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Computed tomography of the celiac trunk and superior mesenteric artery (In Italian)
OCTOBER-DECEMBER
1994
COMPUTED TOMOGRAPHY OF THE CELIAC TRUNK AND SUPERIOR MESENTFJUC ARTERY (In Italian) Sponza M, Pozzi Mucelli R, Pozzi Mucelli F (R.P.M.: Istituto di Radiologia, Universiti-Ospedale di Cattinara, Strada di Fiume, I-34149 Trieste )TS), Italy). Radio1 Med 1993;86:260-267. A hundred patients with different conditions underwent computed tomography (CT) and the results were retrospectively reviewed to evaluate the visibility of the celiac trunk, of its branches, and of the superior mesenteric artery. Thirty-six patients underwent angiography too, which allowed the anatomical variants suspected on CT to be demonstrated, according to Kuhns’criteria. The other 64 patients were consecutively selected and only aneurysmal changes were not included. All examinations were performed using a General Electric 9800 Advantage scanner, with 2-second scanning time and IO-mm-thick contiguous scans. In 20 patients 5-mm contiguous scans were performed. All examinations followed intravenous injections of contrast agents which were given with an automatic injector. The cases with suspected anatomical variants on CT but with no angiographic confirmation were not considered. A hundred CT examinations were retrospectively reviewed: The celiac trunk and the common hepatic artery were demonstrated in all of them. Visibility of the other branches was 40% for the hepatic artery, 53 % for the right branch of the hepatic artery and 39 % for its left branch, 70% for the gastroduodenal artery, 82% for the left gastric artery, 97% for the splenic artery, and 100% for the superior mesenteric artery. As for the 36 patients who underwent both CT and angiography, the right hepatic artery from the superior mesenteric artery was seen in 19 % of cases with both modalities; the common hepatic artery arising frcm the superior mesenteric artery was detected in 2 % of cases. In both instances, these anatomical variants appeared as a vessel running posterior to the portal vein. The careful investigation of axial CT scans showed the level of origin of the artery from the superior mesenteric artery. These results are in agreement with the angiographic data reported in the literature. Our study demonstrated that the celiac trunk and its variants are always depicted by the new CT scanner. The knowledge of these variants may be useful in the patients who will undergo liver surgery. The celiac trunk and its variants are demonstrated with conventional lo-mm slices. The use of 5-mm slices improves the visibility of thin anatomical branches but is not essential to recognize the major vessels and anatomical variants. Authors’ Summary
ABSTRACTS
295
THE VARIABLE OF HYPERTROPHIC CHANGES IN HEPATIC MORPHOLOGY: CI’APPEARANCE Soyer Ph, Levesque M (Department of Radiology, HBpital Bichat, F-75877 Paris, Cedex 18, France). J Belge Radio1 1993;76:150-153. The liver has a particular ability to regenerate and demonstrate hypertrophy under several circumstances. The aim of this essay is to illustrate the computed tomographic (CT) appearances of the hypertrophic changes in hepatic morphology and to focus on the broad spectrum of etiologies. One thousand seven hundred and twenty-one patients who had CT of the abdomen were retrospectively studied. One hundred and fifty-three (go/, of them (82 men, 71 women), with a mean age of 50 years (range: 18 to 87 years)) had hypertrophic changes in the liver. The different final diagnoses included liver cirrhosis (n = 75), Budd-Chiari syndrome (n = 35)) partial hepatectomy (n = 25), cholangiocarcinema (n = lo), liver metastasis (n = l), preoperative portal vein embolization (n = 3), shistosomiasis (n = I), and congenital hypertrophy (n = 3). Hypertrophic changes in hepatic morphology are not uncommon conditions and CT is likely to afford the opportunity to detect them. The discovery of such an abnormality must prompt the radiologists to eliminate the possibility of neoplastic etiology or underlying portal hypertension. Authors’ Summary
DOPPLER ULTRASONOGRAPHY AFl-ER RENAL TRANSPLANTATION: VALUE OF REVERSED DIASTOLIC FLOW IN DIAGNOSING RENAL VEIN OBSTRUCI’ION Kribs SW, Rankin RN (R.N.R.: Department of Diagnostic Radiology and Nuclear Medicine, University Hospital, University of Western Ontario, PO Box 5339, London, ON N6A 5A5, Canada). Can Assoc Radio1 J 1993;44:434-438. The observation of reversed diastolic flow during Doppler ultrasonography (US) of renal transplants has been described as sensitive but not specific in the diagnosis of renal vein thrombosis. To determine the diagnostic accuracy of reversed diastolic flow for renal vein obstruction in patients who underwent renal transplantation at a tertiary-care teaching hospital over a 3-year period, the authors identified all patients in whom reversed diastolic flow was observed during Doppler US (17 patients) and those in whom complete renal vein obstruction occurred, necessitating nephrectomy (16 patients). Three types of reversed diastolic flow were
