Atlas of CT Angiography: Normal and Pathologic Findings [2nd ed.] 978-3-030-16094-4;978-3-030-16095-1

Table of contents :
Front Matter ....Pages i-xvi
Cerebral Angiography (Gratian Dragoslav Miclaus, Horia Ples)....Pages 1-43
Cerebral Arteriovenous Malformation (Gratian Dragoslav Miclaus, Horia Ples)....Pages 45-81
Carotid Angiography (Gratian Dragoslav Miclaus, Horia Ples)....Pages 83-111
Thoracic Angiography (Gratian Dragoslav Miclaus, Horia Ples)....Pages 113-144
Coronary Angiography (Gratian Dragoslav Miclaus, Horia Ples)....Pages 145-193
Abdominal Angiography (Gratian Dragoslav Miclaus, Horia Ples)....Pages 195-222
Peripheral Angiography (Gratian Dragoslav Miclaus, Horia Ples)....Pages 223-265
Congenital Cardiac Malformations in Children (Gratian Dragoslav Miclaus, Horia Ples)....Pages 267-371
CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media (Gratian Dragoslav Miclaus, Horia Ples)....Pages 373-455

Citation preview

Atlas of CT Angiography Normal and Pathologic Findings Gratian Dragoslav Miclaus Horia Ples Second Edition

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Atlas of CT Angiography

Gratian Dragoslav Miclaus • Horia Ples

Atlas of CT Angiography Normal and Pathologic Findings Second Edition

Gratian Dragoslav Miclaus Department of Computer Tomography SCM Neuromed Timisoara Romania

Horia Ples Department of Neurosurgery Victor Babeș University of Medicine and Pharmacy Timisoara Romania

ISBN 978-3-030-16094-4    ISBN 978-3-030-16095-1 (eBook) https://doi.org/10.1007/978-3-030-16095-1 © Springer Nature Switzerland AG 2019 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG. The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

Preface

Permanent research in the field of medical radio-imaging concerning the non-­ invasive exploration of the circulatory system has led to the appearance and increasing use of the CT multislice for diagnostic purposes. The acquisition by Neuromed Timisoara of the first computed tomography 64 multislice has placed Romania among the countries using state-of-the-art non-invasive technologies for diagnostic purposes. It is used not only for routine investigations but also in the diagnosis of cardiovascular pathology. Worldwide, the existence and use of this technique avoids almost entirely the use of invasive methods for diagnostic purposes, which takes place only in exceptional circumstances. The invasive part of the diagnosis, which is extremely unpleasant to the patient, is thus eliminated from the diagnostic process, and patients now have the possibility of the diagnosis of vascular pathology without hospitalisation. The technique is also beneficial to the doctors, as it enables them to identify and visualise the exact location of the damaged area, the anatomic details and the severity of lesions leading to a more appropriate planning of the operating techniques by the use of 3D reconstruction. The present atlas aims to present some of the more challenging cases explored in our clinic during a period of 11  years. During this period, we explored more than 5000 CT coronary angiographies and more than 25,000 CT angiographies of other anatomic segments. While the imagistic radiographs presented in this paper do not fully cover the vascular pathology, we consider it useful to present them in the hope that a great number of doctors will become familiar with the exploration possibilities given by this non-invasive method. As was previously stated in the first edition, the present paper is subject to constant improvement, as our acquired experience and inventory of cases studied provide us with new and interesting insight. Therefore, we have added three new chapters and supplemented the first chapter with more cases. The new added chapters are Cerebral Arteriovenous Malformations, Congenital Cardiac Malformations in Children and CT Phlebology.

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Technical Principles Computed tomography is a diagnostic technique which utilises X-rays, in which a small fascicle of X-rays axially traverses the patient’s body from different angles. Parallel collimation is used to model the fascicle of rays into a small slot, which defines the width of the scanning plan. Detectors measure the intensity of the reduction of emerging radiation from the patient’s body. A mathematical algorithm is used (inverse radon transformation) to calculate the reduction in each part of the CT section. These local reduction coefficients are then transformed into “CT numbers” and are finally converted into shades of grey which are then, in turn, shown as images. Multislice tomographs allow the acquisition during a single rotation of the tube of a variable number of images (2-6-4), respectively, of a larger volume. The width of the slice is variable, with the spatial resolution growing in reverse proportion with the width. Therefore, for obtaining isotropy, the use of submillimetric widths is necessary. Isotopic acquisition allows us to reconstruct images in all three dimensions without modifying the spatial resolution. Thus, diagnostic accuracy in the case of isotopic acquisition is the same, indifferent of the spatial dimension in which the images are later reconstructed. In the case of Somatom Sensation 64, the spatial resolution of an image is lower than 0.4 mm, and the acquired volume unit (voxel) has the same size for all three dimensions (under 0.4 mm for the x, y and z axes). Obtaining such a resolution is possible due to the technical parameters offered by this machine and, particularly, the high rotation speed of the tube (330  ms) and the technical ability of the STRATON tube to generate two fascicles of X-rays which intertwine, generating the spatial resolution of 0.3 mm. The length which may be scanned is also important; this machine permits the acquiring of images for a length of up to 1540 mm, which makes its use possible in peripheral angiographic studies. All of these technical details, the high scanning speed and high temporal and spatial resolution, allow the use of the computed tomography in coronary angiographic studies, where the investigation of small arteries belonging to a continually moving organ is necessary. The study does not aim to become a technical treaty or one of the CT exam protocols, but we consider it necessary to present a couple of technical possibilities for examination as well as a couple of advantages offered by the use of this type of computed tomography, in relation to the investigated area.

