RESUMEN
PURPOSE: The purpose of this study was to assess the feasability of CT Angiography (CTA) with a single row of detectors and to compare it to digital subtraction angiography (DSA) in the evaluation of lower limb peripheral arterial disease. MATERIAL: and methods. A total of 22 patients underwent 24 lower limb Helical CTA using a Somatom Plus 4A (Siemens) and 24 DSA using an Angiostar unit (Siemens). CT angiography was performed in one acquisition (collimation 3mm/ couch motion 9mm/ interval 2mm) with tube rotation time of 0.75 sec from the aortic bifurcation to the calf. DSA was performed after catheterization of a common femoral artery using the Seldinger technique. Arteries were classified in four categories (normal or stenosis<50%, stenosis>50%, occlusion, aneurysm). VRT images and axial source images were assessed by two independent radiologists whereas digital angiographies were read by a vascular radiologist. RESULTS: Global interobserver agreement was good (Kappa=0.71). The degree of agreement between CTA and DSA ranged from low to excellent (0.25 to 0.97) depending on the artery. CONCLUSION: Lower limb CT angiography is a promising non invasive technique. VRT allows quick evaluation. However, is not accurate enough to replace digital angiography.
Asunto(s)
Angiografía de Substracción Digital/normas , Angiografía/normas , Pierna/irrigación sanguínea , Enfermedades Vasculares Periféricas/diagnóstico por imagen , Tomografía Computarizada por Rayos X/normas , Adulto , Anciano , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Enfermedades Vasculares Periféricas/clasificación , Índice de Severidad de la Enfermedad , Factores de TiempoRESUMEN
PURPOSE: To assess the clinical success and short-term patency of the Wallstent endoprosthesis in the treatment of superior vena cava (SVC) syndrome. MATERIALS AND METHODS: Twenty-one 14-mm-diameter endoprostheses were implanted in 15 patients (mean age, 60 years) treated for SVC syndrome due to malignant compression (n = 14) or postirradiation fibrotic stenosis (n = 1) of the SVC. RESULTS: Immediate technical success was achieved in all patients. Two early complications occurred: retroperitoneal hemorrhage due to venous iliac tear and early stent thrombosis. In the 14 patients without early stent occlusion, stent placement resulted in complete relief of SVC syndrome; clinical success was 93%. SVC syndrome did not recur from 1 to 14 months, until the patient died (n = 11) or until the end of the study (n = 3). Helical CT showed a patent stent in five patients, respectively, at 3, 6, 8, 10, and 11 months. CONCLUSION: SVC stent placement has good clinical results and a high patency rate at short-term follow-up in patients with SVC syndrome.
Asunto(s)
Stents , Síndrome de la Vena Cava Superior/terapia , Carcinoma de Pulmón de Células no Pequeñas/complicaciones , Diseño de Equipo , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/complicaciones , Masculino , Persona de Mediana Edad , Radiografía Intervencional/métodos , Acero Inoxidable , Stents/efectos adversos , Síndrome de la Vena Cava Superior/diagnóstico por imagen , Síndrome de la Vena Cava Superior/etiología , Factores de Tiempo , Resultado del Tratamiento , Grado de Desobstrucción Vascular/fisiologíaRESUMEN
The authors present a general review on the various techniques of interventional radiology in the treatment of vascular complications of renal transplants. Arterial stenosis require generally percutaneous transluminal angioplasty; arterial stenting is justified in cases of multiple restenosis and occluding dissection. Arterial thrombosis is treated by fibrinolysis or clot aspiration. Treatment of venous complications, such as stenosis or thrombosis, require analogous methods. Arterio-venous fistula and arterial aneurysms due to renal biopsy can be obliterated by dissection with a guide wire, or dropping of metallic coils, or electrical embolization. The authors emphasize the technical aspects, the difficulties and the complications of these procedures. The most frequent complication is the spasm of the renal transplant artery, which may lead to thrombosis. Arterial wall rupture and dissections are very rare. Hematoma at the puncture site of the arterial access are frequent; they may lead to false aneurysm, which can be treated also by noninvasive methods of interventional radiology.
Asunto(s)
Oclusión de Injerto Vascular/terapia , Trasplante de Riñón/efectos adversos , Radiografía Intervencional , Enfermedades Vasculares/terapia , Angioplastia de Balón , Embolización Terapéutica , Humanos , Radiografía Intervencional/efectos adversos , Radiografía Intervencional/métodos , Enfermedades Vasculares/diagnóstico por imagenRESUMEN
Chordoma is a rare tumor in spine. Two cases, exceptional in adolescents, are reported. The clinical evolution is slow and progressive. CT shows a lobulated tumor, precises the degree of vertebral osteolysis and detects intra-tumoral calcifications. MRI is useful to determine especially in high in soft tissues and the vertebral canal. Arteriography is realised in pre-operative time and permits an embolization when the tumor is hypervascularised.
