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1.
Only scattered reports of portal vein and superior mesenteric vein aneurysms appear in the literature. Case reports of three
patients with portal vein and superior mesenteric vein aneurysms diagnosed by computed tomography (CT) and gray-scale, color
Doppler, and duplex Doppler sonography are presented. In one case, an isolated portal vein aneurysm was demonstrated. In the
second case, an aneurysm of the portal vein and superior mesenteric vein resulting in biliary ductal dilatation was observed.
In the third case, an isolated superior mesenteric vein aneurysm was found. None of the patients had a history or clinical
evidence of underlying liver disease, pancreatitis, or other disease states that would predispose them to the development
of aneurysms. The clinical presentations, possible etiologies, and imaging features of portal vein and superior mesenteric
vein aneurysms are reviewed. The value of CT and sonography in the detection and characterization of these rare aneurysms
is discussed.
Received: 29 February 1996/Accepted: 10 April 1996 相似文献
2.
Background: To evaluate the appearance of the arrangement of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV)
on computed tomography (CT) in normal patients and in patients with abdominal masses.
Methods: One hundred seventy-seven consecutive abdominal CT examinations of 143 adults and two children were reviewed. The relationship
of the SMV to the SMA was recorded at four locations: the beginning of the mesenteric vessels and levels 3 cm, 6 cm, and 9
cm caudad to the beginning. The relationship of the SMV to the SMA was divided into four quadrants in relation to the SMA:
I, ventral right or directly ventral; II, dorsal right or directly right; III, dorsal left or directly dorsal; and IV, ventral
left or directly left.
Results: In the beginning of the SMV–SMA complex and levels 3 cm, 6 cm, and 9 cm caudal to the beginning, the SMV was located in quadrant
I in 146, 84, 69, and 43 examinations, in quadrant II in 31, 93, 71, and 27 examinations, in quadrant III in zero, zero, five,
and three examinations, and in quadrant IV in zero, zero, nine, and 15 examinations, respectively. The cases with SMV inversion
had neither malrotation nor adjacent tumor compression. All the cases with an adjacent tumor-induced compression of the SMV–SMA
complex had a normal SMV–SMA relationship.
Conclusion: In the first 3 cm, the SMV is always to the right of the SMA. Caudal to the level of 6 cm, the SMV may be located to the
left of the SMA without evidence of malrotation. A midgut nonrotation is more likely to be present when a proximal SMV inversion
is coexistent with a rightward direction of the proximal jejunal vessels. A hypothetical depiction of the step-by-step change
of the SMV–SMA relationship during embryologic development may explain the arrangement patterns of the mesenteric vessels
in normal rotation and midgut nonrotation.
Received: 6 May 1996/Accepted: 22 May 1996 相似文献
3.
Three-dimensional CT imaging of an isolated dissecting aneurysm of the superior mesenteric artery 总被引:2,自引:0,他引:2
A case of an isolated dissecting aneurysm of the superior mesenteric artey is presented with findings of three-dimensional
CT imaging. False lumen, intimal flap, entry, and re-entry are clearly identified on threedimensional CT imaging.
Received: 27 April 1995/Accepted: 3 June 1995 相似文献
4.
We present a patient with nodular regenerative hyperplasia of the liver (NRH) and portal vein absence studied with CT, MR
imaging, and MR angiography. The most striking feature was exuberant hemorrhoids due to a giant hepatofugal inferior mesenteric
vein. A relationship between unbalanced portal blood flow and nodular regenerative transformation of the liver is suggested
in this patient.
Received: 28 May 1996/Accepted: 10 July 1996 相似文献
5.
G. R. Schmutz A. Benko J. S. Billiard L. Fournier J. M. Péron C. Fisch-Ponsot 《Abdominal imaging》1998,23(6):563-567
During a 5-year period, superior mesenteric vein (SMV) thrombosis was detected with computed tomography (CT) in six patients
shortly after an appendectomy. No sign of SMV was present at appendectomy, and a period of more than 2 weeks free of clinical
symptoms had elapsed between the appendectomy and the onset of the SMV thrombosis. In four cases, the appendicitis was complicated.