Cerebral CT Angiography In our clinic, we use a scanning protocol which includes a native scan and a scan which follows the injection of intravenous contrast substance. We apply this protocol in order to obtain the subtraction of the bone, which allows the evaluation of the circulation in the cerebral arteries, without the presence of the bone structures of the neurocranium.

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Following the bone subtraction, 3D MIP and 3D VRT reconstructions are used to visualise aneurysms as well as artery-vein malformations (AVM). Coming to the aid of neurosurgeons, we also use 3D VRT reconstructions without bone subtraction, which allows the planning of craniotomies in such a way that the remaining bone defect is at a minimum. The method is also used to check post-operatory evolution in the case of applying metal clips or for selective arterial embolising procedures of the AVM.

Cerebral CT Arteriovenous Malformation The method makes it possible to highlight the cerebral malformation, namely, measuring the nidus and displaying the associated feeder vessels and the drainage vessels. The design of the arteriovenous malformation at the brain level allows it to be included in the Spetzler-Martin scale. In this chapter, we exemplify all five types of Spetzler-Martin classification that are useful to the neurosurgeon, the endovascular neuroradiologist and the radiotherapist. In this chapter, you can find comparative pre- and postoperative images. This shows the value of CT scanning in postoperative follow-up of the patient, as it is also a minimally invasive method versus Seldinger’s angiography.

CT Angiography of the Cervical Region This is used to visualise arterial circulation at the level of the cervical region as well as arterial pathology at this level. Thus, we are able to identify stenoses of the common carotid arteries, internal and external, of other arteries at the base of the neck and of vertebral arteries, as well as perform post-­operatory or post-interventional checks at the level of the before-mentioned arteries. Thus, one can check the patency of carotid stenting, showing the presence or absence of restenosis in the stent. Pre-operatory details regarding the parietal calcification at the level of the carotid arteries may be given. As an examination protocol, we use 64 × 0.6 mm acquisition, with 1 mm reconstruction, and the optimisation of the presence of contrast in the carotid arteries is performed through bolus tests. Post-processing consists of 3D MIP, 3D VRT and 3D MPR reconstructions.

Thoracoabdominal CT Angiography This is used for visualising the pathology of the ascending aorta, of the aortic arch and the descending aorta, of the thoracic and abdominal portions and of the branches emerging from these, as well as for studying pulmonary arteries for pulmonary thromboembolism or for malformative pathology.

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As a scanning protocol, we use 64  ×  0.6  mm scanning, with a variable rotation of the tube, according to the pathology, with 1 mm reconstructions; in order to find SDC presence in the arterial circulation, we use bolus tests.

Peripheral CT Angiography This is used for discerning arterial pathology at the level of the lower and upper limbs. It shows the presence of arterial stenoses in obliterating arteriopathy and allows the evaluation of the venous or synthetic graphs used in bypass interventions, as well as the evaluation of the patency of the stents placed at different levels. It may identify arteriovenous fistulas as well as malformative lesions at the level of the limbs’ circulatory bed.

CT Coronary Angiography CT coronary angiography currently represents one of the most important non-invasive diagnostic possibilities offered by computed tomography. In our clinic, over the course of 1 year, over 500 patients were investigated with the purpose of detecting coronary affections, as well as patients with stents and aorto-coronary bypasses with the purpose of determining their patency. In our CT coronary angiography examining protocol, we use native scanning in order to detect and quantify coronary calcifications (Agatston calcium score), followed, if the calcifications are not severe, by the proper angiographic phase. Optimisation of the presence of the contrast substance at the coronary level is done through bolus tests, with the quantity of contrast substance administered depending on the scanned surface. In order to reduce the dose administered to the patient, we use CARE Dose 4D and modulated ECG acquisition with pulsed ECG. The images are acquired in the format 64 × 0.6 mm, with the reconstruction of axial images at 0.75  mm. Post-processing consists of 3D VRT, 3D MPR and 3D MIP reconstructions. The software of the post-processing unit allows the quantification of the degree of stenosis, expressing the result either as an area or percentage.