1994
COMPUTED TOMOGRAPHY OF THE CELIAC TRUNK AND SUPERIOR MESENTFJUC ARTERY (In Italian) Sponza M, Pozzi Mucelli R, Pozzi Mucelli F (R.P.M.: Istituto di Radiologia, Universiti-Ospedale di Cattinara, Strada di Fiume, I-34149 Trieste )TS), Italy). Radio1 Med 1993;86:260-267. A hundred patients with different conditions underwent computed tomography (CT) and the results were retrospectively reviewed to evaluate the visibility of the celiac trunk, of its branches, and of the superior mesenteric artery. Thirty-six patients underwent angiography too, which allowed the anatomical variants suspected on CT to be demonstrated, according to Kuhns’criteria. The other 64 patients were consecutively selected and only aneurysmal changes were not included. All examinations were performed using a General Electric 9800 Advantage scanner, with 2-second scanning time and IO-mm-thick contiguous scans. In 20 patients 5-mm contiguous scans were performed. All examinations followed intravenous injections of contrast agents which were given with an automatic injector. The cases with suspected anatomical variants on CT but with no angiographic confirmation were not considered. A hundred CT examinations were retrospectively reviewed: The celiac trunk and the common hepatic artery were demonstrated in all of them. Visibility of the other branches was 40% for the hepatic artery, 53 % for the right branch of the hepatic artery and 39 % for its left branch, 70% for the gastroduodenal artery, 82% for the left gastric artery, 97% for the splenic artery, and 100% for the superior mesenteric artery. As for the 36 patients who underwent both CT and angiography, the right hepatic artery from the superior mesenteric artery was seen in 19 % of cases with both modalities; the common hepatic artery arising frcm the superior mesenteric artery was detected in 2 % of cases. In both instances, these anatomical variants appeared as a vessel running posterior to the portal vein. The careful investigation of axial CT scans showed the level of origin of the artery from the superior mesenteric artery. These results are in agreement with the angiographic data reported in the literature. Our study demonstrated that the celiac trunk and its variants are always depicted by the new CT scanner. The knowledge of these variants may be useful in the patients who will undergo liver surgery. The celiac trunk and its variants are demonstrated with conventional lo-mm slices. The use of 5-mm slices improves the visibility of thin anatomical branches but is not essential to recognize the major vessels and anatomical variants. Authors’ Summary
ABSTRACTS
295
THE VARIABLE OF HYPERTROPHIC CHANGES IN HEPATIC MORPHOLOGY: CI’APPEARANCE Soyer Ph, Levesque M (Department of Radiology, HBpital Bichat, F-75877 Paris, Cedex 18, France). J Belge Radio1 1993;76:150-153. The liver has a particular ability to regenerate and demonstrate hypertrophy under several circumstances. The aim of this essay is to illustrate the computed tomographic (CT) appearances of the hypertrophic changes in hepatic morphology and to focus on the broad spectrum of etiologies. One thousand seven hundred and twenty-one patients who had CT of the abdomen were retrospectively studied. One hundred and fifty-three (go/, of them (82 men, 71 women), with a mean age of 50 years (range: 18 to 87 years)) had hypertrophic changes in the liver. The different final diagnoses included liver cirrhosis (n = 75), Budd-Chiari syndrome (n = 35)) partial hepatectomy (n = 25), cholangiocarcinema (n = lo), liver metastasis (n = l), preoperative portal vein embolization (n = 3), shistosomiasis (n = I), and congenital hypertrophy (n = 3). Hypertrophic changes in hepatic morphology are not uncommon conditions and CT is likely to afford the opportunity to detect them. The discovery of such an abnormality must prompt the radiologists to eliminate the possibility of neoplastic etiology or underlying portal hypertension. Authors’ Summary
DOPPLER ULTRASONOGRAPHY AFl-ER RENAL TRANSPLANTATION: VALUE OF REVERSED DIASTOLIC FLOW IN DIAGNOSING RENAL VEIN OBSTRUCI’ION Kribs SW, Rankin RN (R.N.R.: Department of Diagnostic Radiology and Nuclear Medicine, University Hospital, University of Western Ontario, PO Box 5339, London, ON N6A 5A5, Canada). Can Assoc Radio1 J 1993;44:434-438. The observation of reversed diastolic flow during Doppler ultrasonography (US) of renal transplants has been described as sensitive but not specific in the diagnosis of renal vein thrombosis. To determine the diagnostic accuracy of reversed diastolic flow for renal vein obstruction in patients who underwent renal transplantation at a tertiary-care teaching hospital over a 3-year period, the authors identified all patients in whom reversed diastolic flow was observed during Doppler US (17 patients) and those in whom complete renal vein obstruction occurred, necessitating nephrectomy (16 patients). Three types of reversed diastolic flow were