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    Why does popliteal artery invisible on an abdominal aorta CT scan?

Posted on Thu, 10 May 2018 in Veins and Arteries
Question: I had ct scan of abdominal aorta and iliobilatral femeral cutoff to view the arteries and legs of veins.they were unable to visalize the popeteal artery.the machine was broken and didn't tell ,e to hold my breath as I was told it would do.plus my foot is very numb.waht caould make the ct scan unable to view the artery?
Answered by Dr. Prof. Kunal Saha 7 hours later
Brief Answer:
This structure is prone to getting missed. Could be no one's fault.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through your query and understand your concerns. Popliteal artery is a deep structure and often difficult to visualize. It is possible for the CT scan to miss it even if there is no problem with the machine.

Let me know if I could help further.

Above answer was peer-reviewed by : Dr. Kampana
Follow up: Dr. Prof. Kunal Saha 17 hours later
here is the ct results if I can paste them, on here.what do you think is
Nonvisualized distal 3rd right anterior tibial artery without
calcific atherosclerotic changes, this could be secondary to technique
(contrast bolus timing), versus noncalcific atherosclerotic disease.
2. Calcified right peroneal, bilateral posterior posterior tibial
arteries throughout their course, their patency cannot be assessed in
the current study.
3. Calcified proximal 3rd left peroneal and posterior tibial arteries,
their patency cannot be assessed in the current study.
4. Venous collaterals in bilateral legs without subcutaneous edema in
bilateral lower extremities.
5. Small uterine fibroids (anterior wall intramural fibroid measuring
1.7 cm, left lateral subserous fibroid measuring 2.1 cm).
8. Post cholecystectomy status.

I have personally reviewed the image(s), and was present during the
physician services associated with the procedure and agree with the

Electronically Signed by: XXXXXXX Meek, D.O. on 12/07/2017 at 16:06:01



51 y/o F with peripheral vascular disease. Patient complains of leg
and foot pain.

None available.

Contiguous 1 mm axial images were obtained through the abdomen and
pelvis followed by run off throughout bilateral lower extremities.
Images were obtained in arterial phase. 3 mm axial, coronal and
sagittal reconstructions were obtained and evaluated. 3D
reconstructions were rendered on a separate station and interpreted.

5.91 mGy

832.1 mGy*cm

CT Angiographic findings:

Visualized portion of the descending aorta appear normal. The
abdominal aorta is normal in course and caliber. The celiac trunk,
superior mesenteric artery, and inferior mesenteric artery are normally
opacified. Images demonstrate two renal arteries on the left and one
on the right. Bilateral common, internal, and external iliac arteries
are normally opacified without narrowing. The left internal iliac
artery has a tortuous course before dividing into anterior and
posterior divisions.

Common femoral arteries are normally opacified bilaterally. Bilateral
superficial, deep femoral and popliteal arteries are normal except for
mild atherosclerotic disease.

3 vessel runoff is seen to right ankle. Right anterior tibial artery
is normal in caliber and contrast opacification in its proximal 2/3, it
is not visualized in the distal 1/3. The visualized dorsalis pedis
arteries calcified and its patency cannot be commented upon in the
current study. Right peroneal and posterior tibial arteries are
calcified throughout most of their course and their patency cannot be
commented upon in the current study.

3 vessel runoff is seen to left ankle. Left posterior tibial artery is
calcified throughout its course and its patency cannot be commented
upon. Proximal 3rd left peroneal and posterior tibial arteries are
calcified, patency cannot be assessed in this segment. However the
distal 2/3 are patent and normal in caliber throughout their course.
Left dorsalis pedis artery is normal

CT Non-angiographic findings:

Images through lung bases show no focal consolidation or pleural
effusion. Pacemaker electrodes are seen in the visualized cardia.
Heart is normal in size. No pericardial effusion seen.

The liver appears normal; no intrahepatic biliary dilatation
identified. No arterially enhancing lesion appreciated. The spleen,
pancreas, and adrenal glands appear normal.The gallbladder is
surgically absent.No extrahepatic biliary dilatation is seen.The
kidneys are normal in size with normal parenchymal enhancement.