Congenital Cardiac Malformations in Children Paediatric cardiac pathology, especially congenital malformative one, represents, through its complexity and, sometimes, dramatic character of its symptomatology, a challenge for the clinician as well as for the radiologist. Throughout my 12 years of activity in our clinic, I have explored around 400 cases of children with congenital cardiac malformations. As an exploration protocol, I have used scanning without ECG synchronisation, with administration of contrast, under IV (intravenous) anaesthesia,

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limiting the duration and exposure to ionising radiation and the length of the scanned area in order to obtain high-quality diagnostic images. The details given by 3D and 3D VRT reconstructions allowed us to specify with great precision the present anatomical modifications and offered a wider field of view that the cardiovascular surgeon can benefit from when planning the operation.

CT Phlebology When exploring the venous system and its pathology, besides Doppler echography, which is the main method of examination, CT phlebography and especially phlebography with anterograde contrast injection can occupy a highly important role in establishing the diagnostic and therapeutic conduit. In our clinic, we have explored about 280 cases using this technique, improving our contrast injection protocol in order to obtain the best opacification of the profound venous system and, implicitly, answer the questions addressed by the physician. The fact that it is possible to view the permeability of the profound veins and perforators, the presence of thrombus as well as anatomical variants and the causes of chronic venous deficiency makes this method a very useful tool that should be taken into consideration when completely evaluating a patient presented with venous pathology of the inferior limbs. Timisoara, Romania

Gratian Dragoslav Miclaus

Contents

1 Cerebral Angiography ��������������������������������������������������������������������   1 1.1 Normal Cerebral Angiography��������������������������������������������������   2 1.2 Arteria Basilaris Aneurysm at the Level of Pars Proximalis������   4 1.3 Aneurysm of Basilar Artery������������������������������������������������������   7 1.4 Aneurysm of Basilar Artery: Follow-Up Examination After 1 Year ������������������������������������������������������������������������������  11 1.5 Wide-Neck Basilar Tip Aneurysm��������������������������������������������  14 1.6 Aneurysm of Medial Third of Basilar Artery: Partially Thrombosis, Associated with Occlusion of Right Internal Carotid Artery ��������������������������������������������������������������������������  17 1.7 Arteria Cerebri Media Sinistra Aneurysm��������������������������������  21 1.8 Arteria Cerebri Media Dextra Aneurysm����������������������������������  24 1.9 Aneurysm of Arteria Pericallosa����������������������������������������������  26 1.10 Aneurysm of Persistent Primitive Hypoglossal Artery ������������  28 1.11 Aneurysm of Arteria Communicans Posterior��������������������������  30 1.12 Aneurysm of Left Arteria Communicans Posterior������������������  32 1.13 Aneurysm of the Left Vertebral Artery: Partially Thrombosis ������������������������������������������������������������������������������  35 1.14 Aneurysm of Posterior Inferior Cerebellar Artery��������������������  38 1.15 Aneurysm of Left Internal Carotid Artery: Partially Thrombosis ������������������������������������������������������������������������������  41 2 Cerebral Arteriovenous Malformation������������������������������������������  45 2.1 Spetzler-Martin Grade 1 Arteriovenous Malformation at the Level of the Right Temporo-Parietal Lobe: Preoperator��������������������������������������������������������������������������������  46 2.2 Spetzler-Martin Grade 1 Arteriovenous Malformation at the Level of the Right Temporo-Parietal Lobe: Postoperator������������������������������������������������������������������������������  49 2.3 Spetzler-Martin Grade 2 Arteriovenous Malformation at the Level of the Left Parietal Lobe����������������������������������������  52 2.4 Spetzler-Martin Grade 3 Arteriovenous Malformation at the Level of the Right Temporal Lobe����������������������������������  56 2.5 Spetzler-Martin Grade 4 Arteriovenous Malformation at the Level of the Right Parieto-occipital and Aneurysm of the Arteria Communicans Anterior��������������������������������������  60

