Robert J. Rizzo, MD, William R. Flinn, MD, James S. T

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Presentation transcript:

Computed tomography for evaluation of arterial disease in the popliteal fossa Robert J. Rizzo, MD, William R. Flinn, MD, James S.T. Yao, MD, PhD, Walter J. McCarthy, MD, Robert L. Vogelzang, MD, William H. Pearce, MD Journal of Vascular Surgery Volume 11, Issue 1, Pages 112-119 (January 1990) DOI: 10.1016/0741-5214(90)90335-8 Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Bilateral popliteal aneurysms. Arteriogram (top) reveals obvious aneurysm (A, small arrows) on the left but does not clearly define the aneurysm on the right. CT (bottom) clearly defines bilateral patent aneurysms (large arrows) lined with thrombus (T). Journal of Vascular Surgery 1990 11, 112-119DOI: (10.1016/0741-5214(90)90335-8) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Bilateral popliteal aneurysms. The CT scan illustrates bilateral popliteal aneurysms (A). The one on the right is large and thrombosed. A thrombosed popliteal aneurysm cannot be diagnosed accurately by arteriography. Journal of Vascular Surgery 1990 11, 112-119DOI: (10.1016/0741-5214(90)90335-8) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Graft aneurysm. CT scan reveals diffuse aneurysmal dilatation and thrombosis of the left femoropopliteal saphenous vein graft (V), which is seen here just below the sartorius muscle (S). Journal of Vascular Surgery 1990 11, 112-119DOI: (10.1016/0741-5214(90)90335-8) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Unilateral entrapment. CT depicts normal anatomic relationship of the popliteal artery (P) to the medial head of the gastrocnemius muscle (G) on the right. Popliteal entrapment diagnosed by CT scan on the left (arrow) could not be identified by arteriography because of arterial occlusion. Journal of Vascular Surgery 1990 11, 112-119DOI: (10.1016/0741-5214(90)90335-8) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Bilateral entrapment. A, Arteriogram reveals popliteal arterial occlusion on the right, without any evidence of medial deviation on either side. Active plantar flexion produced changes on the left consistent with entrapment. B, CT identifies the bilateral presence of a lateral component (black arrows) of the medial head of the gastrocnemius muscle in an abnormal relationship lateral to the popliteal artery (white arrows). Journal of Vascular Surgery 1990 11, 112-119DOI: (10.1016/0741-5214(90)90335-8) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Adventitial cystic disease. A, Arteriogram reveals only a subtle decrease in contrast density (arrow) above the level of the patella, but not the classic scimitar sign. B, CT defines a circumferential adventitial cyst (arrows) with compromise of the arterial lumen. Journal of Vascular Surgery 1990 11, 112-119DOI: (10.1016/0741-5214(90)90335-8) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 Recurrent adventitial cystic disease. A, CT illustrates a large adventitial cyst (C) of the right popliteal artery. B, Eighteen months after excision, another adventitial cyst (C) was identified by CT in the calf below the area of original involvement. Journal of Vascular Surgery 1990 11, 112-119DOI: (10.1016/0741-5214(90)90335-8) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions