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目的探讨影像学检查方法在腓肠肌外侧头附属肌束致腘血管陷迫综合征(Popliteal vascular entrapment syndrome,PVES)中的诊断价值,增加对该病的认识。方法回顾性分析4例经手术病理证实的由腓肠肌外侧头附属肌束致腘血管陷迫综合征患者的影像学资料,包括多普勒超声、数字减影血管检查(DSA)、CT血管成像(CTA)及磁共振检查(MRI)。结果 4例患者中,2例患者腘动脉受累闭塞;1例患者双侧腘静脉内移,左侧腘静脉血栓形成;1例患者左侧腘动静脉均受累,造成左侧腘动脉闭塞,左侧腘静脉及股静脉血栓形成,血栓脱落后造成肺动脉栓塞,慢性血栓栓塞性肺动脉高压及肺心病。4例患者中,超声及DSA检查均能够发现腘动脉及腘静脉的形态变化,术前未明确PVES诊断。CTA及MRI检查能够清晰显示腘窝内腘血管与异常肌束间的关系,明确诊断,与手术结果一致。结论腓肠肌外侧头附属肌束致腘血管陷迫综合征是一种少见的疾病,影像学检查对于该病的诊断与治疗有重要价值。
Objective To investigate the diagnostic value of imaging examination in Popliteal vascular entrapment syndrome (PVES) and to increase the understanding of the disease. Methods The imaging data of 4 patients with pathological confirmed vascular distress syndrome caused by the lateral appendicular muscular bundle of gastrocnemius muscle were retrospectively analyzed, including Doppler ultrasound, digital subtraction angiography (DSA) and CT angiography CTA) and magnetic resonance imaging (MRI). Results Of the 4 patients, 2 patients had occlusion of popliteal artery occlusion, 1 patient had bilateral collateral vein transposition and left collateral vein thrombosis, and 1 patient had left aorta occlusion, occluding the left popliteal artery and left Lateral veins and femoral vein thrombosis, thrombosis caused by pulmonary embolism, chronic thromboembolic pulmonary hypertension and pulmonary heart disease. Four patients, ultrasound and DSA examination can detect the morphological changes of the popliteal and popliteal vein, PVES diagnosis is not clear preoperatively. CTA and MRI can clearly show the relationship between the blood vessels in the popliteal fossa and abnormal muscle bundles, confirm the diagnosis, and the results are consistent. Conclusion Gastrocnemius fasciculus syndrome is a rare disease caused by lateral muscular bundle of gastrocnemius muscle. Imaging examination is of great value in the diagnosis and treatment of the disease.