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2.6 Spetzler-Martin Grade 4 Arteriovenous Malformation at the Level of the Left Parietal Lobe: Preoperator������������������  64 2.7 Spetzler-Martin Grade 4 Arteriovenous Malformation at the Level of the Left Parietal Lobe: Postoperator ����������������  68 2.8 Spetzler-Martin Grade 5 Arteriovenous Malformation at the Level of the Left Frontal Lobe: Preoperator ������������������  72 2.9 Spetzler-Martin Grade 5 Arteriovenous Malformation at the Level of the Left Frontal Lobe: Postoperator������������������  76 2.10 Arteriovenous Malformation at the Level of Pars Precentralis Dextra��������������������������������������������������������������������  79 3 Carotid Angiography ����������������������������������������������������������������������  83 3.1 Normal Carotid Angiography ��������������������������������������������������  84 3.2 Anomalous Origin of Arteria Carotis Communis ��������������������  86 3.3 Calcified Atheromatous Plaques at the Level of Arteria Carotis ��������������������������������������������������������������������������������������  88 3.4 Carotid Angiography: Nonobstructive Calcified Atheromatous Plaques��������������������������������������������������������������  90 3.5 Carotid Angiography: Calcified Atheromatous Lesions and Kinking of Arteria Carotis Interna Sinistra������������������������  93 3.6 Short Lesion: Moderate Stenosis of Arteria Carotis Interna Sinistra��������������������������������������������������������������������������  96 3.7 Carotid Angiography Emphasising a Severe Stenotic Lesion (Subocclusive) at the Level of Arteria Carotis Interna Dextra ��������������������������������������������������������������������������  99 3.8 Carotid Angiography Emphasising a Subocclusive Lesion at the Level of the Emerging Arteria Carotis Interna Sinistra�������������������������������������������������������������������������� 102 3.9 Carotid Angiography Ostial Occlusive Lesion at the Level of Arteria Carotis Interna Sinistra ���������������������������������� 104 3.10 Carotid Angiography: Complete Occlusion of the Arteria Carotis Interna Dextra�������������������������������������������������������������� 106 3.11 Carotid Angiography: Severe Stenotic Lesion at the Level of the Pars Proximalis of Arteria Subclavia Sinistra���������������� 108 3.12 Carotid Angiography: Stent Occlusion at the Level of Arteria Subclavia Sinistra ���������������������������������������������������� 110 4 Thoracic Angiography �������������������������������������������������������������������� 113 4.1 Aneurysm of the Aorta Ascendens�������������������������������������������� 114 4.2 Supravalvular Aortic Stenosis �������������������������������������������������� 117 4.3 Aneurysm of the Aorta Ascendens: Isthmic Stenosis �������������� 119 4.4 Aneurysm of the Arcus Aortae�������������������������������������������������� 121 4.5 Aneurysm of the Aorta Ascendens: Chronic Dissection of the Aorta ������������������������������������������������������������������������������ 123 4.6 Post-traumatic Aneurysm of the Aorta Descendens������������������ 125 4.7 Gigantic Aneurysm at the Level of the Aorta Descendens ������ 128

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4.8 Chronic Dissection of the Aorta Descendens���������������������������� 130 4.9 Stenosis of A. Pulmonalis Dextra �������������������������������������������� 132 4.10 Aneurysm and Dissection of the Aorta Ascendens After Valvular Aortic Replacement���������������������������������������������������� 134 4.11 Pulmonary Thromboembolism ������������������������������������������������ 137 4.12 Right Partially Anomalous Venous Drainage���������������������������� 139 4.13 Partially Aberrant Venous Drainage������������������������������������������ 141 4.14 Interrupted Arcus Aortae���������������������������������������������������������� 143 5 Coronary Angiography�������������������������������������������������������������������� 145 5.1 Normal Arteriae Coronariae������������������������������������������������������ 146 5.2 Abnormal Emergence of the R. Circumflexus�������������������������� 149 5.3 Abnormal Emergence of the A. Coronaria Dextra Placed on the Posterior Aortic Wall������������������������������������������������������ 152 5.4 Emergence Through Separate Ostium of the Three A. Coronariae�������������������������������������������������������������������������������� 154 5.5 Abnormal A. Coronaria Dextra Emergence from the Truncus A. Pulmonalis�������������������������������������������������������������� 156 5.6 Coronary and Aortopulmonary Fistulas������������������������������������ 159 5.7 Coronary Calcification�������������������������������������������������������������� 162 5.8 Monovascular Coronary Disease: A. Coronaria Dextra Occlusion���������������������������������������������������������������������������������� 165 5.9 Occlusive Lesion at the Middle Segment of the R. Interventricularis Anterior: Collateral Circulation A. Coronaria Dextra: R. Interventricularis Anterior���������������������� 167 5.10 Bivascular Coronary Disease���������������������������������������������������� 169 5.11 Trivascular Coronary Disease �������������������������������������������������� 172 5.12 Aneurysm of the Left Ventricle and R. Interventricularis Anterior Occlusion�������������������������������������������������������������������� 175 5.13 Monovascular Coronary Disease Patent Stent in the Middle Segment of R. Interventricularis Anterior�������������������� 178 5.14 Restenosis at Stent Level���������������������������������������������������������� 181 5.15 Occlusion of R. Interventricularis Anterior������������������������������ 184 5.16 Coronary Bypass Evaluation���������������������������������������������������� 187 5.17 Fallot Tetralogy ������������������������������������������������������������������������ 189 5.18 Fallot Tetralogy in an Adult Patient������������������������������������������ 192 6 Abdominal Angiography ���������������������������������������������������������������� 195 6.1 Normal Abdominal Angiography���������������������������������������������� 196 6.2 Aneurysm of Truncus Coeliacus and Stenotic Lesion of A. Hepatica Communis�������������������������������������������������������� 199 6.3 Left Renal Arteriovenous Fistula���������������������������������������������� 201 6.4 Aorta Abdominalis Aneurysm with Aortoduodenal Fistula������ 204 6.5 Operated Aorta Abdominalis Aneurysm: Postoperatory Complications �������������������������������������������������������������������������� 207 6.6 Stenosis of A. Renalis Sinistra�������������������������������������������������� 210

