Thaker Siddharth, Gupta Harun, Beh Joey, Kirwadi Anand, Chari Basavaraj
Department of Radiology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, United Kingdom.
Department of Musculoskeletal Radiology, Leeds General Infirmary, Leeds Teaching Hospital NHS Trust, Great George Street, Leeds, United Kingdom.
Indian J Radiol Imaging. 2023 Nov 23;34(2):283-290. doi: 10.1055/s-0043-1777014. eCollection 2024 Apr.
Vascular complications in athletes are common and mimic musculoskeletal injuries such as muscle sprains, fractures, and cartilage abnormalities. They include traumatic vascular injuries and more subtle pathologies like entrapment syndromes, pseudoaneurysms, arterial occlusions, and venous thrombosis. Such vascular complications may be occult on imaging and can be difficult for a musculoskeletal radiologist to diagnose, resulting in a lack of timely diagnosis and potentially limb-threatening consequences. Although the final diagnosis may require multidisciplinary input from orthopaedic, sports and exercise medicine, and vascular and interventional radiology inputs, a musculoskeletal radiologist with prior knowledge of such conditions can be the first to diagnose such conditions aiding the athlete's performance. A musculoskeletal radiologist should pay due attention to anatomical courses of vascular channels and look for potential causes of vascular compression, aberrant myotendinous bands, accessory muscles, etc., before concluding a computed tomography (CT) or magnetic resonance imaging (MRI) as normal. Doppler ultrasound, CT, or MR angiography are commonly employed techniques for primary evaluation, whereas digital subtraction angiography is generally reserved for troubleshooting as advanced dynamic imaging.
运动员的血管并发症很常见，且症状类似肌肉骨骼损伤，如肌肉拉伤、骨折和软骨异常。这些并发症包括创伤性血管损伤以及一些较为隐匿的病症，如卡压综合征、假性动脉瘤、动脉闭塞和静脉血栓形成。此类血管并发症在影像学检查中可能不易被发现，肌肉骨骼放射科医生诊断起来可能会有困难，从而导致诊断不及时，并可能产生危及肢体的后果。尽管最终诊断可能需要骨科、运动与运动医学、血管与介入放射学等多学科的参与，但对这些病症有先验知识的肌肉骨骼放射科医生可能会最先诊断出这些病症，这有助于运动员的表现。在认定计算机断层扫描（CT）或磁共振成像（MRI）结果正常之前，肌肉骨骼放射科医生应充分关注血管通道的解剖走行，并寻找血管受压、异常肌腱束、副肌等潜在原因。多普勒超声、CT或磁共振血管造影是常用的初步评估技术，而数字减影血管造影通常作为高级动态成像技术用于疑难问题的排查。
