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Abstract

We read with interest the letter to the editor regarding our article “High spatial resolution magnetic resonance imaging of cystic adventitial disease of the popliteal artery.”1Maged I.M. Turba U.C. Housseini A.M. Kern J.A. Kron I.L. Hagspiel K.D. High spatial resolution magnetic resonance imaging of cystic adventitial disease of the popliteal artery.J Vasc Surg. 2010; 51: 471-474Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar As the title implies, we reported the (never before published) use of a novel magnetic resonance (MR) technique, high spatial resolution magnetic resonance imaging (MRI) in three patients with cystic adventitial disease (CAD). The MR technique used in our cases provides a far higher spatial resolution than MR techniques reported in previous MRI publications on CAD. The voxel size of 0.4 × 0.4 × 0.7 mm achieved in our work allowed us to detect even very small communications between the adventitial cysts and the joint space, such as the one shown in our Fig 1, E. By our estimates, the spatial resolution of our technique is 10 to 30 times higher than the one achieved in the Crolla and Chiche reports.2Crolla R.M.P.H. Steyling J.F. Hennipman A. Slootweg P.J. Taams A. A case of cystic adventitial disease of the popliteal artery demonstrated by magnetic resonance imaging.J Vasc Surg. 1993; 18: 1052-1055Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar, 3Chiche L. Barranger B. Cordoliani Y.S. Darrieus H. Guyon P. Vicq P. Two cases of cystic adventitial disease of the popliteal artery Current diagnostic approach.J Mal Vasc. 1994; 19: 57-61PubMed Google Scholar The focus of our article was not the description of the MRI features of CAD, something that indeed has been described previously. Rather, we report the use of a novel, high spatial resolution MRI technique that enabled us to detect these communications in all our patients. We are therefore somewhat surprised that the authors “doubt the value” of our study. We do congratulate them however on the successful surgical treatment and ultrasonographic diagnosis of their CAD patient. We believe that high spatial resolution MRI reliably allows the detection of connections between adventitial cysts and adjacent joints in CAD patients and thus has the potential to diminish postsurgical CAD recurrence rates. Regarding “High spatial resolution magnetic resonance imaging of cystic adventitial disease of the popliteal artery”Journal of Vascular SurgeryVol. 52Issue 2PreviewWe have read with interest the case reports by Maged et al1 describing different cases of cystic adventitial disease (CAD). We came to realize that we are already aware of the role of magnetic resonance imaging (MRI) in an early specific preoperative diagnosis with regard to CAD. Maged propagates the use of MRI, for it best demonstrates the presence of connections between adventitial cysts and the adjacent joint. This is important to know, because total resection of the cysts, including connections to the joint, prevents recurrence. Full-Text PDF Open Archive