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6.7 Right A. Renalis Dextra Occlusion Collateral Circulation for Renal Parenchyma�������������������������������������������������������������� 213 6.8 Dissection of Aorta Abdominalis���������������������������������������������� 216 6.9 Separate Emergence of A. Hepatica Communis and A. Splenica Additional Polar Left Superior A. Renalis Sinistra�������������������������������������������������������������������������������������� 218 6.10 Multiple Aneurysms of A. Splenica Associated with Aneurysm of A. Renalis Dexter������������������������������������������������ 221 7 Peripheral Angiography������������������������������������������������������������������ 223 7.1 Normal Peripheral Angiography ���������������������������������������������� 224 7.2 Leriche Syndrome�������������������������������������������������������������������� 229 7.3 Leriche Syndrome Axillobifemoral Bypass������������������������������ 232 7.4 Leriche Syndrome Aortobifemoral and Femoropopliteal Graft�������������������������������������������������������������� 234 7.5 Aortobifemoral Graft and Aneurysms at the Level of Anastomosis�������������������������������������������������������������������������� 238 7.6 Right Arm Occlusion of the Aortobifemoral Graft ������������������ 241 7.7 Right Femoro-Fibular Graft: Occlusion of the Left Lower Limb Arteries���������������������������������������������������������������� 244 7.8 Iliac and Femoral Stents: In-Stent Restenosis�������������������������� 247 7.9 Iliac and Femoral Stents: Occluded Iliac Stents ���������������������� 250 7.10 Autoimmune Vasculitis ������������������������������������������������������������ 253 7.11 Tumour of the Leg�������������������������������������������������������������������� 256 7.12 Giant Tumour of the Thigh ������������������������������������������������������ 258 7.13 CT Angiography of the Right Upper Limb: Occlusion of the Arteria Radialis Dextra �������������������������������������������������� 260 7.14 Arteriovenous Malformation in Deltoid Region ���������������������� 262 7.15 CTA Run-Off: Incidental Finding�������������������������������������������� 265 8 Congenital Cardiac Malformations in Children �������������������������� 267 8.1 Pulmonary Atresia with MAPCA �������������������������������������������� 269 8.2 Atrial Septal Defect with Pulmonary Hypertension ���������������� 274 8.3 Right Aortic Arch with Aberrant Left Subclavian Artery Arising from Kommerell Diverticulum������������������������������������ 278 8.4 Situs Inversus. Single Atrium. Atrial Septal Defect. Severe Pulmonary Subvalvular Stenosis. Polisplenia �������������� 280 8.5 Aortic Arch Hypoplasia. Agenezia of the Right Superior Vena Cava. Aberrant Left Superior Vena Cava with Drainage in Coronary Sinus������������������������������������������������������ 285 8.6 Patent Ductus Arteriosus���������������������������������������������������������� 288 8.7 Kawasaki Disease �������������������������������������������������������������������� 291 8.7.1 Kawasaki Disease: Baseline Examination�������������������� 291 8.7.2 Kawasaki Disease: Same Patient, After Therapy���������� 294 8.8 Pulmonary Arteriovenous Malformation. Left Aortic Arch with Aberrant Right Subclavian Artery�������������������������������������������� 298 8.9 Double-Outlet Right Ventricle. Pulmonary Stenosis. Systemic-­Pulmonary Shunt. Aberrant Left Superior Vena Cava with Drainage in Coronary Sinus���������������������������� 303