Small hiatal hernia is seen. The distal esophagus is normal. The
stomach is mildly distended and without focal wall abnormality. No
abnormally dilated loop of small bowel is identified. The large bowel
is normal in caliber with minimal pneumatosis coli in the ascending
colon and cecum. The appendix is not visualized.

The urinary bladder is well distended. Uterus is normal in size with
1.7 cm anterior wall intramural fibroid and a 2.1 cm left lateral
subserous fibroid. Ovaries are normal in size and enhancement. No
lymphadenopathy or ascites is seen within the abdomen or pelvis.

No subcutaneous edema is seen in bilateral lower extremities.
Superficial venous collaterals are seen in bilateral legs.

Examination of bone windows reveals grade 1 retrolisthesis of L5 over
S1 with reduced posterior disc height at L5-S1 level. Small bone
island is seen in L5 vertebral body. Calcaneal partially cannulated
screw, there are plates and screws are seen in right foot.

Component Results

There is no component information for this result.

General Information


12/07/2017 4:06 PM

Ordered By:

Result Status:

Final result

This test result has been released by an automatic process.

Back to the Test Results List wrong?
Answered by Dr. Prof. Kunal Saha 3 hours later
Brief Answer:
Inputs needed

Detailed Answer:
Thanks for the inputs. I have checked the reports. Apart from the calcification (possibly age related) and some amount of spondylotic changes I do not see any major issues. Could you please mention the problems that made you seek medical assistance? I could guide you accordingly.

Above answer was peer-reviewed by : Dr. Yogesh D
Follow up: Dr. Prof. Kunal Saha 19 minutes later
thank you.is it normal to have calification on arteries?i ma 51 years old.i am disabled in my feet and legs and used to be a jogger.i have bben extremely sedatary for a few years/I wake up with numbness in my feet and legs and hands and my feet gre very numb at times.what does it mean when they say the left internal ilieac artery is tortousous?also if they cannot visailize the patentency of the arteries should agiogram be done.the ultrasound didn't pick it up either.what does it mkean a small bone island is seen at L5. my foot doctor sent me to this vascular doctor because my foot xrays are worsening inn calification.i have numbness in feet.the ultrasound showed the great saphouous vein in both legs were moderately incontinent also. thank you for your help.i appreciate you.
Answered by Dr. Prof. Kunal Saha 1 hour later
Brief Answer:
A Doppler study can help

Detailed Answer:
The calcification is associated with degenerative changes. It may or may not be associated with narrowing of the arteries. In other words, narrowing of the arteries could occur and that could lead to compromise of blood flow to lower limbs, thus causing symptoms like numbness of feet. A Doppler can assess the flow and thereby the patency. The tortuousness is not a cause for concern.

It is hard to comment on the bony island without taking a direct look at the structure. However, as mentioned it is possibly due to spondylotic changes, thus causing nerve compression and that too can cause numbness of lower limbs.

Above answer was peer-reviewed by : Dr. Yogesh D
Follow up: Dr. Prof. Kunal Saha 7 hours later
what is a dopler?i already had a ultrasound and that didn't show the artery at hat time prior to the ct
Answered by Dr. Prof. Kunal Saha 1 hour later
Brief Answer:
You need to ask for Doppler study of lower limb blood vessels

Detailed Answer:
Doppler ultrasound is a particular type of ultrasound wherein the flow of blood is evaluated. You need to specifically ask for it.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
Follow up: Dr. Prof. Kunal Saha 24 minutes later
Answered by Dr. Prof. Kunal Saha 14 minutes later
Brief Answer:
Two different things

Detailed Answer:
I understand. But an ultrasound and a color Doppler arterial study of lower limb (respective side) are two different things. The latter is available only at select centers and can only be done by doctors who are skilled in it. I think that you need to ask for it.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
Follow up: Dr. Prof. Kunal Saha 3 hours later
thank you for your aqdvice.whatwould yu rate my severity of my problem ob scale of 1-10 wit 10 being severe
Answered by Dr. Prof. Kunal Saha 1 hour later
Brief Answer:

Detailed Answer:
I would not be able to comment on the severity. The severity can be assessed by you based on how intense the symptoms seem to be.

Above answer was peer-reviewed by : Dr. Prasad
Answered by
Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4439 Questions


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