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Visceral Artery Aneurysms: Evaluation Using 3D Contrast-Enhanced MR Angiography

¹ All authors: Department of Radiology, Changhai Hospital, Second Military Medical University, 174 Changhai Rd., Shanghai, Shanghai 200433, China.

View larger version (77K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1 —Distal splenic artery aneurysm in 52-year-old woman with liver cirrhosis. Coronal volume-rendered image shows 1.9 x 2.3 cm aneurysm in distal portion of splenic artery. Patient was treated with aneurysmectomy and splenectomy.

View larger version (125K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —41-year-old woman with mid splenic artery aneurysm. Coronal oblique (A) and axial oblique, from inferior viewing orientation (B), volume-rendered images show 1.8 x 2.5 cm aneurysm in middle portion of splenic artery. Patient was treated with coil embolization 5 days after contrast-enhanced MR angiography.

View larger version (59K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —41-year-old woman with mid splenic artery aneurysm. Coronal oblique (A) and axial oblique, from inferior viewing orientation (B), volume-rendered images show 1.8 x 2.5 cm aneurysm in middle portion of splenic artery. Patient was treated with coil embolization 5 days after contrast-enhanced MR angiography.

View larger version (63K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —66-year-old woman with large proximal splenic artery aneurysm and small distal splenic artery aneurysm. SA = splenic artery, CA = celiac artery, HA = hepatic artery, SMA = superior mesenteric artery. Coronal oblique (A) and axial oblique, from superior viewing orientation (B), volume-rendered images reveal 2.6 x 3.3 cm aneurysm (narrow arrowhead) arising from proximal portion of splenic artery and 1.3 x 1.8 cm aneurysm (wide arrowhead) within distal portion of splenic artery.

View larger version (44K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —66-year-old woman with large proximal splenic artery aneurysm and small distal splenic artery aneurysm. SA = splenic artery, CA = celiac artery, HA = hepatic artery, SMA = superior mesenteric artery. Coronal oblique (A) and axial oblique, from superior viewing orientation (B), volume-rendered images reveal 2.6 x 3.3 cm aneurysm (narrow arrowhead) arising from proximal portion of splenic artery and 1.3 x 1.8 cm aneurysm (wide arrowhead) within distal portion of splenic artery.

View larger version (36K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —66-year-old woman with large proximal splenic artery aneurysm and small distal splenic artery aneurysm. SA = splenic artery, CA = celiac artery, HA = hepatic artery, SMA = superior mesenteric artery. Oblique posteroanterior volume-rendered image shows relationship of large aneurysm to its feeding artery (black arrowhead, C) more clearly than digital subtraction angiography image (D). Both aneurysms (white arrowhead, C) were embolized by coils.

View larger version (194K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3D —66-year-old woman with large proximal splenic artery aneurysm and small distal splenic artery aneurysm. SA = splenic artery, CA = celiac artery, HA = hepatic artery, SMA = superior mesenteric artery. Oblique posteroanterior volume-rendered image shows relationship of large aneurysm to its feeding artery (black arrowhead, C) more clearly than digital subtraction angiography image (D). Both aneurysms (white arrowhead, C) were embolized by coils.

View larger version (91K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —72-year-old woman with common hepatic artery aneurysm and celiac artery aneurysm. Coronal volume-rendered (A) and digital subtraction angiography (B) images show 3.5 x 4.0 cm aneurysm (white arrowhead, A) of common hepatic artery and 1.8 x 3.2 cm fusiform aneurysm (black arrowhead, A) of celiac artery.

View larger version (162K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —72-year-old woman with common hepatic artery aneurysm and celiac artery aneurysm. Coronal volume-rendered (A) and digital subtraction angiography (B) images show 3.5 x 4.0 cm aneurysm (white arrowhead, A) of common hepatic artery and 1.8 x 3.2 cm fusiform aneurysm (black arrowhead, A) of celiac artery.

View larger version (145K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4C —72-year-old woman with common hepatic artery aneurysm and celiac artery aneurysm. Multiplanar reconstruction (C) and true fast imaging with steady-state precession (D) images reveal partial thrombus (asterisk) in aneurysm. Patient was treated with coil embolization for common hepatic artery aneurysm and celiac artery aneurysm was not treated. Four months after treatment, reembolization with coils and absorbable gelatin sponge (Gelfoam, Upjohn) was performed for recurrence. In D, arrowhead = aneurysm.

View larger version (181K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4D —72-year-old woman with common hepatic artery aneurysm and celiac artery aneurysm. Multiplanar reconstruction (C) and true fast imaging with steady-state precession (D) images reveal partial thrombus (asterisk) in aneurysm. Patient was treated with coil embolization for common hepatic artery aneurysm and celiac artery aneurysm was not treated. Four months after treatment, reembolization with coils and absorbable gelatin sponge (Gelfoam, Upjohn) was performed for recurrence. In D, arrowhead = aneurysm.

View larger version (82K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5 —54-year-old man with superior mesenteric artery aneurysm. Oblique sagittal volume-rendered image shows 3.0 x 6.5 cm aneurysm arising from proximal and middle portions of superior mesenteric artery. Patient was under close observation because he refused surgery.

View larger version (130K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6A —63-year-old man with celiac artery aneurysm. Coronal (A) and axial, from inferior viewing orientation (B), volume-rendered images show 1.7 x 2.5 cm aneurysm of celiac artery. Patient was treated with aneurysmectomy. Follow-up contrast-enhanced MR angiography (not shown) performed 1 month after operation showed patency of splenic and hepatic arteries via collaterals.