Contents

xv

8.10 Single Lateral Ventricle. Dextrocardia. Cavo-pulmonary Shunt (Glenn Procedure)������������������������������ 309 8.11 Dextrocardia. Aberrant Left Superior Vena Cava Drainage in Coronary Sinus. Left Aortic Arch with Aberrant Right Subclavian Artery������������������������������������ 316 8.12 Aortic Coarctation�������������������������������������������������������������������� 320 8.13 Right Aortic Arch with Aberrant Brachiocephalic Artery with Non-Kommerell Diverticulum. Tracheal Stenosis������������ 323 8.14 Patent Ductus Arteriosus Connected with Right Pulmonary Artery. Severe Stenosis of Pulmonary Trunk���������������������������� 328 8.15 Operated Pentalogy of Fallot. Pulmonary Artery Aneurysm���� 331 8.16 Tetralogy of Fallot�������������������������������������������������������������������� 336 8.16.1 Tetralogy of Fallot: Preoperator������������������������������������ 336 8.16.2 Tetralogy of Fallot: Postoperation�������������������������������� 340 8.17 Single Atrium. Pulmonary Artery Aneurysm. Complete Situs Inversus. Dextrocardia. Left Superior Vena Cava. Left Aortic Arch with Aberrant Right Subclavian Artery Arising from Kommerell Diverticulum���������������������������������������������������������� 344 8.18 Severe Hypoplastic Aortic Arch. Patent Ductus Arteriosus������ 349 8.19 Anomalous Right Pulmonary Venous Return (Sinus Venosus)������������������������������������������������������������������������ 352 8.20 Total Anomalous Pulmonary Venous Return in Coronary Sinus�������������������������������������������������������������������������� 355 8.20.1 Total Anomalous Pulmonary Venous Return in Coronary Sinus: Preoperator������������������������������������ 355 8.20.2 Total Anomalous Pulmonary Venous Return in Coronary Sinus: Postoperator ���������������������������������� 358 8.21 Common Arterial Trunk. Pulmonary Trunk and Right Pulmonary Artery Stenosis. Left Pulmonary Artery from Aorta. Right Aortic Arch with Aberrant Left Subclavian Artery�������������������������������������������������������������� 362 8.21.1 Common Arterial Trunk. Pulmonary Trunk and Right Pulmonary Artery Stenosis. Left Pulmonary Artery from Aorta. Right Aortic Arch with Aberrant Left Subclavian Artery: Preoperator������������������������������������ 362 8.21.2 Common Arterial Trunk. Pulmonary Trunk and Right Pulmonary Artery Stenosis. Left Pulmonary Artery from Aorta. Right Aortic Arch with Aberrant Left Subclavian Artery: Postoperator������������ 366 8.22 Giant Left Atrial Aneurysm������������������������������������������������������ 369 9 CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media������������������������������������������������������ 373 9.1 Anatomic Variation of the Profound Venous System of the Lower Limb������������������������������������������������������� 375 9.2 Post-thrombotic Syndrome After Deep Vein Thrombosis of the Right Calf �������������������������������������������������� 380

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xvi

9.3 Post-thrombotic Syndrome After Deep Vein Thrombosis of the Left Calf with Varicose Dilatation of the Great Saphenous Vein ������������������������������������������������������������������������ 387 9.4 Post-thrombotic Syndrome After Deep Vein Thrombosis of the Right Calf with Occlusion of the Anterior Tibial Veins and Varicose Dilatation of the Great Saphenous Vein���� 393 9.5 Complete Occlusion of Anterior and Fibular Veins and Occlusion of the Distal 1/3 of the Posterior Tibial Veins of the Left Calf������������������������������������������������������ 399 9.6 Acute Thrombosis of the Popliteal and Femoral Right Vein���� 403 9.7 Occlusion of the Fibular Veins�������������������������������������������������� 409 9.8 Occlusion of the Anterior Tibial Veins and Duplication of the Left Femoral Vein ���������������������������������������������������������� 414 9.9 Occlusion of the Anterior Tibial Veins and Acute Thrombosis of the Right Great Saphenous Vein. Extrinsic Compression of Right External Iliac Vein by External Iliac Artery�������������������������������������������������������������������������������� 422 9.10 May-Thurner Syndrome: Complete Occlusion of Common and External Left Iliac Vein, with Prepubic Collateral Circulation���������������������������������������� 429 9.11 Acute Thrombosis of the Left Popliteal and Left Femoral Vein with Open Cocket’s Perforators. Occlusion of the Left Anterior Tibial Veins������������������������������ 437 9.12 Same Patient with Repermeabilization of the Veins, After Treatment. Checkup After 2 Years. Occlusion of the Left Anterior Tibial Veins ���������������������������������������������� 442 9.13 Complete Occlusion of the Right Posterior Tibial and Fibular Veins, Occlusion of the Proximal 1/3 of the Right Popliteal Vein and Occlusion of the Right Femoral Vein �������������������������������������������������������� 447 9.14 May-Thurner Syndrome. Occlusion of the Mid and Proximal 1/3 of Left Femoral Vein, Left Common Femoral Vein and External and Common Left Iliac Vein ���������������������������������������������������� 451

