Computed Tomography Angiography of the Renal and Mesenteric Vasculature: Concepts and Applications
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- [Show abstract] [Hide abstract] ABSTRACT: The renal arteries and veins typically branch from the aorta and inferior vena cava, respectively, at the level of the second lumbar vertebral body, below the level of the anterior takeoff of the superior mesenteric artery. The right renal artery passes behind the IVC in its course and is considerably longer than the left renal artery. The main renal artery typically divides into four or more segmental vessels, with five branches most commonly described. The first and most constant segmental division is a posterior branch, which usually exits the main renal artery before it enters the renal hilum and proceeds posteriorly to the renal pelvis to supply a large posterior segment of the kidney. The remaining anterior division of the main renal artery typically branches as it enters the renal hilum. The renal arteries are end branch vessels and do not communicate with each other. This is in contrast to the renal venous system that contains many intrarenal anastomoses. Accessory renal arteries are anatomic variants that occur in 15–25 % of patients and can range from a single to multiple renal arteries.
- [Show abstract] [Hide abstract] ABSTRACT: The recent introduction of multidetector computed tomography scanners has significantly improved computed tomography angiographic (CTA) applications, especially for the evaluation of medium- and small-arterial structures. CTA of the superior mesenteric artery has been reported previously. However, there have been few systematic and detailed reviews of the superior mesenteric artery pathologies that use CTA. The purpose of this pictorial essay is mainly to review the various superior mesenteric artery pathologies at CTA with our own experiences.
- [Show abstract] [Hide abstract] ABSTRACT: To study the manifestations of arc of Riolan expansion (ARE) using multi-detector computed tomography angiography (MDCTA). The manifestations and clinical data of 626 consecutive mesentery CTA images were retrospectively analyzed. The 47 cases with ARE and 47 patients without expansion were involved. The average diameter of arc of Riolan was measured. Two radiologists after reaching consensus analyzed the shapes of mesenteric artery, CT findings and the occurrence and causes of ARE. The mean diameter of arc of Riolan was 1.2 mm, 4.6 mm, 2.5 mm, 2.3 mm, 1.9 mm, 2.5 mm, and 2.0 mm at baseline and following obstruction of superior mesenteric artery (SMA), stenosis of SMA, obstruction of inferior mesenteric artery (IMA), stenosis of IMA, colon cancer, and active ulcerative colitis, respectively. The expansion of arc of Riolan was the most significant following obstruction of SMA. The diameters of arc of Riolan were significantly different between the upward flow group and the downward or the two-way flow groups, and between the colon tumor group and the active ulcerative colitis group. CT findings such as bowel wall thickening, contrast enhancement, intestinal obstruction, marginal artery expansion, lymph node enlargement varied and were help to identify the cause of ARE. ARE often suggests the occurrence of obstructed intestinal feeding artery or intestinal lesions. MDCTA can clearly display the situation of arc of Riolan and collateral circulation, and together with CT symptoms, can guide the selection of diagnosis and treatment schemes in clinic.
Cardiac MR and CT imaging in children with suspected or confirmed pulmonary hypertension/pulmonary hypertensive vascular disease. Expert consensus statement on the diagnosis and treatment of paediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK
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