Improved characterization of popliteal aneurysms using gadofosveset-enhanced equilibrium phase magnetic resonance angiography Mauricio S. Galizia, MD,

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Presentation transcript:

Improved characterization of popliteal aneurysms using gadofosveset-enhanced equilibrium phase magnetic resonance angiography Mauricio S. Galizia, MD, Emily Ward, MD, Heron Rodriguez, MD, Jeremy Collins, MD, James Carr, MD Journal of Vascular Surgery Volume 57, Issue 3, Pages 837-841 (March 2013) DOI: 10.1016/j.jvs.2012.09.018 Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 1 A 17-year-old male with swelling of the right thigh. Subtracted maximum intensity projection image of a time-resolved magnetic resonance angiogram of the right popliteal region demonstrates a contrast-filled mass in the popliteal fossa during the arterial phase, suggesting a popliteal artery pseudoaneurysm. Note that the right popliteal artery is not well depicted at the level of the pseudoaneurysm, although it reconstitutes below the knee level. Journal of Vascular Surgery 2013 57, 837-841DOI: (10.1016/j.jvs.2012.09.018) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 2 A 17-year-old male with swelling of the right thigh. High-resolution T1-weighted magnetic resonance angiographic images with fat saturation, after injection of a blood pool contrast agent. a, Axial image demonstrating a heterogeneous mass located posteromedially to the right femur, surrounding the above-the-knee right popliteal artery (white arrow). b, Coronal image demonstrating a well-defined, contrast-enhanced mass surrounded by low-signal material (white arrow) representing thrombus. c, Axial image demonstrating a small connection between the right popliteal artery and the enhanced mass (white arrow), characterizing a pseudoaneurysm of the popliteal artery. d, An osteochondroma (white arrow) compresses the pseudoaneurysm and most likely is the cause of the popliteal artery rupture. e, Axial image proximal to the mass demonstrating an enhanced popliteal artery (white arrow) and a low-signal popliteal vein (white arrowhead) representing venous thrombosis. f, Coronal view showing that the popliteal vein is being compressed by the pseudoaneurysm, thus explaining the origin of the venous thrombus (white arrowhead). Journal of Vascular Surgery 2013 57, 837-841DOI: (10.1016/j.jvs.2012.09.018) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 3 A 51-year-old man with swelling of the left thigh. a, Noncontrast computed tomography showing a well-defined mass located posteriorly to the left femur (white arrows). b, Ultrasound scan demonstrating a soft tissue mass surrounding the left popliteal artery in the area of the palpable mass. At this point, the differential diagnosis includes a popliteal aneurysm, a popliteal pseudoaneurysm, and a vessel wall tumor. c, High-resolution magnetic resonance angiographic image after injection of a blood pool contrast agent showing a patent popliteal artery, surrounded by low-signal material, typical of mural thrombus (white arrows), characterizing a popliteal artery aneurysm. The popliteal vein is also well opacified and can be seen next to the artery (white arrowhead). d, The aneurysm (white arrowheads) can be seen compressing the popliteal vein (white arrow). e, Maximum intensity projection (MIP) in the arterial phase of the injection demonstrating continuity between the above-the-knee popliteal artery, the dilated aneurysm, and the below-the-knee popliteal artery, further strengthening the diagnosis of popliteal aneurysm. f, Sagittal oblique view of the MIP reformats showing an elongated, tortuous left popliteal artery. Journal of Vascular Surgery 2013 57, 837-841DOI: (10.1016/j.jvs.2012.09.018) Copyright © 2013 Society for Vascular Surgery Terms and Conditions