1

Cerebral Angiography

Contents 1.1

Normal Cerebral Angiography

   2

1.2

Arteria Basilaris Aneurysm at the Level of Pars Proximalis

   4

1.3

Aneurysm of Basilar Artery

   7

1.4

Aneurysm of Basilar Artery: Follow-Up Examination After 1 Year

 11

1.5

Wide-Neck Basilar Tip Aneurysm

 14

1.6

 neurysm of Medial Third of Basilar Artery: Partially Thrombosis, A Associated with Occlusion of Right Internal Carotid Artery

 17

1.7

Arteria Cerebri Media Sinistra Aneurysm

 21

1.8

Arteria Cerebri Media Dextra Aneurysm

 24

1.9

Aneurysm of Arteria Pericallosa

 26

1.10 Aneurysm of Persistent Primitive Hypoglossal Artery

 28

1.11 Aneurysm of Arteria Communicans Posterior

 30

1.12 Aneurysm of Left Arteria Communicans Posterior

 32

1.13 Aneurysm of the Left Vertebral Artery: Partially Thrombosis

 35

1.14 Aneurysm of Posterior Inferior Cerebellar Artery

 38

1.15 Aneurysm of Left Internal Carotid Artery: Partially Thrombosis

 41

© Springer Nature Switzerland AG 2019 G. D. Miclaus, H. Ples, Atlas of CT Angiography, https://doi.org/10.1007/978-3-030-16095-1_1

1

1  Cerebral Angiography

2

1.1

Normal Cerebral Angiography Fig. 1.1 Neuro DSA—VRT 1. A. carotis interna 2. A. vertebralis 3. A. basilaris 4. A. cerebri anterior 5. A. cerebri anterior— segmentum A2 6. A. cerebri media— segmentum M1 7. A. cerebri media— segmentum M2 8. A. cerebri posterior

Fig. 1.2  Neuro DSA—MIP

Fig. 1.3  Neuro DSA—VRT

1.1 Normal Cerebral Angiography

3

Fig. 1.4  Neuro DSA—VRT colour

Fig. 1.6  Cerebral angiography 3D VRT reconstruction

Fig. 1.5  Neuro DSA—VRT colour

Fig. 1.7  Cerebral angiography 3D VRT reconstruction

1  Cerebral Angiography

4

1.2

 rteria Basilaris Aneurysm A at the Level of Pars Proximalis Fig. 1.8  Neuro DSA 3D VRT colour reconstruction 1. A. carotis interna 2. A. vertebralis 3. Giant aneurysm 4. A. basilaris 5. A. cerebri media— segmentum M1 6. A. cerebri anterior— segmentum A2 7. A. cerebri anterior— segmentum A1 8. A. cerebri posterior

Fig. 1.9  Neuro DSA 3D MIP reconstruction

Fig. 1.10  Neuro DSA 3D MIP reconstruction

1.2 Arteria Basilaris Aneurysm at the Level of Pars Proximalis

5

Fig. 1.11  Neuro DSA 3D VRT colour reconstruction

Fig. 1.13  Cerebral angiography 3D VRT reconstruction in posterior coronal plan. The arrow indicates the aneurysm

Fig. 1.12  Cerebral angiography axial 3D VRT reconstruction. The arrow indicates the aneurysm

Fig. 1.14  Cerebral angiography 3D VRT reconstruction, sagittal plane. The arrow indicates the aneurysm

6

Fig. 1.15  Endoluminal navigation

1  Cerebral Angiography

1.3 Aneurysm of Basilar Artery

1.3

7

Aneurysm of Basilar Artery

Fig. 1.16  3D VRT reconstruction. The arrow indicates aneurysm of basilar artery

8

1  Cerebral Angiography

Fig. 1.17  3D VRT reconstruction. The arrow indicates aneurysm of basilar artery 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris

Fig. 1.19 Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of basilar artery 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

Fig. 1.18 Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of basilar artery 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

Fig. 1.20 Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of basilar artery 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

1.3 Aneurysm of Basilar Artery

9

Fig. 1.21 Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of basilar artery 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

Fig. 1.23  3D MIP reconstruction 1. Arteria basilaris 2. Aneurysm of basilar artery

Fig. 1.22  3D MIP reconstruction 1. Arteria basilaris 2. Aneurysm of basilar artery

Fig. 1.24  3D MIP reconstruction 1. Arteria basilaris 2. Aneurysm of basilar artery 3. Arteria vertebralis 4. Arteria cerebri media

10

Fig. 1.25  3D MIP reconstruction 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Aneurysm of basilar artery

