MDCT angiography of the extremities in pediatric patients: initial experience

OBJECTIVE: We studied the feasibility of extremity MDCT angiography in pediatric patients with congenital anomalies, an extremity mass, and a suspected arterial occlusion. CONCLUSION: In pediatric patients, MDCT angiography of the extremities with a short imaging time and a low dose of contrast material is feasible and can be used as a noninvasive alternative to conventional angiography.     

A rare vascular malformation,Klippel-Trenaunay syndrome. Report of a case with deep vein agenesis and review of the literature

The Klippel-Trenaunay syndrome (KTS) is a rare anomaly characterized by naevus, soft tissue hypertrophy and varicosities which is mainly unknown etiology. Associated deep venous system abnormalities have been reported with KTS. Here, a 4-year-old-boy with KTS was reported, because of the associated popliteal vein, common femoral vein with its deep and superficial branches, and external iliac vein agenesis. The originality of the presented case is that we have never observed such a case before.     

Guglielmi detachable coil treatment of a partially thrombosed giant basilar artery aneurysm in a child

We report a partially thrombosed giant of the aneurysm basilar artery with prominent mass effect, diagnosed in an 11 year-old child who presented with neurological deficits due to brain stem compression. After the patent portion of the aneurysm was embolised with Guglielmi detachable coils, remarkable clinical improvement occurred. Angiography demonstrated complete occlusion of the aneurysm and MRI revealed dramatic shrinkage of the aneurysm at 6-month and 1-year follow-up. Received: 24 December 1998/Accepted: 5 May 1999     

Endovascular management of life-threatening retroperitoneal bleeding

Background: The aim of this study was to evaluate efficiency of embolotherapy in management of retroperitoneal bleedings. Methods: A total of 16 patients with retroperitoneal bleeding who underwent angiography followed by transcatheter embolization within a 4‐year period in a single centre were reviewed retrospectively. Electronic charts as well as procedural reports were reviewed to assess immediate angiographic findings and results of embolization. Results: Computed tomography was carried out in eight patients. All computed tomography scans showed retroperitoneal haematoma. In addition, contrast material extravasation consistent with active bleeding was seen in two patients and pseudoaneurysm in one. In the remaining eight patients, diagnosis of retroperitoneal bleeding was established based on combined ultrasound and clinical findings. The technical success rate for selective embolotherapy was 100%. Five of these 16 patients (three women and 13 men) had lumbar artery injury; 10 patients were associated with renal artery injury and one had bilateral internal iliac artery injury. Angiography showed active extravasation, pseudoaneurysm and arteriovenous fistula. For embolization, coils were used in six patients and N‐butyl‐2‐cyanoacrylate in the remaining 10 patients. Four patients died within 1 month of embolotherapy. Conclusion: Transcatheter embolotherapy appears to be a life‐saving, safe and effective treatment for retroperitoneal bleedings that may be carried out in emergency situations in haemodynamically unstable patients.     

Complex venous anomalies: magnetic resonance imaging findings in a 5-year-old boy

We report magnetic resonance imaging (MRI) findings of a very unusual venous anomaly case. A 5-year-old boy who had surgical repair of coarctation of the thoracic aorta was referred to our department for evaluation of an enlarged venous structure anterior to the aorta, which had been noted during the surgery. Contrast enhanced dynamic MRI revealed partial anomalous pulmonary venous return to the left azygos vein, double inferior and superior vena cava with the left azygos continuation of the left superior vena cava. The recognition of venous anomalies allows correct planning of surgical and interventional procedures. MRI is a valuable imaging tool providing detailed anatomical information.     

Imaging Characteristics of Takayasu Arteritis

Takayasu arteritis is a rare, large-vessel vasculitis in which the nonspecific systemic inflammatory symptoms are followed by inflammation of the aorta and its major branches. The inflammation of this vessel leads to progressive luminal stenosis or aneurysm formation resulting in limb or organ ischemia. Although conventional angiography is still accepted as the gold standard modality, the information obtained is limited to the vessel lumen. Multidetector computed tomographic angiography and magnetic resonance angiography can provide valuable information not only regarding intraluminal pathologies but also concerning the thickening of the vessel wall, which may be the earliest manifestation of the disease.