ABSTRACT
Renal arteriovenous fistula (AVF) is an uncommon clinical entity, which can be congenital, acquired, or idiopathic. Diagnosis is aided by radiological studies, with digital subtraction angiography as a gold standard. However, Doppler ultrasound with color Doppler interrogation and computed tomography (CT) angiography are alternative imaging techniques that are noninvasive and can be used for patients to whom no intervention is planned. In this report, we present a case of idiopathic renal AVF diagnosed by Doppler ultrasound and CT angiography. Grayscale ultrasound showed a cyst-like lesion which was confirmed to be a focal aneurysmatic dilatation with heterogeneous fill-in and turbulent blood flow on color Doppler and spectral analysis. CT angiography demonstrated multiple aneurysmatic dilatations of the segmental branch and early opacification of right renal vein on the arterial phase, consistent with renal AVF.
Subject(s)
Arteriovenous Fistula/diagnosis , Renal Artery/abnormalities , Renal Veins/abnormalities , Tomography, X-Ray Computed/methods , Ultrasonography, Doppler/methods , Adult , Angiography , Arteriovenous Fistula/diagnostic imaging , Female , Humans , Renal Artery/diagnostic imaging , Renal Veins/diagnostic imaging , Ultrasonography, Doppler, Color/methodsABSTRACT
We describe the features of a duplicated middle cerebral artery identified by computed tomographic angiography that originates from a previously undefined origin, ie, from the petrous portion of the internal carotid artery. Recognition of this anomaly is important in patients with a possible aneurysm, which was not present in our patient.
Subject(s)
Cerebral Angiography , Intracranial Arteriovenous Malformations/diagnostic imaging , Middle Cerebral Artery/abnormalities , Tomography, Spiral Computed , Basal Ganglia/blood supply , Carotid Artery, Internal/abnormalities , Carotid Artery, Internal/diagnostic imaging , Dominance, Cerebral/physiology , Female , Humans , Intracranial Arteriovenous Malformations/classification , Middle Aged , Middle Cerebral Artery/diagnostic imaging , Posterior Cerebral Artery/abnormalities , Posterior Cerebral Artery/diagnostic imaging , Temporal Lobe/blood supplyABSTRACT
Pancreatic infiltration with leukemic cells is a rare manifestation of acute lymphoblastic leukemia. There are only a few reported cases. We report the clinical and radiologic findings of a 4-year-old boy with mature B-cell acute lymphoblastic leukemia and pancreatic involvement. A computed tomography scan of his abdomen demonstrated diffuse hypodense lesions in the pancreas. Plasma amylase and lipase levels at that time were high, but no signs of hypoglycemia or hyperglycemia were observed. After 2 cycles of chemotherapy, the lesions in his pancreas, liver, and kidney disappeared, and his pancreatitis resolved as well. At 11 months' follow-up, after completion of therapy, the patient continues to be in remission.
Subject(s)
Leukemia, B-Cell/diagnostic imaging , Leukemia, B-Cell/drug therapy , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/drug therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnostic imaging , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Acute Disease , Amylases/blood , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Child, Preschool , Diagnosis, Differential , Humans , Kidney Neoplasms/blood , Kidney Neoplasms/diagnostic imaging , Kidney Neoplasms/drug therapy , Kidney Neoplasms/secondary , Leukemia, B-Cell/blood , Lipase/blood , Liver Neoplasms/blood , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Male , Pancreatic Neoplasms/blood , Pancreatic Neoplasms/secondary , Pancreatitis/blood , Pancreatitis/diagnostic imaging , Pancreatitis/drug therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/blood , Tomography, X-Ray ComputedABSTRACT
This report describes two cases in which proximally migrated Amsterdam-type biliary stents were extracted using transhepatic snare introduction into the bile ducts. In one case, the migrated stent was removed transhepatically via a percutaneous approach, and in the other a combination transhepatic-endoscopic extraction was successful. No complications were encountered. Percutaneous introduction of snare via transhepatic route offers a good alternative to surgery for removal of migrated biliary stents.
