Ultrasound assessment of the posterior circumflex humeral artery in elite volleyball players: Aneurysm prevalence, anatomy, branching pattern and vessel characteristics

Eur Radiol. 2017 Mar;27(3):889-898. doi: 10.1007/s00330-016-4401-8. Epub 2016 Jun 2.

Abstract

Objectives: To determine the prevalence of posterior circumflex humeral artery (PCHA) aneurysms and vessel characteristics of the PCHA and deep brachial artery (DBA) in elite volleyball players.

Methods: Two-hundred and eighty players underwent standardized ultrasound assessment of the dominant arm by a vascular technologist. Assessment included determination of PCHA aneurysms (defined as segmental vessel dilatation ≥150 %), PCHA and DBA anatomy, branching pattern, vessel course and diameter.

Results: The PCHA and DBA were identified in 100 % and 93 % (260/280) of cases, respectively. The prevalence of PCHA aneurysms was 4.6 % (13/280). All aneurysms were detected in proximal PCHA originating from the axillary artery (AA). The PCHA originated from the AA in 81 % of cases (228/280), and showed a curved course dorsally towards the humeral head in 93 % (211/228). The DBA originated from the AA in 73 % of cases (190/260), and showed a straight course parallel to the AA in 93 % (177/190).

Conclusions: PCHA aneurysm prevalence in elite volleyball players is high and associated with a specific branching type: a PCHA that originates from the axillary artery. Radiologists should have a high index of suspicion for this vascular overuse injury. For the first time vessel characteristics and reference values are described to facilitate ultrasound assessment.

Key points: • Prevalence of PCHA aneurysms is 4.6 % among elite volleyball players. • All aneurysms are in proximal PCHA that originates directly from AA. • Vessel characteristics and reference values are described to facilitate US assessment. • Mean PCHA and DBA diameters can be used as reference values. • Radiologists need a high index of suspicion for this vascular overuse injury.

Keywords: Aneurysm; Posterior circumflex humeral artery; Surveillance; Ultrasound; Volleyball.

MeSH terms

  • Adolescent
  • Adult
  • Aneurysm / diagnostic imaging*
  • Athletes*
  • Brachial Artery / anatomy & histology*
  • Brachial Artery / diagnostic imaging*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Humerus / anatomy & histology
  • Humerus / blood supply*
  • Humerus / diagnostic imaging*
  • Male
  • Prevalence
  • Ultrasonography / methods*
  • Volleyball*
  • Young Adult