Asunto(s)
Vértebras Cervicales , Cordoma/diagnóstico por imagen , Neoplasias de la Columna Vertebral/diagnóstico por imagen , Adolescente , Angiografía , Niño , Cordoma/diagnóstico , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Neoplasias de la Columna Vertebral/diagnóstico , Vértebras Torácicas , Tomografía Computarizada por Rayos XRESUMEN
With the development of abdominal echotomography and computed tomography, the abdominal aortic aneurysm is no longer explored by arteriography alone. After a retrospective review of 167 patients with aneurysms, the authors propose a schematic diagnostic procedure in 4 arms: positive diagnosis, extension evaluation, emergency statement and follow-up of the aneurysm. The expenditure with these tools has to be considered because of the large deviations in cost price between them. Arteriography is still selectively used for exploration of renal segment but it can often be replaced by computed tomography which is cheaper, external, simply and repeatedly used.
Asunto(s)
Aneurisma de la Aorta/diagnóstico , Aorta Abdominal , Aortografía , Reacciones Falso Negativas , Reacciones Falso Positivas , Humanos , Imagen por Resonancia Magnética , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
The authors describe a recurrent case of an hemangiopericytoma of the left serratus anterior muscle, touching a 21 year-old woman. The different ways of imaging are exposed and compared with data of literature. It seems that none of them offers any decisive possibility of nature diagnosis. Conversely, radiological examinations are of greatest interest in the initial lesional statement, in the follow up and in early discovery of a possible recurrence, principally in case of difficulties in the pathological examination. CT appears to have the first role among the different ways of medical imaging, initially and in the appreciation of clinical course.
Asunto(s)
Diagnóstico por Imagen , Hemangiopericitoma/diagnóstico , Enfermedades Musculares/diagnóstico por imagen , Neoplasias Torácicas/diagnóstico , Adulto , Femenino , Hemangiopericitoma/diagnóstico por imagen , Humanos , Neoplasias Torácicas/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
After 1,748 translumbar aortograms three cases of intervertebral disk space infection were observed over a five-year period, for an incidence of 0.15%. Cultures suggested that the intervertebral disk had been inoculated with digestive tract organisms by the needle used to puncture the aorta. Diagnosis of this complication can be made early by retrieval of the responsible organisms from the intervertebral disk under CT control. Treatment consists of prolonged immobilization associated with appropriate antibiotic therapy for at least three months.
Asunto(s)
Aortografía/efectos adversos , Discitis/etiología , Isquemia/diagnóstico por imagen , Pierna/irrigación sanguínea , Vértebras Lumbares , Adulto , Humanos , Vértebras Lumbares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
Stenosis of the renal artery secondary to an extrinsic acquired compression of the renal artery because of a tumor is rare. We report two cases. The first case is a boy of 14 months with a large neurogenic tumor from the right renal plexus with compression of the right renal artery. The second case is a girl of 2 years which had a neuroblastoma displacing the right kidney. The right renal vessels were invaded by very calcified solid masses and the removal was very difficult. Arterial hypertension secondary to an acquired unilateral renal stenosis may be healed definitely thanks to surgery.
Asunto(s)
Neoplasias de las Glándulas Suprarrenales/complicaciones , Ganglioneuroma/complicaciones , Hipertensión Renovascular/etiología , Neoplasias Renales/complicaciones , Obstrucción de la Arteria Renal/etiología , Preescolar , Femenino , Humanos , Hipertensión Renovascular/terapia , Lactante , Neoplasias Renales/diagnóstico por imagen , Neoplasias Renales/cirugía , Masculino , Radiografía , Obstrucción de la Arteria Renal/complicacionesRESUMEN
Analysis of 356 angiographic images of hand from 216 patients with Raynaud's phenomenon confirmed the higher prevalence of occlusive arterial lesions (75% of cases) when compared with idiopathic Raynaud's syndrome. The ulnar artery (30% of cases) and digital collateral arteries of free borders of hand (45 to 62% of cases) were the most frequently affected. This preferential localization of the arterial thromboses can be explained by repeated microtrauma from manual occupations (markedly increased in cases of digital arteriopathy). Correlation between the occlusive lesions and a thoracic outlet syndrome is lacking.
Asunto(s)
Arteriopatías Oclusivas/diagnóstico por imagen , Dedos/irrigación sanguínea , Enfermedad de Raynaud/diagnóstico por imagen , Adolescente , Adulto , Anciano , Angiografía , Arteriopatías Oclusivas/etiología , Circulación Colateral , Femenino , Dedos/diagnóstico por imagen , Antebrazo/irrigación sanguínea , Antebrazo/diagnóstico por imagen , Mano/irrigación sanguínea , Mano/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Ocupaciones , Enfermedad de Raynaud/etiología , Riesgo , FumarRESUMEN
Percutaneous subclavian venous cannulation has now become a routine procedure in anaesthesia and intensive care. Its early complications are well-known, but its delayed complications, somewhat rarer, remain often undiagnosed. A case is reported of a 32 year old man who presented with a subclavian arterial pseudo-aneurysm associated with a recurrent nerve palsy some 18 months after undergoing major trauma in a car crash. The post-traumatic origin of this complication is discussed. It was probably due to percutaneous venous cannulation, which led to a subclavian arterial lesion.
