Atilla S, Ilgit E T, Akpek S, Yücel C, Tali E T, Işik S
Department of Radiology, Gazi University School of Medicine, TR-06510 Ankara, Turkey.
Eur Radiol. 1998;8(6):1025-9. doi: 10.1007/s003300050509.
Popliteal artery entrapment (PAE) syndrome is an uncommon congenital anomaly seen in young adults causing ischemic symptoms in the lower extremities. It is the result of various types of anomalous relationships between the popliteal artery and the neighboring muscular structures. The purpose of this study was to define the role of MR imaging combined with MR angiography in the diagnosis of PAE cases. Four cases with segmental occlusion and medial displacement of popliteal artery in digital subtraction angiography (DSA) examinations were diagnosed as PAE syndrome by MR imaging and MR angiography. The DSA and MRA images are compared. All of the cases showed various degrees of abnormal intercondylar insertion of the medial head of the gastrocnemius muscle. The MR images showed detailed anatomy of the region revealing the cause of the arterial entrapment. Subclassification of the cases were done and fat tissue filling the normal localization of the muscle was evaluated. The DSA and MRA images demonstrated the length and localization of the occluded segment and collateral vascular developments equally. It is concluded that angiographic evaluation alone in PAE syndrome might result in overlooking the underlying cause of the arterial occlusion, which in turn leads to unsuccessful therapy procedures such as balloon angioplasty. Magnetic resonance imaging combined with MR angiography demonstrates both the vascular anatomy and the variations in the muscular structures in the popliteal fossa successfully, and this combination seems to be the most effective way of evaluating young adults with ischemic symptoms suggesting PAE syndrome.
腘动脉受压（PAE）综合征是一种在年轻人中少见的先天性异常，可导致下肢缺血症状。它是腘动脉与邻近肌肉结构之间各种异常关系的结果。本研究的目的是确定磁共振成像（MR）联合磁共振血管造影（MRA）在PAE病例诊断中的作用。4例在数字减影血管造影（DSA）检查中出现腘动脉节段性闭塞和向内侧移位的患者，经MR成像和MRA诊断为PAE综合征。对DSA和MRA图像进行了比较。所有病例均显示腓肠肌内侧头髁间插入部不同程度的异常。MR图像显示了该区域的详细解剖结构，揭示了动脉受压的原因。对病例进行了亚分类，并评估了填充肌肉正常位置的脂肪组织。DSA和MRA图像同样显示了闭塞节段的长度和位置以及侧支血管的情况。得出的结论是，仅对PAE综合征进行血管造影评估可能会忽略动脉闭塞的潜在原因，进而导致诸如球囊血管成形术等治疗方法失败。磁共振成像联合MRA能够成功显示腘窝的血管解剖结构和肌肉结构的变异，这种联合似乎是评估有提示PAE综合征缺血症状的年轻人的最有效方法。
