Learning objectives
With the introduction of modern imaging modalities,
the diagnosis of pseudoaneurysms has become more common.
The early detection and proper assessment using noninvasive techniques is essential to choose an appropriate treatment.
Our objectives are:
To review the epidemiology and clinical presentation of pseudoaneurysms.
To highlight the radiologic features of pseudoaneurysms,
with special emphasis on angio-CT findings.
To learn to identify all information provided by the TC,
this is essential in the choice of treatment technique.
Background
A pseudoaneurysm (PSA) is a common vascular injury that represents a rupture of the arterial wall contained in a defined sac of turbulent flow,
with a persistent connection (neck) to the artery. Arterial disruption is usually secondary to trauma,
inflammation/infection or iatrogenic causes.
They are in contrast to true aneurysms,
which have all three layers of intima,
media and adventitia that form the normal arterial wall,
with arteriosclerosis being the primary factor in their development.
Following injury of the arterial wall,
under the influence of...
Imaging findings OR Procedure details
A retrospective review of all PSA detected in our radiology department from January 2011 to April 2012 was performed. All patients were evaluated by computed tomography.
In some cases arteriography was available.
A multi-detector helical (16-slice) CT scanner was used to perform exams.
Our protocol included an axial non-contrast-enhanced CT scan and image acquisition after intravenous contrast,
completed with MPR and 3D reconstructions.
Unenhanced CT scans usually demonstrated a low-attenuation rounded structure arising from the side of the donor artery.
The wall of the pseudoaneurysm...
Conclusion
1.
CT angiography is a safe,
fast and accurate tool for diagnosis of pseudoaneurysms.
2.
It provides critical information (size,
location,
neck,
collateral circulation and expandability of the artery) which is essential in the choice of the treatment technique.
3.
CT can help detect other associated disease that may not be detected with other imaging modalities such as pancreatitis.
References
1.
- J.
L.
Del Cura,S.
Pedraza,
A.
Gayete.
Radiología Esencial; 1.ª Edición; Tomo I; 2009.
2.
– William E.
Brant,ClydeA.
Helms.
Fundamentos de Radiología Diagnóstica; 3.ª Edición; Volumen III; Pag 1045-1047.
3.
– Baljendra S.
Kapoor,
Heather L.
Haddad.
Diagnosis and Management of Pseudoaneurysms: An Update; Current Problems in Diagnostic Radiology 2009; 38:170-188.
4.
– Nael E.
A.
Saad,
Wael E.
A.
Saad,
Mark G.
Davis.
Pseudoaneurysms and the Role of Minimally Invasive Techniques in Their Management; Radiographics 2005; 25:S173-S189.
5.
– A.
N....