Cardiovascular radiology最新文献

Roentgenographic studies, including plain chest roentgenography, thoracic aortography, and coronary angiography, were performed in seven adult patients with nonobstructive coarctation, a congenital deformity of the upper thoracic aorta. The chest roentgenographic findings were compared with those of ten patients with obstructive coarctation studied during the same period. A great similarity was found in the morphology and associated lesions of these two conditions, which supports the idea that nonobstructive and obstructive coarctation are stages of the same disease. Patients with nonobstructive coarctation had a more prominent aortic arch, and the indentation in the thoracic aorta was higher than in patients with obstructive coarctation. In addition, patients with nonobstructive coarctation had no rib notching on plain chest roentgenograms. Angiographic evaluation in patients with nonobstructive disease demonstrated the anatomic lesion, the absence of collateral circulation, and the commonly associated anomalies of the aortic valve.

The abdominal angiograms of 381 patients were critically reexamined for the existence of collateral circulation in cases of renal artery stenosis or occlusion. Typical renal artery stenosis was found in 39 patients; among these, 17 had a collateral circulation, which was extrarenal in 15 and intrarenal in two. Collateral circulation involving the lumbar arteries was most common. In two patients a collateral circulation was established via the inferior mesenteric artery.

Angiographic examination in a patient with sciatic-like pain on the right side and a firm, pulsatile, non-tender mass in the right buttock revealed a large sciatic artery aneurysm. The aneurysm was successfully resected at surgery. The primitive sciatic artery is the main arterial supply to the lower extremities in the 9-mm embryo. Its persistence, while very rare, is of clinical significance because of the tendency for aneurysms to develop in the artery. Surgical resection is indicated in sciatic artery aneurysms because of the danger of rupture or embolic occlusion of arteries distal to the aneurysm.

Thallium-201 myocardial scintigraphy, which has been shown accurate in the assessment of myocardial perfusion, was employed in the evaluation of 34 patients after coronary artery bypass surgery. In 28 patients (82.4%), there was a clear correspondence in the postoperative studies between the defects shown on scintigraphy and the coronary artery stenosis documented by arteriography. Thallium imaging after coronary artery bypass revealed an increased or newly developed scintigraphic defect in eight of 10 patients with recurrent angina. Follow-up arteriography in these 10 patients revealed occlusion or stenosis of the bypass graft in five, perioperative myocardial infarction in two, and increased stenosis of a preoperatively less occluded artery in two. In 24 patients with postoperative clinical improvement or relief of angina, 201Tl scintigraphy revealed complete normalization of thallium uptake in three, improvement of uptake in 17, and unchanged uptake defects in four.

The intrahepatic portal venous flow in cirrhosis of the liver was evaluated by percutaneous transhepatic portography and hepatic arteriography. Spontaneous reversal of flow in segmental portal vein branches was documented. Changes in hepatic arterial inflow and portal venous pressure may result in intermittent changes in the direction of flow in segmental portal venous branches within the cirrhotic liver. Segmental reversal of blood flow seems to be the precursor of total hepatofugal portal flow.