Résumé
A coronary aneurysm (CA) can occur in sirolimus-eluting stent (SES)-implanted coronary lesions. Although several possible mechanisms have been suggested, the precise pathogenesis of a CA in SES-implanted lesions is still unknown. We report a patient with Churg-Strauss syndrome who underwent successful percutaneous coronary intervention with SES and then experienced a CA in an SES-implanted coronary lesion. We describe the CA characteristics through the use of coronary angiography, coronary 64-multidetector computed tomography, and intravascular ultrasound and discuss the etiological factors for the CA in this patient.
Sujets)
Humains , Syndrome de Churg-Strauss , Anévrysme coronarien , Coronarographie , Intervention coronarienne percutanée , EndoprothèsesRésumé
A coronary artery aneurysm is an uncommon disorder and is seen as a characteristic dilatation of a localized portion of the coronary artery. Clinical manifestation of a coronary artery aneurysm varies from an asymptomatic presentation to sudden death of a patient. Although coronary aneurysms are typically diagnosed by the use of coronary angiography, a new generation of coronary 64-slice multidetector computed tomography (64-MDCT) scanners have successfully been used for evaluating this abnormality in a noninvasive manner. In the present case, we performed coronary 64-MDCT scanning preoperatively and postoperatively on a patient with multiple giant coronary aneurysms. The use of coronary 64-MDCT may provide an evaluation technique not only for diagnosis but also for follow-up after surgery for this condition.
Sujets)
Sujet âgé , Humains , Mâle , Anévrysme coronarien/anatomopathologie , Coronarographie , Pontage aortocoronarien , Soins postopératoires , Soins préopératoires , Indice de gravité de la maladie , TomodensitométrieRésumé
PURPOSE: To evaluate the efficacy of the arterial phase of spiral CT in parametrial invasion of uterine cervical carcinoma. MATERIALS AND METHODS: Two-phase spiral CT images of 22 patients with pathologically proven cervical carcinomas were retrospectively, studied. With regard to the lateral margin of the cervix, eccentric parametrial soft tissue, Parametrial strands and obliteration of periureteral fat, images of the arterial phase were compared by three radiologists with those of the late phase. RESULTS: Five of 15 surgically-proven cervical cancers with no parametrial involvement (33%) showed parametrial strands or eccentric soft tissue lesion in the late phase. Four of the five patients (80%) showed early vascular enhancement of the linear strands or eccentric soft tissue mass in the arterial, phase and because of this additional scan, correct diagnosis was possible. Six of seven cases of invasive cervical cancer (85.7%) showed linear strands in the late phase but two patients showed partial vascular enhancement of the parametrial strands and correct diagnosis was therefore possible. For the evaluation of the lateral margin of the cervix (4/7, 57.1%) and periureteral fat obliteration (3/7, 42.9%), images of the late phase were superior to those of the arterial phase. CONCLUSION: In uterine cervical carcinoma, the late phase of conventional CT is normally used to identify vascular structures as false-positive parametrial strands ; the arterial phase of spiral CT is, however, superior.