European Radiology

, Volume 14, Issue 11, pp 2025–2029 | Cite as

Parkes Weber or Klippel-Trenaunay syndrome? Non-invasive diagnosis with MR projection angiography

  • S. Ziyeh
  • J. Spreer
  • J. Rössler
  • R. Strecker
  • A. Hochmuth
  • M. Schumacher
  • J. Klisch


Klippel-Trenaunay and Parkes Weber (Klippel-Trenaunay-Weber) syndromes consist of vascular malformations of the capillary, venous and lymphatic systems combined with soft tissue and bone hypertrophy of the affected extremity. Klippel-Trenaunay syndrome is a pure low-flow condition, while Parkes Weber syndrome is characterized by significant arteriovenous fistulas. The distinction of both entities is relevant, since the prognosis and therapeutic strategies differ significantly. Our purpose is to demonstrate that thick-slice dynamic magnetic resonance projection angiography (MRPA) is a non-invasive tool to detect arteriovenous shunting in Parkes Weber syndrome. Four patients underwent MR imaging and MRPA. MRPA demonstrated arteriovenous shunting in three patients. Arteriovenous shunting was characterized by early appearing draining veins. The time of arrival between normal arteries and pathological veins varied between less than 0.5 and 1.0 s. Therefore, the diagnosis in these cases could be specified as Parkes Weber syndrome. In all these cases, arteriovenous shunting was confirmed by intraarterial digital subtraction angiography. One patient showed normal results in MRPA and could be diagnosed as having Klippel-Trenaunay syndrome.


Vascular malformation Parkes Weber syndrome Klippel-Trenaunay syndrome MR projection angiography 



All patients were presented and discussed at the interdisciplinary conference “Hemangiomas and Vascular Malformations” at the University Hospital Freiburg. We thank all persons who contributed to and participated in this conference.


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • S. Ziyeh
    • 1
  • J. Spreer
    • 1
  • J. Rössler
    • 2
  • R. Strecker
    • 3
  • A. Hochmuth
    • 1
  • M. Schumacher
    • 1
  • J. Klisch
    • 1
  1. 1.Section of Neuroradiology, NeurocenterUniversity of FreiburgFreiburgGermany
  2. 2.Department of Pediatric Hematology and OncologyUniversity of FreiburgFreiburgGermany
  3. 3.Section of Medical Physics, Department of RadiologyUniversity of FreiburgFreiburgGermany

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