MR-IMAGING AND MR-ANGIOGRAPHY IN POPLITEAL ARTERY ENTRAPMENT SYNDROME

Popliteal artery entrapment (PAE) syndrome is an uncommon congenital a nomaly seen in young adults causing ischemic symptoms in the lower ext remities. 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 combin ed with MR angiography in the diagnosis of PAE cases. Four cases with segmental occlusion and medial displacement of popliteal artery in dig ital 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 intercon dylar insertion of the medial head of the gastrocnemius muscle. The MR images showed detailed anatomy of the region revealing the cause of t he arterial entrapment. Subclassification of the cases were done and f at tissue filling the normal localization of the muscle was evaluated. The DSA and MRA images demonstrated the length and localization of th e occluded segment and collateral vascular developments equally. It is concluded that angiographic evaluation alone in PAE syndrome might re sult in overlooking the underlying cause of the arterial occlusion, wh ich in turn leads to unsuccessful therapy procedures such as balloon a ngioplasty. Magnetic resonance imaging combined with MR angiography de monstrates both the vascular anatomy and the variations in the muscula r structures in the popliteal fossa successfully, and this combination seems to be the most effective way of evaluating young adults with is chemic symptoms suggesting PAE syndrome.