View larger version (71K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6B —63-year-old man with celiac artery aneurysm. Coronal (A) and axial, from inferior viewing orientation (B), volume-rendered images show 1.7 x 2.5 cm aneurysm of celiac artery. Patient was treated with aneurysmectomy. Follow-up contrast-enhanced MR angiography (not shown) performed 1 month after operation showed patency of splenic and hepatic arteries via collaterals.

View larger version (139K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7A —59-year-old woman with celiac artery aneurysm. Coronal volume-rendered (A); axial, from inferior viewing orientation, volume-rendered (B); and axial multiplanar reconstruction (C) images show 4.2 x 5.2 cm aneurysm at bifurcation of celiac artery (CA, C) involving orifice of common hepatic artery (HA, B) and splenic artery (SA, B). Patient was treated with aneurysmectomy. Follow-up contrast-enhanced MR angiography (not shown) 1 month after operation showed patency of splenic and hepatic arteries via collaterals.

View larger version (85K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7B —59-year-old woman with celiac artery aneurysm. Coronal volume-rendered (A); axial, from inferior viewing orientation, volume-rendered (B); and axial multiplanar reconstruction (C) images show 4.2 x 5.2 cm aneurysm at bifurcation of celiac artery (CA, C) involving orifice of common hepatic artery (HA, B) and splenic artery (SA, B). Patient was treated with aneurysmectomy. Follow-up contrast-enhanced MR angiography (not shown) 1 month after operation showed patency of splenic and hepatic arteries via collaterals.

View larger version (110K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7C —59-year-old woman with celiac artery aneurysm. Coronal volume-rendered (A); axial, from inferior viewing orientation, volume-rendered (B); and axial multiplanar reconstruction (C) images show 4.2 x 5.2 cm aneurysm at bifurcation of celiac artery (CA, C) involving orifice of common hepatic artery (HA, B) and splenic artery (SA, B). Patient was treated with aneurysmectomy. Follow-up contrast-enhanced MR angiography (not shown) 1 month after operation showed patency of splenic and hepatic arteries via collaterals.

View larger version (123K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8 —53-year-old woman with splenic artery aneurysm and left renal artery aneurysm. Coronal volume-rendered image shows 1.2 x 1.4 cm aneurysm (wide arrowhead) of distal portion of splenic artery and 2.0 x 2.3 cm aneurysm (narrow arrowhead) of distal portion of left renal artery. Patient was under regular observation without treatment because of stable size and special position of renal aneurysm.

View larger version (100K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9A —32-year-old woman with multiple visceral artery aneurysms. Coronal (A–C) and sagittal (D) volume-rendered images show multiple aneurysms involving celiac artery, superior mesenteric artery and its branches, and bilateral renal arteries. Patient was under observation.

View larger version (60K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9B —32-year-old woman with multiple visceral artery aneurysms. Coronal (A–C) and sagittal (D) volume-rendered images show multiple aneurysms involving celiac artery, superior mesenteric artery and its branches, and bilateral renal arteries. Patient was under observation.

View larger version (108K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9C —32-year-old woman with multiple visceral artery aneurysms. Coronal (A–C) and sagittal (D) volume-rendered images show multiple aneurysms involving celiac artery, superior mesenteric artery and its branches, and bilateral renal arteries. Patient was under observation.

View larger version (54K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9D —32-year-old woman with multiple visceral artery aneurysms.A–D, Coronal (A–C) and sagittal (D) volume-rendered images show multiple aneurysms involving celiac artery, superior mesenteric artery and its branches, and bilateral renal arteries. Patient was under observation.

View larger version (126K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 10 —48-year-old woman with anomalous splenic artery aneurysm. Coronal volume-rendered image shows 5.0 x 6.0 cm aneurysm in proximal portion of splenic artery just after anomalously arising from superior mesenteric artery and shows hepatic artery arising from abdominal aorta alone. Patient was treated with coil, absorbable gelatin sponge (Gelfoam, Upjohn), and glue embolization. Nine months after treatment, she was treated with splenectomy because of splenic abscess.

View larger version (78K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 11A —45-year-old man with celiomesenteric trunk aneurysm. Coronal oblique (A) and sagittal (B) arterial phase volume-rendered images show 3.1 x 3.7 cm aneurysm arising from celiac artery just after bifurcation of celiomesenteric trunk.

View larger version (65K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 11B —45-year-old man with celiomesenteric trunk aneurysm. Coronal oblique (A) and sagittal (B) arterial phase volume-rendered images show 3.1 x 3.7 cm aneurysm arising from celiac artery just after bifurcation of celiomesenteric trunk.

View larger version (146K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 11C —45-year-old man with celiomesenteric trunk aneurysm. Coronal venous phase volume-rendered image reveals relationship of aneurysm to portal vein and splenic vein.

View larger version (67K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 11D —45-year-old man with celiomesenteric trunk aneurysm. Coronal oblique (D) and sagittal (E) volume-rendered images after aneurysmectomy and arterial ligation show patency of hepatic artery and splenic artery.

View larger version (62K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 11E —45-year-old man with celiomesenteric trunk aneurysm. Coronal oblique (D) and sagittal (E) volume-rendered images after aneurysmectomy and arterial ligation show patency of hepatic artery and splenic artery.

View larger version (132K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 12A —31-year-old man with multiple aneurysms accompanied with celiomesenteric trunk. Coronal volume-rendered images show multiple aneurysms involving splenic artery and common hepatic artery that arise from celiomesenteric trunk. Patient was not treated because of complex anatomic configuration of aneurysms.

View larger version (97K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 12B —31-year-old man with multiple aneurysms accompanied with celiomesenteric trunk. Coronal volume-rendered images show multiple aneurysms involving splenic artery and common hepatic artery that arise from celiomesenteric trunk. Patient was not treated because of complex anatomic configuration of aneurysms.

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