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MRA of abdominal and pelvic vessels (In German)
JULY-SEPTEMBER
ABSTRACTS
1995
relationship to the stenoses and occlusions. MIP also proved valuable in controlling the position of intravascular stems. Complementary to DSA, the MIP method seems to be clinically valuable for calcified and noncalcified stenoses. Authors’ Summary DIFFERENTIAL DIAGNOSIS AND REPAlR OF FEMORAL AM’ERY PSEUDOANEURYSMS: REPORT OF CLINICAL EXPERIENCE USING COIQR DOPPLER IMAGING Trigaux J-P, Daube A, De Wispelaere J-F, Van Beers B (Department of Radiology, Cliniques UCL de Mont-Godinne, B-5530 Yvoir, Belgium). J Belge Radio1 1994;77:111-116. Sixty-two sonograms of the groin in 58 patients referred after cardiac catheterization (n = 45) or local surgical bypass (n = 13) were reviewed retrospectively to determine the accuracy of color Doppler imaging in distinguishing femoral artery pseudoaneurysms from other causes of groin masses (e.g., hematomas) and to evaluate the therapeutic impact of ultrasonography (U.S.)-guided compression. Thirty-seven cases of pseudoaneurysm, 3 arteriovenous fistulae (1 isolated and 2 associated with a pseudoaneurysm), 16 hematomas, and 8 other conditions were studied; U.S.-guided compression repair was considered to treat 13 pseudoaneurysms. The sensitivity and specificity of color Doppler imaging in comparison with angiography and/or surgery in detecting femoral artery pseudoaneurysm was 100% and 94%, respectively. U.S.guided compression repair was not attempted in 2 out of 13 cases (one critical leg ischemia and one unsuitable anatomy) and successful in 7 out of 11 cases. We conclude that color Doppler imaging is of great value in the differential diagnosis of groin masses, reducing the number of diagnostic and pretherapeutic angiographies. However, in our experience, U.S.-guided compression repair was effective in the treatment of no more than 54% (7113cases) of nonselected femoral pseudoaneurysms. Authors’ Summary
MRA OF ABDOMINAL AND PELVIC VESSEIS (In G=manJ Davis CP, Debatin JF, Krestin GP (Department Medizinische Radiologie, Universittitsspital, Rlimistrasse 100, CH-8091 Zurich, Switzerland). Radiologe 1994;34:469-476.
225
The assessment of abdominal vessels using conventional methods is invasive and frequently yields an inaccurate diagnosis, particularly in evaluating the portal venous system. Magnetic resonance angiography (MRA) is noninvasive and well suited for the examining of abdominal vessels. Both vessel morphology and intravascular flow patterns can be characterized with this method. Clinical indications include portal hypertension, portal vein thrombosis, portosystemic shunts, assessment of congenital anomalies, thrombus, and tumor propagation into the inferior vena cava and the renal veins, proximal renal artery stenosis, and assessment of the pelvic arteries and veins. In the future, MRA may become an important part of the noninvasive evaluation of abdominal and pelvic vessels. Authors’ Summary MRA OF THE PERIPHERAL VESSEIS (In Gznm@ Vosshenrich R, Fischer U, Grabbe E (Abteilung Rtintgendiagnostik I der Universitst, Robert-Koch-Strasse 40, D-37975 Gtittingen, Germany). Radiologe 1994;34:477-482. Magnetic resonance angiography (MRA) of the extremities is in its infancy. The potential appears great, but several problems must be solved before MRA can routinely be used as the definitive diagnostic procedure. MRA can detect arterial stenoses and occlusions, and determine their length. The degree of stenosis, however, is overestimated. Although the spatial resolution of MRA allows depiction of the tibia1 vessels, evaluation of their major branches is necessary for distal bypass surgery. The postoperative examination of patients with bypasses seems a practical alternative to established angiography techniques. At present, MRA is cost-effective but not as readily available as conventional angiography. MRA technology continues to advance rapidly. With improved technology, judicious use, and appropriate patient selection, MRA should in the future assume a role in evaluating peripheral arterial occlusive disease. Authors’ Summary
EARLY DIAGNOSIS BY COMPUTED TOMOGRAPHY OF INFF.CI’ED COLLECI’IONS IN ACUTE PANcREATFllS (In German) Friedrich JM, Leibling U, Pfeifer Th, et al. (Radiologische Klinik and Poliklinik der Univesitiit Ulm, Robert-Koch-Strasse 8, D-89081 Ulm/Donay, Germany). Fortschr Rontgenstr 1994;161: 208-213.
