Three-dimensional spiral computed tomographic angiography: An alternative imaging modality for the abdominal aorta and its branches Geoffrey D. Rubin,

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Presentation transcript:

Three-dimensional spiral computed tomographic angiography: An alternative imaging modality for the abdominal aorta and its branches Geoffrey D. Rubin, MD, Philip J. Walker, FRACS, Michael D. Dake, MD, Sandy Napel, PhD, R.Brooke Jeffrey, MD, Charles H. McDonnell, MD, R.Scott Mitchell, MD, D.Craig Miller, MD Journal of Vascular Surgery Volume 18, Issue 4, Pages 656-665 (October 1993) DOI: 10.1016/0741-5214(93)90075-W Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Diagrammatic representation of technique of spiral CT scanning compared with conventional CT. Simulated slice profiles indicate effective slice thickness and thus z-direction resolution for conventional CT, spiral CT pitch 1, and spiral CT pitch 2. Although pitch 2 results in twice z coverage as pitch one, slice profile is widened resulting in larger effective slice thickness. Journal of Vascular Surgery 1993 18, 656-665DOI: (10.1016/0741-5214(93)90075-W) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Shaded-surface display of normal splanchnic circulation shows aorta (A), splenic artery (s), hepatic artery (open arrow), splenic vein (sv), and portal vein (p). Renal arteries with stenosis of left renal artery origin (curved arrows) and renal veins (straight arrows) entering inferior vena cava (i) are also demonstrated. Because cephalad aspect of CT angiogram is obtained 30 seconds before caudal aspect, spatial variations in contrast material appear in spleen. Journal of Vascular Surgery 1993 18, 656-665DOI: (10.1016/0741-5214(93)90075-W) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, Maximum-intensity projection of abdominal aortic aneurysm demonstrates contrast-filled lumen (L), mural thrombus (T), and mural calcifications (C).B, Left anterior oblique shaded-surface display of another patient with abdominal aortic aneurysm. Although main renal arteries (straight arrows) arise above neck of aneurysm, small left accessory renal artery (curved arrow) and patient inferior mesenteric artery (open arrow) arise from anterior aspect of aneurysm. C, Conventional aortogram of same patient as in Fig. 4, B. Journal of Vascular Surgery 1993 18, 656-665DOI: (10.1016/0741-5214(93)90075-W) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Right anterior oblique shaded-surface display in patient with abdominal aortic dissection simultaneously demonstrates false lumen (F) and true lumen (T). Renal arteries (straight arrows), celiac trunk (c), and superior mesenteric artery (s) receive supply from true lumen. Journal of Vascular Surgery 1993 18, 656-665DOI: (10.1016/0741-5214(93)90075-W) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Maximum-intensity projection in patient with abdominal aortic aneurysm, associated with three renal artery stenoses (curved arrows). Severity of right accessory lower pole renal artery stenosis results in diminished right lower pole nephrogram (straight arrow). Mural thrombus and calcifications are seen in distal abdominal aorta (M). Journal of Vascular Surgery 1993 18, 656-665DOI: (10.1016/0741-5214(93)90075-W) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Left anterior oblique shaded-surface display of abdominal aorta after end-to-side aortobifemoral bypass grafting. Flow is seen in two reimplanted left renal arteries (small black arrows); however, there is stenotic anastomosis between upper pole renal artery graft with native vessel (curved arrow). Patency of reimplanted inferior mesenteric artery (white arrow) is established. Journal of Vascular Surgery 1993 18, 656-665DOI: (10.1016/0741-5214(93)90075-W) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 Curved-plane reformation image of renal arteries after placement of left renal artery stent. Position of stent (white arrow) is established with respect to aorta and left renal artery origin. Patency is established by observation of high-attenuation contrast material in stent lumen and opacification of distal renal artery. Small black arrows indicate aortic intimal dissection. Journal of Vascular Surgery 1993 18, 656-665DOI: (10.1016/0741-5214(93)90075-W) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions