Computed tomography and sonography of cystic adventitial disease

Abstract

Cystic adventitial disease (CAD) is an uncommon but important disorder, mainly of the vascular system. Usually, a single macroscopic mucin-containing cyst develops in a focal collection of microscopic cysts within the adventitia of a vessel, most commonly the popliteal artery. This disorder of unknown aetiology has a strong male predominance (8 : 1 male: female ratio) and usually affects relatively young patients (mean age 42 years) who, therefore, present with intermittent claudication at an age younger than expected for degenerative arterial disease (Flanigan et al, 1979). Distinction from other causes of intermittent claudication, and in particular atheroma, is important as the prognosis of CAD is good and its treatment may differ. The typical angiographic appearances have previously been described (Schlesinger & Gottesman, 1976). During the preparation of this paper, two reports of the appearances on computed tomography (CT) and ultrasound have been published (Deutsch et al, 1985; Wilbur et al, 1985) and we wish to report a further case with similar findings.