ABSTRACTS
1995
relationship to the stenoses and occlusions. MIP also proved valuable in controlling the position of intravascular stems. Complementary to DSA, the MIP method seems to be clinically valuable for calcified and noncalcified stenoses. Authors’ Summary DIFFERENTIAL DIAGNOSIS AND REPAlR OF FEMORAL AM’ERY PSEUDOANEURYSMS: REPORT OF CLINICAL EXPERIENCE USING COIQR DOPPLER IMAGING Trigaux J-P, Daube A, De Wispelaere J-F, Van Beers B (Department of Radiology, Cliniques UCL de Mont-Godinne, B-5530 Yvoir, Belgium). J Belge Radio1 1994;77:111-116. Sixty-two sonograms of the groin in 58 patients referred after cardiac catheterization (n = 45) or local surgical bypass (n = 13) were reviewed retrospectively to determine the accuracy of color Doppler imaging in distinguishing femoral artery pseudoaneurysms from other causes of groin masses (e.g., hematomas) and to evaluate the therapeutic impact of ultrasonography (U.S.)-guided compression. Thirty-seven cases of pseudoaneurysm, 3 arteriovenous fistulae (1 isolated and 2 associated with a pseudoaneurysm), 16 hematomas, and 8 other conditions were studied; U.S.-guided compression repair was considered to treat 13 pseudoaneurysms. The sensitivity and specificity of color Doppler imaging in comparison with angiography and/or surgery in detecting femoral artery pseudoaneurysm was 100% and 94%, respectively. U.S.guided compression repair was not attempted in 2 out of 13 cases (one critical leg ischemia and one unsuitable anatomy) and successful in 7 out of 11 cases. We conclude that color Doppler imaging is of great value in the differential diagnosis of groin masses, reducing the number of diagnostic and pretherapeutic angiographies. However, in our experience, U.S.-guided compression repair was effective in the treatment of no more than 54% (7113cases) of nonselected femoral pseudoaneurysms. Authors’ Summary
MRA OF ABDOMINAL AND PELVIC VESSEIS (In G=manJ Davis CP, Debatin JF, Krestin GP (Department Medizinische Radiologie, Universittitsspital, Rlimistrasse 100, CH-8091 Zurich, Switzerland). Radiologe 1994;34:469-476.
225
The assessment of abdominal vessels using conventional methods is invasive and frequently yields an inaccurate diagnosis, particularly in evaluating the portal venous system. Magnetic resonance angiography (MRA) is noninvasive and well suited for the examining of abdominal vessels. Both vessel morphology and intravascular flow patterns can be characterized with this method. Clinical indications include portal hypertension, portal vein thrombosis, portosystemic shunts, assessment of congenital anomalies, thrombus, and tumor propagation into the inferior vena cava and the renal veins, proximal renal artery stenosis, and assessment of the pelvic arteries and veins. In the future, MRA may become an important part of the noninvasive evaluation of abdominal and pelvic vessels. Authors’ Summary MRA OF THE PERIPHERAL VESSEIS (In Gznm@ Vosshenrich R, Fischer U, Grabbe E (Abteilung Rtintgendiagnostik I der Universitst, Robert-Koch-Strasse 40, D-37975 Gtittingen, Germany). Radiologe 1994;34:477-482. Magnetic resonance angiography (MRA) of the extremities is in its infancy. The potential appears great, but several problems must be solved before MRA can routinely be used as the definitive diagnostic procedure. MRA can detect arterial stenoses and occlusions, and determine their length. The degree of stenosis, however, is overestimated. Although the spatial resolution of MRA allows depiction of the tibia1 vessels, evaluation of their major branches is necessary for distal bypass surgery. The postoperative examination of patients with bypasses seems a practical alternative to established angiography techniques. At present, MRA is cost-effective but not as readily available as conventional angiography. MRA technology continues to advance rapidly. With improved technology, judicious use, and appropriate patient selection, MRA should in the future assume a role in evaluating peripheral arterial occlusive disease. Authors’ Summary
EARLY DIAGNOSIS BY COMPUTED TOMOGRAPHY OF INFF.CI’ED COLLECI’IONS IN ACUTE PANcREATFllS (In German) Friedrich JM, Leibling U, Pfeifer Th, et al. (Radiologische Klinik and Poliklinik der Univesitiit Ulm, Robert-Koch-Strasse 8, D-89081 Ulm/Donay, Germany). Fortschr Rontgenstr 1994;161: 208-213.