Zystische Adventitiadegeneration

Zystische

Adventitiadegeneration der Arteria poplitea bei einem sonst gefäßgesunden Mann um die 40. Es traten subakut rezidivierende Durchblutungsstörungen auf. Die Angiographie zeigt die scharfe, bogenförmige Einengung durch de Zyste. Unter Kenntnis des MRTs ist caudal davon eine weitere sehr flache Einengung zu erkennen.

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Zystische

Adventitiadegeneration der Arteria poplitea bei einem sonst gefäßgesunden Mann um die 40. Es traten subakut rezidivierende Durchblutungsstörungen auf. MRT coronar T2w. Die Arteria mit mehreren länglichen T2-hellen Zysten eingeengt.

Wikipedia • CC BY-SA 3.0

Cystic

adventitial disease • Cystic adventitial disease - left common femoral vein - Ganzer Fall bei Radiopaedia

Hocking, J. Cystic adventitial disease - left common femoral vein. Case study, Radiopaedia.org. (accessed on 21 Oct 2022) https://doi.org/10.53347/rID-96475 • CC by-nc-sa 3.0 (modified)

Cystic

adventitial disease • Cystic adventitial disease - Ganzer Fall bei Radiopaedia

Crosta, J. Cystic adventitial disease. Case study, Radiopaedia.org. (accessed on 21 Oct 2022) https://doi.org/10.53347/rID-58702 • CC by-nc-sa 3.0 (modified)

Cystic

adventitial disease • Adventitial cystic disease of the popliteal artery - Ganzer Fall bei Radiopaedia

E, P. Adventitial cystic disease of the popliteal artery. Case study, Radiopaedia.org. (accessed on 21 Oct 2022) https://doi.org/10.53347/rID-11035 • CC by-nc-sa 3.0 (modified)

Cystic

adventitial disease • Cystic adventitial disease of the popliteal artery - Ganzer Fall bei Radiopaedia

Igler, C. Cystic adventitial disease of the popliteal artery. Case study, Radiopaedia.org. (accessed on 21 Oct 2022) https://doi.org/10.53347/rID-52759 • CC by-nc-sa 3.0 (modified)

Cystic

adventitial disease of the popliteal artery: features on 3T cardiovascular magnetic resonance. Maximal intensity projection (MIP) reconstruction image from high spatial resolution contrast enhanced MR angiography reveals a long segment focal near occlusion of the right popliteal artery (arrow). Note is made of high take-off of the bilateral posterior tibial arteries (arrowheads).

jcmr-online.biomedcentral.com • CC-by-2.0

Cystic

adventitial disease of the popliteal artery: features on 3T cardiovascular magnetic resonance. Axial and coronal T1-weighted post-contrast fat saturated gradient echo (GRE) images show no evidence of contrast enhancement of the well defined hypo-intense cystic mass. Compression of the popliteal arterial lumen (figure 2a and 2b, arrows), and normal enhancement of the popliteal vein (figure 2a, arrowhead) are noted.

jcmr-online.biomedcentral.com • CC-by-2.0

Cystic

adventitial disease of the popliteal artery: features on 3T cardiovascular magnetic resonance. Axial T2-weighted fat saturated turbo spin echo images demonstrate a well defined, homogeneously hyper-intense multi-lobulated cystic lesion in the right popliteal fossa (Figure 1a and 1b, arrows).

jcmr-online.biomedcentral.com • CC-by-2.0

Uncommon

Diseases of The Popliteal Artery: A Pictorial Review. Drawing showing cystic adventitial disease of the popliteal artery. Eccentric cystic lesions arising from the anterior wall of the popliteal artery are shown (arrows)

insightsimaging.springeropen.com • Open Access

Uncommon

Diseases of The Popliteal Artery: A Pictorial Review. Adventitial cystic disease of the popliteal artery in a 50-year-old woman with intermittent claudication of the right lower extremity. (a) Axial CT angiography shows a well-circumscribed fluid-density lesion within the popliteal fossa (asterisk) compressing the popliteal artery. (b) Sagittal maximum-intensity projection reconstruction of CT angiography shows eccentric stenosis of the popliteal artery (scimitar appearance), with significant narrowing of the vessel lumen (solid arrows). Note the collateralization (curved arrow) with dilation of the sural artery (dashed arrow). (c, d) Sagittal and axial fat-suppressed T2-weighted MR images show hyperintense signal of the arterial wall mass (arrows) confirming its cystic nature. (e) Axial T1-weighted MR image shows hyperintense signal of the cystic mass (arrow) related to mucinous content. (f) Intraoperative photo showing cystic lesion arising from the popliteal artery wall (arrows). (g) Photograph of the resected specimen after longitudinal transection, showing cystic lesion developing within the lumen of the popliteal artery (arrow)

insightsimaging.springeropen.com • Open Access

This image

is part of a series which can be scrolled interactively with the mousewheel or mouse dragging. This is done by using Template:Imagestack. The series is found in the category Cystic adventitial disease - case 001. Zystische Adventitiadegeneration in der DSA

