CT Angiography and MRI in Patients with Popliteal Artery Entrapment Syndrome
Zhong Hai1,
Shao Guangrui1,
Zhao Yuan2,
Xu Zhuodong3,
Liu Cheng3,
Liao Jingmin4 and
Shen Yun4
1 Department of Radiology, The Second Hospital of Shandong University, 247
Beiyuan Rd., 250033 Jinan, Shandong, China.
2 Shandong University of Traditional Chinese Medicine, Jinan, China.
3 Department of CT, Shandong Medical Imaging Research Institute, Jinan,
China.
4 GE China CT Imaging Research Center, Beijing, China.
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Fig. 1A —16-year-old girl (case 2 in
Table 2) with popliteal artery
entrapment syndrome of right lower extremity who presented with calf
claudication. Digital subtraction angiography image shows segmental occlusion
of right popliteal artery and genicular collateral developments.
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Fig. 1B —16-year-old girl (case 2 in
Table 2) with popliteal artery
entrapment syndrome of right lower extremity who presented with calf
claudication. Volume-rendered image shows occlusion of right popliteal artery
and genicular collateral developments comparable to digital subtraction
angiography findings (A).
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Fig. 1C —16-year-old girl (case 2 in
Table 2) with popliteal artery
entrapment syndrome of right lower extremity who presented with calf
claudication. Axial CT angiography image reveals lateral location of medial
head of right gastrocnemius muscle (long arrow) and occlusion of
popliteal artery (short arrow), consistent with type II anomaly.
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Fig. 1D —16-year-old girl (case 2 in
Table 2) with popliteal artery
entrapment syndrome of right lower extremity who presented with calf
claudication. Axial (D) and coronal (E) T2-weighted images show
popliteal artery is trapped, located anterolaterally to medial head of
gastrocnemius (arrow). Muscle originates abnormally laterally at
intercondylar notch (type II anomaly).
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Fig. 1E —16-year-old girl (case 2 in
Table 2) with popliteal artery
entrapment syndrome of right lower extremity who presented with calf
claudication. Axial (D) and coronal (E) T2-weighted images show
popliteal artery is trapped, located anterolaterally to medial head of
gastrocnemius (arrow). Muscle originates abnormally laterally at
intercondylar notch (type II anomaly).
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Fig. 2A —Bilateral popliteal artery entrapment in 64-year-old man
(case 3 in Table 2) who
presented with intermittent claudication of right calf for 3 months in setting
of swelling in both lower extremities for several years. Type III was
diagnosed in right knee and type I in left knee. Axial CT angiography images
show aberrant accessory muscle slip of medial head of right gastrocnemius
muscle (long straight arrow, A) and entrapped right popliteal
artery (short straight arrow, A). Abnormal accessory muscle
slip of medial head of right gastrocnemius muscle joins to medial head of
right gastrocnemius muscle in distal portion (not illustrated). Right
popliteal artery is occluded and caudal portion shows aneurysm with
thrombolysis (arrow, B). Muscle origin (curved arrow,
A) of left lower limb is normally above medial femoral condyle. Left
popliteal artery is of normal caliber but deviates medially, consistent with
type I anomaly.
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Fig. 2B —Bilateral popliteal artery entrapment in 64-year-old man
(case 3 in Table 2) who
presented with intermittent claudication of right calf for 3 months in setting
of swelling in both lower extremities for several years. Type III was
diagnosed in right knee and type I in left knee. Axial CT angiography images
show aberrant accessory muscle slip of medial head of right gastrocnemius
muscle (long straight arrow, A) and entrapped right popliteal
artery (short straight arrow, A). Abnormal accessory muscle
slip of medial head of right gastrocnemius muscle joins to medial head of
right gastrocnemius muscle in distal portion (not illustrated). Right
popliteal artery is occluded and caudal portion shows aneurysm with
thrombolysis (arrow, B). Muscle origin (curved arrow,
A) of left lower limb is normally above medial femoral condyle. Left
popliteal artery is of normal caliber but deviates medially, consistent with
type I anomaly.
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Fig. 2C —Bilateral popliteal artery entrapment in 64-year-old man
(case 3 in Table 2) who
presented with intermittent claudication of right calf for 3 months in setting
of swelling in both lower extremities for several years. Type III was
diagnosed in right knee and type I in left knee. Volume-rendered image shows
segmental occlusion of right popliteal artery (short arrow) and
deviation medially of left popliteal artery (long arrow).
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Fig. 3A —Right popliteal artery entrapment syndrome in 45-year-old man
(case 1 in Table 2) who
presented with swelling and aching pain of 6 months' duration. Axial CT
angiography image (A) and transverse spin-echo T1-weighted MR image
(B) show that right popliteal artery is entrapped by aberrant accessory
muscle slip of medial head of right gastrocnemius muscle (arrow) that
passes between popliteal artery and vein.
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Fig. 3B —Right popliteal artery entrapment syndrome in 45-year-old man
(case 1 in Table 2) who
presented with swelling and aching pain of 6 months' duration. Axial CT
angiography image (A) and transverse spin-echo T1-weighted MR image
(B) show that right popliteal artery is entrapped by aberrant accessory
muscle slip of medial head of right gastrocnemius muscle (arrow) that
passes between popliteal artery and vein.
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Fig. 3C —Right popliteal artery entrapment syndrome in 45-year-old man
(case 1 in Table 2) who
presented with swelling and aching pain of 6 months' duration. Coronal
T1-weighted MR image shows relationship between abnormal aberrant accessory
muscle slip of medial head of right gastrocnemius muscle (arrow) and
popliteal artery. Gastrocnemius muscle originates normally, consistent with
type III anomaly.
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Fig. 4A —Bilateral popliteal artery entrapment syndrome in 18-year-old
woman (case 7 in Table 2) who
presented with intermittent claudication of left calf for 1 month. Patient had
no right-sided symptoms. Digital subtraction angiography image (right anterior
oblique 30° view) shows left popliteal artery (arrow) deviates
medially, and poststenotic ectasia is shown distally.
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Fig. 4B —Bilateral popliteal artery entrapment syndrome in 18-year-old
woman (case 7 in Table 2) who
presented with intermittent claudication of left calf for 1 month. Patient had
no right-sided symptoms. Axial (A) and coronal (B) spin-echo
T1-weighted MR images of left knee show popliteal artery (short
arrow) with aberrant course medial to medial head of gastrocnemius muscle
(long arrow). Muscle originates abnormally laterally at superior
intercondylar notch, consistent with type II anomaly.
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Fig. 4C —Bilateral popliteal artery entrapment syndrome in 18-year-old
woman (case 7 in Table 2) who
presented with intermittent claudication of left calf for 1 month. Patient had
no right-sided symptoms. Axial (A) and coronal (B) spin-echo
T1-weighted MR images of left knee show popliteal artery (short
arrow) with aberrant course medial to medial head of gastrocnemius muscle
(long arrow). Muscle originates abnormally laterally at superior
intercondylar notch, consistent with type II anomaly.
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