Asunto(s)
Aneurisma/etiología , Cateterismo/efectos adversos , Vena Subclavia , Adulto , Aneurisma/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Arteria Subclavia , Factores de TiempoRESUMEN
The scimitar sign, characterised by a vertical opacity crossing the medial part of the right diaphragm, is generally attributed to abnormal pulmonary venous return draining into the inferior vena cava. This is not the only situation in which the scimitar sign is observed, which can also be seen in association with systemic anomalies, in particular sequestration. The authors report the case of a young adult in whom the chest x-ray presented the scimitar sign from childhood. This image was related to a pure pulmonary vessel sequestration by a right sub-phrenic artery. The authors stress the possibility of a purely arterial origin for the scimitar sign in the absence of any abnormality of pulmonary venous return.
Asunto(s)
Secuestro Broncopulmonar/diagnóstico por imagen , Venas Pulmonares/anomalías , Síndrome de Cimitarra/etiología , Adolescente , Aorta Abdominal/diagnóstico por imagen , Arterias/anomalías , Preescolar , Diagnóstico Diferencial , Diafragma/diagnóstico por imagen , Humanos , Lactante , Pulmón/irrigación sanguínea , Pulmón/diagnóstico por imagen , Masculino , Arteria Pulmonar/anomalías , Venas Pulmonares/diagnóstico por imagen , Radiografía , Síndrome de Cimitarra/diagnóstico por imagen , Vena Cava InferiorRESUMEN
I.V. arterio-nephro- urotomogram turns out to be very useful in the work-up of renal traumas mainly by studying the cortical phase and the arterial phase. This technique allows to limit the indications for selective renal arteriogram.
Asunto(s)
Riñón/lesiones , Angiografía , Humanos , Riñón/irrigación sanguínea , Riñón/diagnóstico por imagen , TomografíaRESUMEN
The authors recall the main pathologic and physiopathologic data necessary to understand the angiographic patterns of hepatic alveolar echinococcosis, by means of a rereading of a personal series of 37 cases. They show that this affection has a diagnostic angiographic shape which associate four signs: avascular aspect of the lesions, regular invasion of vessels, presence of a collateral circulation, absence of neovascularisation. Digestive angiography stays a good diagnostic method for the parasitosis, when epidemiological context, ultrasound or CT scan gave no explicit conclusion. It keeps an interest in the preoperative evaluation and in the supervision of portal vein.
Asunto(s)
Equinococosis Hepática/diagnóstico por imagen , Adulto , Anciano , Angiografía , Diagnóstico Diferencial , Equinococosis Hepática/fisiopatología , Femenino , Humanos , Hígado/irrigación sanguínea , Hepatopatías/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Flebografía , Sistema Porta/diagnóstico por imagenRESUMEN
Spasms of the mesenteric and renal arteries are of great concern to the radiologist specialized in angiography. In most cases, they appear to be of iatrogenic origin, due to difficulties in selective catheterization and especially in superselective catheterization of the mesenteric and renal arteries. In this case, spasm may be a most unwelcome side-effect. In other less frequent cases, spasms appear as indirect signs of an underlying spasmogenic disease, such as G. I. tract carcinoid, pheochromocytoma, pancreatitis or poisoning such as ergotism or digitalis overdosage. Most of all, it may occur during some non-occlusive intestinal ischemias. On the other hand, spasm can be considered as a way of treatment, especially in cases of G. I. bleeding, particularly due to ulcerations.
Asunto(s)
Sistema Digestivo/irrigación sanguínea , Arteria Renal/diagnóstico por imagen , Enfermedades Vasculares/diagnóstico por imagen , Arterias , Diagnóstico Diferencial , Humanos , Arterias Mesentéricas/diagnóstico por imagen , Radiografía , Espasmo/diagnóstico por imagen , Espasmo/etiología , Enfermedades Vasculares/etiologíaRESUMEN
After rapidly reviewing the anatomy and the physiology of vasoconstrictive pathways and numbering predisposing factors involved in vasoconstrictive, the authors report different causes of peripheral arterial spasm. They particularly insist upon the causes of acute ischemia or the causes which may result on a long term in cutaneous sign of chronic ischemia. Arterial spasm due to arteriography itself is evoked. Studies are based on vascular radiographic opacification after arteriography: constituting a precise and easy technique, this allowing identification, localization as well as definition of the different images uncountered in arterial spasm. Arteriography is not mandatory for diagnostic evidence, but good technical conditions allow a precise view of the arterial status of the limbs taken as a whole, as well as a pathophysiological view of the mechanism involved in same vasomotor troubles. It may also reveal complications. In a great number of cases, indications for treatment can be adapted.