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Popliteal artery entrapment syndrome: morphological classification utilizing MR imaging
Hee Kyung Kim1, Myung Jin Shin, Sung Moon Kim
1Department Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1, Pungnap-dong, Songpa-Gu, Seoul, 138-736, South Korea.
Skeletal Radiology
|June 3, 2006
Summary
Popliteal artery entrapment syndrome (PAES) is often caused by the gastrocnemius medial head anomaly. However, the gastrocnemius lateral head anomaly, particularly aberrant slips, also causes PAES, affecting popliteal arteries and veins.
Area of Science:
- Vascular Surgery
- Radiology
- Anatomy
Background:
- Popliteal artery entrapment syndrome (PAES) is a condition caused by abnormal anatomical relationships between the popliteal artery and surrounding muscles.
- Understanding the specific anatomical variations is crucial for accurate diagnosis and effective treatment.
Purpose of the Study:
- To retrospectively analyze magnetic resonance (MR) findings in patients diagnosed with popliteal artery entrapment syndrome (PAES).
- To classify the types of gastrocnemius muscle anomalies associated with PAES.
Main Methods:
- Retrospective review of MRI and CT scans from 12 patients (23 limbs) diagnosed with PAES over a 10-year period.
- Classification of PAES based on anomalous relationships between the popliteal artery and the gastrocnemius muscle (medial and lateral heads).
- Detailed classification of gastrocnemius medial head anomalies (Whelan and Rich types 1-6) and definition of lateral head anomalies.
Main Results:
- Gastrocnemius medial head anomaly was identified in 14 out of 23 limbs.
- Specific types of medial head anomalies observed: Type 2 (6 limbs), Type 3 (5 limbs), Type 5 (1 limb), and Type 6 (2 limbs).
- Gastrocnemius lateral head anomaly was found in 8 out of 23 limbs, often involving aberrant accessory slips.
Conclusions:
- Gastrocnemius medial head anomaly is a primary cause of PAES, with various subtypes contributing.
- Gastrocnemius lateral head anomaly, especially due to aberrant accessory slips, is also a significant cause of PAES, potentially entrapping the popliteal artery and vein.