Reference values of vessel diameters, stenosis prevalence, and arterial variations of the lower limb arteries in a male population sample using contrast-enhanced MR angiography

Introduction

Morphological characterization of leg arteries is of significant importance to detect vascular remodeling triggered by atherosclerotic changes. We determined reference values of vessel diameters and assessed prevalence of stenosis and arterial variations of the lower limb arteries in a healthy male population sample.

Methods

Gadolinium-enhanced magnetic resonance angiography at 1.5 Tesla was performed in 756 male participants (median age = 52 years, range = 21–82 years) of the population-based Study of Health in Pomerania. Vessel diameters were measured in 9 predefined segments of the pelvic and leg arteries and 95th percentiles were used for upper reference values of means of left and right side arteries.

Results

Reference values of vascular diameters decreased from proximal to distal arteries: common iliac = 1.18cm; internal iliac = 0.75cm; external iliac = 1.03cm; proximal femoral = 1.02cm; distal femoral = 0.77cm; popliteal = 0.69cm; anterior tibial = 0.42cm; posterior tibial = 0.38cm; fibular = 0.40cm. Body-surface area indexed reference values increased with age in all segments. A number of 53 subjects (7.0%) had at least one stenosis, mainly in the lower leg arteries anterior tibial (n = 28, 3.7%), posterior tibial (n = 18, 2.4%) and fibular (n = 20, 2.6%). The risk of stenosis increased considerably with age (odds ratio = 1.08; p<0.001). The most common arterial variant was type I-A in both legs (n = 620, 82%).

Conclusion

We present reference values for different pelvic and leg artery segment diameters in men that decrease from proximal to distal and increase with age. Stenoses were most prevalent in lower leg arteries and type I-A was the most common variant in the lower leg.

[Exogenous psychoses in Parkinson syndrome. Frequency and causal conditions]

Exogenous psychotic symptoms of a wide variety have been reported to appear more and more frequently since the introduction of levodopa in the therapy of Parkinson's disease. They were considered to be caused by treatment related imbalance of cerebral neurotransmitters and hypersensitivity of the dopaminergic receptors, respectively. In the present investigation an analysis was done concerning the relevance of different antiparkinsonian drugs and other factors such as severity of neurological and cerebroorganic symptomatology, age, duration of treatment, EEG and brain atrophic changes and additional physical diseases for the appearance of psychotic symptoms. The questions were posed to 152 patients (54 men, 88 women) aged 34-76 years, which received a treatment with levodopa alone, in combination with a decarboxylase inhibitor, amantadines and/or anticholinergics for a period of 1-9 years. An exogenous psychotic symptomatology was observed in 42 patients (27,6%), explicitly under all antiparkinsonistic drugs, but not when amantadines were given as the initial treatment. In patients receiving levodopa/decarboxylase inhibitor psychotic symptoms could be observed most frequently but at the same time the duration of treatment was the longest. In 15 patients psychotic symptoms appeared under different antiparkinsonian drugs. In 28 patients this symptomatology was followed by a constant severe dementia. Predisposing factors for exogenous psychosis proved to be: a higher age at the beginning of the treatment and the initiation of treatment, a pronounced neurological symptomatology and signs of dementia as well as additional physical diseases. Because of the very complex conditions under which exogenous psychosis can be observed and the additional fact that they can appear under each antiparkinsonian substance, levodopa cannot be considered as the sole cause.(ABSTRACT TRUNCATED AT 250 WORDS)