Abstract
Vascular injury resulting in pseudoaneurysm formation in the plantar aspect of the foot is an uncommon injury after trauma. Such injuries are more often reported in the lateral plantar artery rather than the medial plantar artery, most likely because of its more superficial location. Traditional modalities in diagnosis have included ultrasound and digital subtraction angiography. We present a case of traumatic pseudoaneurysm of the lateral plantar artery following a foot laceration. Diagnosis was made by the use of high-resolution, time-resolved contrast-enhanced 3D magnetic resonance angiography, also referred to as “TRICKS” (time-resolved imaging of contrast kinetics). This technique provided high spatial resolution for the arterial anatomy as well as temporal resolution which allowed better delineation of the hemodynamic characteristics of the pseudoaneurysm.
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Animation 1
The temporal resolution of time-resolved contrast-enhanced 3D MR angiography (TRICKS)—the dynamic phases of contrast enhancement are displayed in continuity. Note the rapid contrast filling of the lateral plantar artery pseudoaneurysm and the delayed washout of the lesion, after venous and soft tissue enhancement is seen. (MPG 438 kb)
Animation 2
TRICKS MR angiography at 2 months follow-up demonstrates diminished flow within the lateral plantar artery and the complete lack of contrast filling of the pseudoaneurysm, indicating complete thrombosis. (i) Anterior tibial artery, (ii) posterior tibial artery, (iii) medial plantar artery, (iv) lateral plantar artery, and (v) distal fibular arteries. (MPG 438 kb)
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Murakami, A.M., Chang, A. & Foo, L.F. Traumatic Lateral Plantar Artery Pseudoaneurysm and the Use of Time-Resolved MR Angiography. HSS Jrnl 6, 214–218 (2010). https://doi.org/10.1007/s11420-010-9170-3
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DOI: https://doi.org/10.1007/s11420-010-9170-3