These patients had nonspecific signs and symptoms, although two of them had elevation of blood hepatic enzyme levels. In all
cases, postcontrast CT demonstrated enlargement of the SMV, with well-defined enhancement of the vascular wall and an intraluminal
clot. In one case, CT showed extension of the thrombus to the portal vein with the presence of low-attenuation areas in the
liver, consistent with hepatic infarcts. Two patients had predisposing diseases: idiopathic hypersplenism in one case and
chronic hepatic disease in the other. SMV thrombosis is a possible complication of appendicitis, and early appendectomy in
appendicitis can prevent this complication. Moreover, as in any abdominal surgery, early appendectomy may be complicated by
thrombosis of the SMV, thus creating problems of postoperative diagnosis. The complication is more frequent when the initial
operation is performed under difficult conditions (peritonitis), or when the patient presents with a coagulopathy. CT is useful
in the diagnosis of SMV thrombosis, thus leading to early management with anticoagulant therapy, with a view to avoiding complications
such as intestinal ischemia, portal vein thrombosis, and hepatic infarction.
Received: 19 March 1997/Accepted after revision: 15 July 1997 相似文献
6.
A new criterion in differentiation of pancreatitis and pancreatic carcinoma: artery-to-vein ratio using the superior mesenteric vessels 总被引:3,自引:0,他引:3
Evaluation of infiltration of the superior mesenteric vein (SMV) and artery (SMA) fat planes has been considered in differentiating
pancreatic carcinoma from pancreatitis. Some pancreatitis cases, however, can cause perivascular fat plane obliteration due
to extension of the inflammatory process, mimicking appearances of carcinoma. This study investigated the diameters of SMV
and SMA on CT scans, just caudal to the origin of SMA and portal confluens, in 68 pancreatitis and in 48 pancreatic carcinoma
patients. SMA-to-SMV diameters (A/V diameter) were compared and ratios were obtained. In conclusion, it appears that when
the A/V ratio is over 1.0, a malignant condition can be suspected. This may be used as a secondary criterion in the differential
diagnosis of pancreatitis and pancreatic carcinoma.
Received: 11 January 1995/Accepted after revision: 31 March 1995 相似文献
7.
Percutaneous transluminal angioplasty in the treatment of chronic mesenteric ischemia: results and 3 years of follow-up in 23 patients 总被引:3,自引:0,他引:3
F. Maspes G. Mazzetti di Pietralata R. Gandini L. Innocenzi L. Lupattelli F. Barzi G. Simonetti 《Abdominal imaging》1998,23(4):358-363
Background: We evaluated the clinical efficacy of visceral angioplasty in the treatment of chronic mesenteric ischemia.
Methods: Over a 14-year period, we performed percutaneous transluminal angioplasty of 41 occlusive diseases of visceral arteries founded
by angiography in 23 patients with chronic mesenteric ischemia. All but one (fibrodysplasic) stenoses were atherosclerotic,
and 13 were localized in the ostial tract. Clinical follow-up was evaluated at 2, 6, 12, 24, and 36 months (mean follow-up
= 27 months).
Results: Angioplasty demonstrated a residual stenosis of 30% or less in 37 procedures, for a technical success rate of 90%. Seventeen
of 20 patients had symptom remission after the first treatment, for a short-term clinical success of 77%; two patients needed
a reangioplasty after 2 months, and one was referred for aortomesenteric bypass. During a mean follow-up of 27 months (range
= 2–36), the clinical success was 88%; 2/15 patients underwent successful repeat angioplasty at 24 and 36 months, for a 100%
secondary long-term clinical success. Only two minor complications were encountered.
Conclusion: Although surgical results are undoubtedly positive, visceral angioplasty is justified in relation to both the high surgical
mortality and the low incidence of complications arising from visceral angioplasty.
Received: 31 October 1996/Accepted after revision: 2 April 1997 相似文献
8.
Intraoperative US diagnosis of pylephlebitis (portal vein thrombosis) as a complication of appendicitis: a case report 总被引:1,自引:0,他引:1
We report a case of infectious thrombosis of the superior mesenteric vein (pylephlebitis) that was suspected preoperatively
with computed tomography and confirmed at intraoperative ultrasonography as confined to the extrahepatic portal vein and superior
mesenteric vein. Intraoperative ultrasonography revealed intraluminal echogenic thrombus material in the dilated superior
mesenteric and extrahepatic portal veins, slightly dilated open splenic vein, and numerous venous collaterals in the hepatoduodenal
ligament. When preoperative imaging studies are inconclusive, intraoperative sonography can confirm the correct diagnosis
of pylephlebitis and may give valuable information about the extent of the thrombosis.
