Takayasu's Arteritis in Thailand

Takayasu's arteritis is a disease of protean manifestations and worldwide distribution. Geographic difference of the sex incidence, anatomical distribution and the type of lesion is observed. Hypertension is very common in the present series. A combination of absent or deficient peripheral pulses and hypertension is also commonly encountered. These symptoms correlate well with arteriographic findings of brachiocephalic and renal artery obstructive lesions. While aneurysm and stenotic lesions have a predilection for the abdominal aorta, the ascending aorta is commonly dilated and stenosis of the thoracic aorta occurs more often than aneurysm. However aneurysm of the aorta as well as of the brachiocephalic arteries is frequently more developed than in those reports of others. The presence of “funnel-shaped” or triangular configuration resulting from renal artery obstuctive lesions, prestenotic dilatation and/or contiguous aortic aneurysm is emphasized as the most likely characteristic of Takayasu's arteritis occurring in this part of the world. Extensive arterial involvement with evidence of lumbar and intercostal occlusion indicates the seventy of the disease. Total aortography is of value not only for the diagnosis of Takayasu's arteritis, but also for demonstration of the anatomical distribution, severity and type of the lesions.     

Radiology of Peripheral Arteriovenous Malformations*

Radiologic investigations have proved useful in the evaluation of 26 patients with peripheral arteriovenous malformations which are classified as: hemangioma, congenital arteriovenous fistula and venous malformation. Plain film findings of a soft-tissue mass are common in most patients except in the congenital arteriovenous fistula. Calcification in soft-tissue is noted mostly in hemangiomas and venous malformations. The angiographic findings are characteristic. Hemangiomas reveal slightly dilated small vessels arranged in a fine plexiform network, associated with small collections of contrast. Dilated veins, varicosities or clusters of rounded collections of contrast are seen. Congenital arteriovenous malformations show dilated feeding arteries, rapid arteriovenous shunting and dilated draining veins. Venous malformations have normal arteriograms. Venous stenosis with enlarged veins is seen in phleban-giomas; saccular dilatation of veins is noted in venous angiomas or phlebangiomatosis. Characteristic findings of the venous phase of arteriograms and phlebograms are very helpful in differentiating hemangiomas from soft tissue neoplasm.