютерная томография во многих случаях является методом первого выбора, так как позволяет проводить комплексную оценку состояния сосудов и связанных с ней морфологических изменений внутренних органов. Структурные изменения, сопровождающие эти синдромы, могут также встречаться у пациентов, которые проходят обследование по другим причинам. Однако диагностику этих синдромов не следует проводить исключительно на основании результатов визуализации, следует сопоставлять выявленные находки с клиникой, что подразумевает тесный контакт лучевого диагноста и клинициста.

Abnormalities of the abdominal aorta branches may cause chronic mesenteric ischemia, progressive pathological changes of the internal organs in this setting, and chronic pain syndrome. The causes of chronic mesenteric ischemia may be divided into atherosclerotic and non-atherosclerotic. Atherosclerosis of the unpaired branches of the abdominal aorta involves stenosis or occlusion. Other causes include fibromuscular dysplasia, vasculitis (Takayasu, segmental mediolytic arteriopathy), and median arcuate ligament syndrome. These syndromes, the pathogenesis of some of which remains controversial, lead to nonspecific complaints such as abdominal pain, weight loss, and others. Digital subtraction angiography or duplex ultrasound may provide hemodynamic information in cases of vascular disease in this area. However, multislice spiral computed tomography is in many cases the first choice because it allows for a comprehensive assessment of the state of blood vessels and associated morphological changes of internal organs. Structural changes accompanying these syndromes can also occur in patients who are undergoing a medical examination for other reasons. However, these syndromes should not be diagnosed solely on the basis of imaging; instead, the findings should be compared with the clinical presentation, which implies collaboration of radiologists and clinicians.

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The authors declare that there are no conflicts of interest present.