Mohrs O K, Dahm T, Nowak B, Fach W A, Reinhart A, Hoffmann K, Voigtländer T
Cardioangiologisches Centrum Bethanien (CCB), Frankfurt/Main.
Vasa. 2004 May;33(2):93-6. doi: 10.1024/0301-1526.33.2.93.
A 30-year old man with pain in the right calf was submitted. Typical cardiovascular risk factors were excluded. Contrast enhanced MR-angiography at rest showed occlusion of right popliteal artery with collateral vessels due to an abnormal origin of medial head of gastrocnemius muscle at femoral diaphysis. In contrast to a normal MR-angiography at rest the exercise test detected a lateral deviation and a severe functional stenosis of the left popliteal artery. This was caused by an abnormal medial origin of medial head of gastrocnemius muscle at the inner femoral condylus. The patient has been treated with vascular reconstruction combined with myectomy on the right side and with myectomy only on the left side. These findings showed two different types of popliteal artery entrapment syndrome in one patient. MRI is able to detect the different types especially in different stages. Irreversible damages of popliteal artery in early diagnosed stages may thereby be prevented.
收治了一名30岁右小腿疼痛的男性患者。排除了典型的心血管危险因素。静息状态下的对比增强磁共振血管造影显示右侧腘动脉闭塞,伴有侧支血管,原因是腓肠肌内侧头在股骨干处起源异常。与静息状态下正常的磁共振血管造影不同,运动试验检测到左侧腘动脉向外偏移且存在严重的功能性狭窄。这是由腓肠肌内侧头在内侧股骨髁处内侧起源异常所致。该患者接受了右侧血管重建联合肌肉切除术以及左侧单纯肌肉切除术的治疗。这些发现表明一名患者存在两种不同类型的腘动脉受压综合征。MRI能够检测出不同类型,尤其是在不同阶段。由此可预防早期诊断阶段腘动脉的不可逆损伤。