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Case of the Month

December 2013

Patient Data: Female patient 50 years old

Clinical Info: Patient was referred to exclude a deep venous thrombosis. She had pain in the calf that progressed during walking. She could not walk without pain for more than 100 meters


52101-Afbeelding1.jpg
Longitudinal image of the popliteal artery showing a severe stenosis with a very narrow and irregular lumen


52102-Afbeelding2.jpg
Another longitudinal image of the same popliteal artery with severe stenosis. The more superficial lying popliteal vein is patent


52103-Afbeelding3.jpg
Transverse image of the same artery and vein


52104-Afbeelding4.jpg
Detail image of the popliteal artery. The stenosis is not caused by atherosclerotic changes


52105-Afbeelding5.jpg
transverse image of the popliteal artery showing cystic changes in the wall of the artery


52552-poplitea2.swf MRA showing absent flow in the politeal artery


52553-poplitea.swf Detail of the popliteal area


52554-poplitea3.swf MRI of the knee showing cystic lesions


52555-poplitea4.swf MRI


52556-poplitea5.swf MRI


52557-poplitea6.swf MRI


52106-Afbeelding6.jpg
Longitudinal image of the common femoral artery in another older male patient also showing cystic changes in the outer layer of the arterial wall. The intima layer is completely normal. The cystic changes cause minimal impression of the lumen


52107-Afbeelding7.jpg
Longitudinal image of the common femoral artery showing the cystic changes


52108-Afbeelding8.jpg
Transverse image of the common femoral artery showing the cystic changes


52109-Afbeelding9.jpg
Longitudinal detail image of the cystic changes

The deep venous system in both patients was completely normal.
There was a significant stenosis in the popliteal artery of the first patient that was caused by cystic adventitial disease. The second older patient also had cystic adventitial changes but without a significant stenosis


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