Wikipedia • CC BY-SA 3.0

This image

is part of a series which can be scrolled interactively with the mousewheel or mouse dragging. This is done by using Template:Imagestack. The series is found in the category Cystic adventitial disease - case 001. Zystische Adventitiadegeneration in der MRT und DSA

Wikipedia • CC BY-SA 3.0

This image

is part of a series which can be scrolled interactively with the mousewheel or mouse dragging. This is done by using Template:Imagestack. The series is found in the category Cystic adventitial disease - case 001. Zystische Adventitiadegeneration in der MRT und DSA

Wikipedia • CC BY-SA 3.0

This image

is part of a series which can be scrolled interactively with the mousewheel or mouse dragging. This is done by using Template:Imagestack. The series is found in the category Cystic adventitial disease - case 001. Zystische Adventitiadegeneration in der MRT und DSA

Wikipedia • CC BY-SA 3.0

Zystische

Adventitiadegeneration der Arteria poplitea bei einem sonst gefäßgesunden Mann um die 40. Es traten subakut rezidivierende Durchblutungsstörungen auf. MRT axial T2w. links im Bild ein Schnitt oberhalb, in dem die dunkle (flow void) Arterie rechts (links im Bild) neben der helleren Vene normal zu sehen ist. Rechts der Schnitt durch die Zyste in der Adventitia T2-hell mit erheblicher Einengung des Lumens.

Wikipedia • CC BY-SA 3.0

Zystische

Adventitiadegeneration der Arteria poplitea bei einem sonst gefäßgesunden Mann um die 40. Es traten subakut rezidivierende Durchblutungsstörungen auf. MRT coronar T1w mit Kontrastmittel. Die Vene ist oben hell nur kurz angeschnitten, die Arteria mit mehreren länglichen T1-dunklen Zysten eingeengt.

Wikipedia • CC BY-SA 3.0

Zystische

Adventitiadegeneration der Arteria poplitea bei einem sonst gefäßgesunden Mann um die 40. Es traten subakut rezidivierende Durchblutungsstörungen auf. MRT axial T1w FS mit Kontrastmittel. Die Vene ist hell, die Arteria mit durch die T1-dunkle Zyste stark eingeengt und nur am Rand intens.

Wikipedia • CC BY-SA 3.0

Involvement

of the genicular branches in cystic adventitial disease of the popliteal artery as a possible marker of unfavourable early clinical outcome: a case report. T2-weighted image of our patient"s magnetic resonance imaging scan. The sagittal image on the left demonstrates one cyst in the posterior wall of the popliteal artery and a further anterior wall cyst causing stenosis. The axial image on the right shows the popliteal and genicular artery cysts. Lucent areas represent the arterial lumen.

jmedicalcasereports.biomedcentral.com • CC-by-2.0

Radiopaedia • CC-by-nc-sa 3.0 • de

Cystic adventitial disease (CAD) is an uncommon vascular pathology predominantly affecting peripheral vessels. The vast majority of cases occur in arteries, with venous involvement being an extremely rare occurrence .

Epidemiology

It typically affects young to middle-aged individuals without evidence of atherosclerosis or other systemic vascular disease. There is a recognized male predilection with a M:F ratio of ~15:1 .

Clinical presentation

Although cystic adventitial disease can affect any peripheral vessel, there is a striking predilection in the popliteal region, affected in ~85% of cases .

Typical symptoms include:

rapidly progressive calf claudication
lower extremity pain

Pathology

The condition is characterized by a collection of mucinous material (mucous cysts) within adventitial wall of the affected vessel.

Radiographic features

Ultrasound

May show multiple anechoic to hypoechoic lesions within the affected arterial wall. Color Doppler interrogation shows no flow within the lesions. There may also be associated arterial stenoses, with relevant changes in arterial Doppler wave flow and velocity.

MRI

Appearances on MRI are variable, depending on the distribution and size of the cysts.

May be seen as aggregates of multiple small round/ovoid masses originating in affected arterial wall, which if concentric lead to hourglass stenosis. When the lesions are large, they can have a multi-loculated appearance, and can displace the artery to one side - the so-called scimitar sign .

Lesional signal characteristics include

T1: individual lesions are of variable signal dependent on mucoid content
T2/STIR: individual lesions are high signal

Angiography (DSA)

Angiography may demonstrate curvilinear/spiral narrowing of vessels with a paucity of collaterals and an absence of poststenotic dilatation. When cystic lesions are large and eccentric they may displace the artery to one side - the so-called scimitar sign .