Partial anomalous pulmonary venous return associated with vascular anomalies of the aorta: multidetector computed tomography findings

Partial anomalous pulmonary venous return (PAPVR) is a congenital anomaly that involves drainage of one to three pulmonary veins directly into the right heart or systemic venous system, creating a partial left-to-right shunt. This drainage is associated with cardiac abnormalities such as mitral stenosis and pulmonary stenosis, patent ductus arteriosus, and atrial septal defects. We report a case of PAPVR associated with vascular anomalies of the aorta by multidetector computed tomography in an adult female patient

The utility of multidetector computed tomography for evaluation of congenital heart disease

Background: Congenital heart diseases (CHD) are the leading cause of birthdefect-related deaths. Multidedector computed tomography (MDCT) plays animportant role for imaging CHD in addition to echocardiography and providesa comprehensive evaluation of complex heart malformations for the referringcardiologist. The aim of the study was to evaluate the utility of MDCT in theassessment of CHD.Materials and methods: A 102 patients with CHD were investigated after initialassessment by echocardiography. The information obtained by MDCT and findingsof echocardiography were reviewed together by paediatric cardiologistsand cardiac radiologists. Perioperative anatomic descriptions, wherever available(n = 34) formed the gold standard for the comparison.Results: The clinical consensus diagnosis defined 154 cardiovascular lesions inthe patients. The results were classified in groups. We present the appearanceof various congenital cardiac lesions seen in clinical practice.Conclusions: MDCT provides important information about anatomic details ofCHD for the referring cardiologist. The evaluation of different anatomic structuressuch as heart, great vessels, lungs and abdomen is possible in one acquisitionwith this technique

Analysis of posterior circulation diameters depending on age, sex and side by computed tomography angiography

Background: Posterior circulation of brain is important because of vital organs’ blood supply provided by them. In this study, we evaluate the relationship of posterior circulation measurements with age, gender and side by using computed tomography angiography (CTA) images.Materials and methods: A total 199 brain CTA examinations were retrospectively analysed for all posterior circulation arteries (vertebral artery, basilar artery, posterior cerebral artery [PCA], superior cerebellar artery [SCA], anterior inferior cerebellar artery, and posterior inferior cerebellar artery [PICA]) to compare the difference based on age, gender and side.Results: There is no correlation between age and the mean diameters of all vessels (p > 0.05). The mean diameter of left vertebral artery was higher than right vertebral artery in all genders (p = 0.004 for males and p < 0.001 for females). The mean diameter of left SCA and PICA were higher than right SCA and PICA in females (p = 0.032 and p = 0.027, respectively). The mean diameters of basilar, left PCA, left SCA, left vertebral, right PCA, right SCA, right PICA and right vertebral artery were higher in males and that differences were statistically significant (p < 0.001, p = 0.002, p = 0.006, p = 0.004, p = 0.001, p = 0.003, p = 0.002, and p = 0.006, respectively).Conclusions: The posterior circulation vessel diameter is not affected by aging. The mean diameters of basilar artery, both PCAs, both SCAs, right PICA, both vertebral arteries were higher in males. The mean diameter of left vertebral artery is higher than that of right vertebral artery in all genders

Non-invasive detection of biliary leaks using Gd-EOB-DTPA-enhanced MR cholangiography: Comparison with T2-weighted MR cholangiography

Objective: To evaluate the added role of T1-weighted (T1w) gadolinium ethoxybenzyl diethylenetriamine penta-acetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance cholangiography (MRC) compared with T2-weighted MRC (T2w-MRC) in the detection of biliary leaks. Methods: Ninety-nine patients with suspected biliary complications underwent routine T2w-MRC and T1w contrast-enhanced (CE) MRC using Gd-EOB-DTPA to identify biliary leaks. Two observers reviewed the image sets separately and together. MRC findings were compared with those of surgery and percutaneous transhepatic cholangiopancreatography. The sensitivity, specificity and accuracy of the techniques in identifying biliary leaks were calculated. Results: Accuracy of locating biliary leaks was superior with the combination of Gd-EOB-DTPA-enhanced MRC and T2w-MRC (P 0.05).The mean sensitivities were 79 % vs 59 %, and the mean accuracy rates were 84 % vs 58 % for combined CE-MRC and T2w-MRC vs sole T2w-MRC. Nineteen out of 21 patients with biliary-cyst communication, 90.4 %, and 12/15 patients with post-traumatic biliary extravasations, 80 %, were detected by the combination of Gd-EOB-DTPA-enhanced MRC and T2w-MRC images, P 0.05. Conclusions: Gd-EOB-DTPA-enhanced MRC yields information that complements T2w-MRC findings and improves the identification and localisation of the bile extravasations (84 % accuracy, 100 % specificity, P 0.05). We recommend Gd-EOB-DTPA-enhanced MRC in addition to T2w-MRC to increase the preoperative accuracy of identifying and locating extravasations of bile. Key Points: • Magnetic resonance cholangiography (MRC) does not always detect bile leakage and cysto-biliary communications. • Gd-EOB-DTPA-enhanced MRC helps by demonstrating extravasation of contrast material into fluid collections. • Gd-EOB-DTPA-enhanced MRC also demonstrates the leakage site and bile duct injury type. • Combined Gd-EOB-DTPA-enhanced and T2w-MRC can provide comprehensive information about biliary system. • Gd-EOB-DTPA-enhanced MRC is non-invasive and does not use ionising radiation. © 2013 The Author(s)

Brain herniation into the transverse sinuses’ arachnoid granulations in the pediatric population investigated with 3 T MRI

We aimed to evaluate the frequency, radiological–clinical findings of brain herniation into arachnoid granulation (BHAG) in pediatric age group using 3 T magnetic resonance imaging. Patients were under 18 years of age and underwent brain MRI examination which consists of 3D T1, 3D T2 FLAIR and 3D T2 sequences. A total of 2320 patients were enrolled in the study. All cases of AG into transverse sinus were included. The location of the AG, the deep, transverse, vertical and neck diameters and volume of AG were recorded. Clinical findings and imaging findings of patients were also recorded. The patients were categorized as BHAG and AG without brain herniation (AGWBH). The mean diameters (deep, transverse, vertical and neck) of AG, volume of AG, age, sex, clinical findings and imaging findings were evaluated and compared in each group. 135 patients (71 female, 64 male) had AG in a total of 2320 patients (prevalence 5.81%). Fifteen patients (10.7% of all patients, 11 female, 4 male) had BHAG. The mean diameters (deep, transverse, vertical and neck) and volume of AGWBH were 5.23 ± 1.91, 4.07 ± 1.58, 4.99 ± 1.68, 3.64 ± 1.84 mm and 85.05 ± 89.10 mm3, respectively. The mean diameters (deep, transverse, vertical and neck) and volume of BHAG were 7.46 ± 2.6, 6.85 ± 2.34, 8.32 ± 2.35, 5.41 ± 1.79 mm and 331 ± 361.26 mm3, respectively. The mean diameters and volume of BHAG were significantly larger than AGWBH (p 0.05). Brain herniation into arachnoid granulation is seen in pediatric age group as frequently as adults. Its frequency is not related to age. It is not significantly associated with neurological symptoms. As the AG size increases, the risk of BHAG increases