Functional CTA in Athletes

RC112C

Functional CTA in Athletes

Refresher/Informatics

Presented on November 30, 2014
Presented as part of RC112: Advanced Vascular Imaging Techniques and Applications (An Interactive Session)

Richard Lee Hallett MD, Presenter: Nothing to Disclose

1) Identify anatomic and functional lesions that predispose to vascular entrapment and fibrotic syndromes in athletes. 2) Describe methods to assess vascular entrapment and fibrotic syndromes in athletes using dynamic, functionally challenged CTA and MRA. 3) Describe the imaging findings for diagnosis and follow-up of affected athletes.

While exercise is a mainstay in preventing and treating atherosclerotic peripheral vascular disease, some vascular disorders manifest primarily in athletes. Both recreational and competitive athletes are at risk for development of non-atherosclerotic vascular diseases. These disease entities range from iliac endofibrosis in cyclists, popliteal entrapment syndrome in running sports, and thoracic inlet / outlet syndromes in “overhead” athletes. Recently, computed tomography angiography (CTA) and magnetic resonance angiography (MRA) have become valuable diagnostic options for many vascular diseases that can occur in the athlete. Optimum imaging in these disorders requires the ability to tailor the exam protocol to the specific disease entity and vascular territory in question. By combining rapid CT image acquisition with functional, physiologic provocative maneuvers, diagnostic information can be maximized. Newer blood-pool MR contrast agents also allow functional assessment without ionizing radiation exposure. This session will review the pathophysiology, risk factors, diagnosis, and classification of vascular diseases seen in the athlete. Logical protocol development utilizing (when necessary) provocative maneuvers will be reviewed. Interpretation strategies for interacting with these resulting large, dynamic datasets will also be reviewed.