Received: 19 December 1995/Accepted: 31 January 1996 相似文献
9.
CT differentiation between necrotic and nonnecrotic small bowel in closed loop and strangulating obstruction 总被引:4,自引:0,他引:4
Makita O Ikushima I Matsumoto N Arikawa K Yamashita Y Takahashi M 《Abdominal imaging》1999,24(2):120-124
Background: The purpose of this study was to evaluate computed tomographic (CT) findings for predicting the presence of intestinal necrosis
in patients with closed loop and strangulating obstruction of the small bowel.
Methods: Twenty-five patients with surgically confirmed closed loop and strangulating obstruction were divided into two groups with
(n= 16) and without (n= 9) intestinal necrosis. By using univariate and multivariate statistical procedures, we evaluated the differences in CT
findings between the two groups on the basis of the following six findings: bowel dilatation of strangulated loops (bowel
dilatation), wall thickening of strangulated intestines (wall thickening), ascites, vascular dilatation of affected mesenteries
(vascular dilatation), elevation of mesenteric attenuation (mesenteric attenuation), and radial distribution of the mesenteric
vessels (radial distribution).
Results: Of the six findings, ascites, vascular dilatation, mesenteric attenuation, and radial distribution provided significant discriminating
findings between the two groups on univariate analysis. On multivariate analysis, mesenteric attenuation was the most important
discriminative factor, followed by radial distribution and ascites. Using these three parameters, the CT was correlated with
the surgical findings in 15 of the 16 patients in the necrosis group (sensitivity = 93.8%) and in eight of the nine patients
in the nonnecrosis group (specificity = 88.9%). The overall accuracy was 92.0%.
Conclusions: Mesenteric attenuation, radial distribution, and ascites, depicted on CT differentiate well between necrosis and nonnecrosis
of the small bowelin patients with closed loop and strangulating obstruction.
Received 5 December 1997/Accepted: 14 January 1998 相似文献
10.
Background: We evaluated the efficacy of transcatheter embolization in visceral artery pseudoaneurysms with platinum coils and N-butyl-cyano-acrylate (NBCA).
Methods: Over the past 7 years, 20 patients were treated by transcatheter embolization in the same sitting with diagnostic angiography.
Four right hepatic, one cystic, two gastroduodenal, one cavernosal artery, three superior mesenteric artery branch, and 11
renal artery branch pseudoaneurysms were included in the study.
Results: Surgery was completely avoided in 19 patients. In the remaining patient with a superior mesenteric artery branch pseudoaneurysm,
endovascular embolization was unsuccessful. Eighteen pseudoaneurysms were thrombosed with coil embolization alone. The remaining
three pseudoaneurysms needed NBCA embolization. Two patients died from sepsis within 5 weeks after embolization.
Conclusion: Emergent diagnosis and treatment are essential in visceral artery pseudoaneurysms because of the high rate of death. Transcatheter
embolization with platinum coils is an efficient, safe treatment of choice. NBCA may be used to avoid proximal embolization
of the visceral arteries that could not be catheterized selectively because of tortuosity, vessel size, or anatomic location.
Received: 27 September 2001/Revision accepted: 16 January 2002 相似文献
11.
Intestinal malrotation as an incidental finding on CT in adults 总被引:3,自引:0,他引:3
R. Zissin V. Rathaus A. Oscadchy E. Kots G. Gayer M. Shapiro-Feinberg 《Abdominal imaging》1999,24(6):550-555
Background:Intestinal malrotation in adults is usually an incidental finding on computed tomography (CT). We present the CT findings
of 18 adult patients with malrotation and discuss the clinical implications.
Methods: Abdominal scans of 18 patients (12 women, six men; age range = 15–79 years) with intestinal malrotation were reviewed. Special
attention was directed to the location of the superior mesenteric vessels, the location of the small and large bowels, the
size of the uncinate process, the situs definition, and additional anomalies.
Results: The malrotation was an incidental finding in all but one patient. The malrotation was type Ia in 17 patients and IIc in the
one symptomatic patient. The superior mesenteric vessels were vertically oriented in 10, inverted in two, normally positioned
in four, and mirror imaged in two cases with situs ambiguus. All patients had aplasia of the pancreatic uncinate process,
five had a short pancreas, and two had a preduodenal portal vein. Fourteen patients had a normal situs and four had heterotaxia.
Seven patients had polysplenia, six of which with associated inferior vena cava anomalies.
Conclusions: Intestinal malrotation can be diagnosed on CT by the anatomic location of a right-sided small bowel, left-sided colon, an
abnormal relationship of the superior mesenteric vessels, and aplasia of the uncinate process. Awareness of these abnormalities
is necessary to diagnose this anomaly. It should be sought in patients with a situs problem, inferior vena cava anomalies,
polysplenia, or preduodenal portal vein. Although usually an incidental finding, it is important to diagnose such a malrotation
because it may cause abdominal symptoms. Also, knowledge of associated vascular anomalies is important when abdominal surgery
is planned.
Received: 1 October 1998/Revision accepted: 27 January 1999 相似文献
12.
Sato M Ishida H Konno K Komatsuda T Hamashima Y Naganuma H Kon H Watanabe S Ishida J 《Abdominal imaging》2000,25(5):517-522
Background: Neurofibromatosis 1 (NF1) has been studied from many viewpoints, but its abdominal involvement has rarely been reported.
Sonography (US) is now the initial diagnostic tool for abdominal exploration, which prompted us to determine the clinical
manifestations and US findings of abdominal involvement in NF1.
Methods: We analyzed the US findings and clinical data of eight NF1 cases with abdominal involvement.
Results: Abdominal involvement included neurofibromatous tumor growth in the liver, mesentery, and retroperitoneum, in addition to
mesenteric leiomyomatosis and gastric carcinoma. Color Doppler US was useful not only in detecting blood flows in the lesions
but also in preventing hazardous vascular injury during tumor biopsy.
Conclusion: A better understanding of the clinical manifestations and US findings of abdominal involvement in NF1 translates into improved
NF1 patient care.
Received: 6 October 1999/Revision accepted: 26 January 2000 相似文献
13.
Torsion of a wandering accessory spleen: CT findings 总被引:1,自引:0,他引:1
Torsion of an accessory spleen is a rare entity that can have a variable clinical presentation. We report the computed tomographic
(CT) findings of an acute torsion of an accessory spleen in a 13-year-old girl. CT disclosed a hypodense mesenteric mass with
peripheral inflammatory changes.
Received: 20 November 1996/Accepted: 24 December 1996 相似文献
14.
H. Ishida K. Konno Y. Hamashima T. Komatsuda H. Naganuma Y. Asanuma J. Ishida O. Masamune 《Abdominal imaging》1998,23(4):354-357
Two cases of small bowel (S-B) varices associated with portal hypertension, one with liver cirrhosis and one with portal
thrombus, are reported. Detection of S-B varices has been a challenging task and several invasive diagnostic techniques have
been used for this purpose. However, in our cases, color Doppler sonography revealed the S-B varices supplied by the superior
mesenteric vein and draining to the iliac (one case) or ovarian vein (other case), which helped to establish an early appropriate
diagnostic and treatment plan.
Received: 19 March 1997/Accepted: 14 May 1997 相似文献
15.
We report two cases of portal vein visualization during ERCP in patients with pancreatitis, one from inadvertent cannulation
of the superior mesenteric vein, and in the other, through a preexisting fistula. Prompt recognition of this potentially significant
event will obviate confusion and unnecessary prolongation of the procedure.
Received: 9/9/96/Accepted: 10/16/96 相似文献
16.
Portal tumor thrombus due to gastrointestinal cancer 总被引:3,自引:0,他引:3
H. Ishida K. Konno Y. Hamashima H. Naganuma T. Komatsuda M. Sato H. Kimura J. Ishida T. Sakai S. Watanabe 《Abdominal imaging》1999,24(6):585-590
Methods: We studied the clinical data of seven patients with portal tumor thrombus (PTT) due to gastrointestinal (GI) cancer to determine
the radiologic patterns and clinical implications of this rare complication.
Results: (a) PTT was located along the entire splenic vein in three cases, at the splenomesenteric confluence in one case, and in
the superior mesenteric vein in one case. Intrahepatic PTT occurred in two of four cases with liver metastasis. (b) One cirrhotic
case was complicated by the occurrence of colon cancer associated with PTT in the splenic vein; the esophageal varices became
rapidly enlarged and poorly controlled, and the patient died due to repeated variceal rupture. (c) In all patients, abdominal
sonography (US) detected PTT and color Doppler sonography confirmed the US findings.
Conclusions: The splenic vein should be meticulously observed by color Doppler sonography to check for PTT in patients with GI cancer
to improve patient care.
Received: 29 December 1998/Accepted: 24 February 1999 相似文献
17.
Antonopoulos P Tavernaraki K Charalampopoulos G Constantinidis F Petroulakis A Drossos Ch 《Abdominal imaging》2008,33(3):294-300
Background: This study attempts to demonstrate the role of computed tomography in the diagnosis of hepatic hydatid cyst rupture based
on specific imaging findings and to propose combinations of the imaging findings diagnostic for specific types of rupture.
Methods: Eleven patients were studied with computed tomography of the abdomen, with 4–8 mm slice thickness, after the oral administration
of contrast material and intravenous contrast material in 6 cases.
Results: Based on a combination of imaging findings the types of hepatic hydatid cyst rupture were: intrabiliary rupture in 7 patients,
intraperitoneal rupture in 1 patient, intrathoracic rupture in 1 patient, hepatic subcapsular rupture in 2 patients. Structural
deformity of the cyst was present in all cases, combined with: dilatation of the intrahepatic bile ducts (intrabiliary rupture);
intraperitoneal fluid collections with diffuse haziness and stranding of the mesenteric fat (intraperitoneal rupture); an
inhomogeneous lesion in the thorax with ipsilateral pleural effusion (intrathoracic rupture); a hydatid cyst located peripherally,
with discontinuity of its adjacent to the hepatic capsule wall and subcapsular fluid collection (subcapsular rupture). The
imaging findings were surgically and pathologically confirmed.
Conclusions: Using combinations of specific imaging findings we correctly diagnosed the type of hepatic hydatid cyst rupture in all cases. 相似文献
18.
Sato M Ishida H Konno K Komatsuda T Konno S Watanabe S Ishida J Sakai T Hirata M 《Abdominal imaging》2000,25(3):306-310
Background: Mesenteric cyst (MC) is a relatively rare disease, and its sonographic characteristics have not been sufficiently analyzed.
Methods: We studied the sonographic findings of eight patients with MC, with attention paid to its size, shape, internal echoes, and
especially the presence or absence of lateral shadowing and the mode of back echoes. In four cases, the sound velocity and
acoustic impedance of cystic fluid were also measured. The mode of blood flow was evaluated by color Doppler sonography.
Results: Six cases showed an oval or comma-shaped mass. Internal echoes were present in six cases, and two of them showed a pseudosolid
pattern. In these cases, M-mode sonography confirmed the movement of these internal echoes. Only one case showed a posterior
echo enhancement, and no case showed lateral shadowing. Sound velocity measured in four cases was 1515–1537 m/s, with an acoustic
impedance of 1.550–1.576 kg/m2/s. No blood flow signals were obtained from the lesion.
Conclusion: MC exhibits so many patterns on ultrasound that we should consider the possibility of MC when encountering an avascular oval
mesenteric mass.
Received: 30 August 1999/Accepted: 6 October 1999 相似文献
19.
Median arcuate ligament syndrome with multivessel involvement: diagnosis with spiral CT angiography 总被引:2,自引:0,他引:2
Intestinal angina may be caused by compression of the celiac artery by the median arcuate ligament of the diaphragm. Aortography
can suggest the diagnosis, but the diaphragm cannot be visualized by this examination. We report a symptomatic woman in whom
spiral computed tomography-guided angiography demonstrated stenosis of the celiac artery, superior mesenteric artery, and
both renal arteries due to diaphragmatic compression. Surgery was beneficial.
Received: 15 August 1995/Accepted: 26 September 1995 相似文献
20.
There are many causative diseases to produced portal vein thrombosis (PVT) with the most common being liver cirrhosis with
hepatocellular carcinoma. Visualization of abnormalities associated with PVT is crucial to diagnosis and appropriate intervention.
Dynamic contrast enhanced CT is the best means of diagnosis of PVT and evaluation of various causative diseases. The findings
of PVT of the dynamic CT are filling defect partially or totally occluding the vessel lumen and rim enhancement of the vessel
wall. Signs and symptoms of PVT may be subtle or nonspecific and overshadowed by the underlying illness. Radiologists should
be aware of the clinical situations that predispose a patient to portal or mesenteric vein thrombosis. 相似文献