1  Cerebral Angiography

1.4 Aneurysm of Basilar Artery: Follow-Up Examination After 1 Year

1.4

11

 neurysm of Basilar Artery: A Follow-Up Examination After 1 Year Fig. 1.26  3D VRT reconstruction. The arrow indicates aneurysm of basilar artery (significantly larger than previous examination) 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris

12

1  Cerebral Angiography

Fig. 1.27  3D VRT reconstruction. The arrow indicates aneurysm of basilar artery (significantly larger than previous examination) 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris

Fig. 1.29 Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of basilar artery (significantly larger than previous examination) 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

Fig. 1.28 Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of basilar artery (significantly larger than previous examination) 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

Fig. 1.30 Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of basilar artery (significantly larger than previous examination) 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

1.4 Aneurysm of Basilar Artery: Follow-Up Examination After 1 Year

13

Fig. 1.31 Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of basilar artery (significantly larger than previous examination) 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

Fig. 1.33  3D MIP reconstruction. The arrow indicates aneurysm of basilar artery (significantly larger than previous examination)

Fig. 1.32  3D MIP reconstruction. The arrow indicates aneurysm of basilar artery (significantly larger than previous examination)

Fig. 1.34  3D MIP reconstruction 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Aneurysm of basilar artery (significantly larger than previous examination)

1  Cerebral Angiography

14

1.5

Wide-Neck Basilar Tip Aneurysm Fig. 1.35  Neuro DSA 3D VRT reconstruction. The arrow indicates wide-neck basilar tip aneurysm 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

1.5 Wide-Neck Basilar Tip Aneurysm

15

Fig. 1.36 Neuro DSA 3D VRT reconstruction. The arrow indicates wide-neck basilar tip aneurysm 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

Fig. 1.38  3D VRT reconstruction. The arrow indicates wide-neck basilar tip aneurysm 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris

Fig. 1.37 Neuro DSA 3D VRT reconstruction. The arrow indicates wide-neck basilar tip aneurysm 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

Fig. 1.39  3D VRT reconstruction. The arrow indicates wide-neck basilar tip aneurysm 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris

16

1  Cerebral Angiography

Fig. 1.40  3D MIP reconstruction. The arrow indicates wide-neck basilar tip aneurysm 1. Arteria cerebri anterior 2. Arteria cerebri media

Fig. 1.42  3D MIP reconstruction. The arrow indicates wide-neck basilar tip aneurysm 1. Arteria basilaris 2. Arteria vertebralis

Fig. 1.41  3D MIP reconstruction. The arrow indicates wide-neck basilar tip aneurysm 1. Arteria basilaris

Fig. 1.43  Neuro DSA 3D MIP reconstruction. The arrow indicates wide-neck basilar tip aneurysm 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

1.6  Aneurysm of Medial Third of Basilar Artery: Partially Thrombosis, Associated with Occlusion of Right…

1.6

Aneurysm of Medial Third of Basilar Artery: Partially Thrombosis, Associated with Occlusion of Right Internal Carotid Artery Fig. 1.44  3D VRT reconstruction. The arrow indicates aneurysm of medial 1/3 basilar artery 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris

17

18

1  Cerebral Angiography

Fig. 1.45  3D VRT reconstruction. The arrow indicates aneurysm of medial 1/3 basilar artery 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris

Fig. 1.47 Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of medial 1/3 basilar artery and arrowhead indicates occlusion of right internal carotid artery 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria vertebralis 6. Arteria carotis interna sinistra

Fig. 1.46  3D VRT reconstruction. The arrow indicates aneurysm of medial 1/3 basilar artery 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris

Fig. 1.48 Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of medial 1/3 basilar artery 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

1.6  Aneurysm of Medial Third of Basilar Artery: Partially Thrombosis, Associated with Occlusion of Right…

Fig. 1.49 Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of medial 1/3 basilar artery 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris

Fig. 1.51  3D MIP reconstruction 1. Aneurysm of medial 1/3 basilar artery 2. Partially thrombosis of the aneurysm 3. Arteria basilaris

Fig. 1.50  3D MIP reconstruction 1. Arteria basilaris 2. Aneurysm of medial 1/3 basilar artery 3. Partially thrombosis of the aneurysm

Fig. 1.52  3D MIP reconstruction 1. Aneurysm of medial 1/3 basilar artery 2. Partially thrombosis of the aneurysm 3. Arteria basilaris

19

20

Fig. 1.53  3D MIP reconstruction 1. Aneurysm of medial 1/3 basilar artery 2. Arteria basilaris 3. Arteria vertebralis 4. Arteria cerebri media

1  Cerebral Angiography

1.7 Arteria Cerebri Media Sinistra Aneurysm

1.7

21

 rteria Cerebri Media A Sinistra Aneurysm Fig. 1.54  Neuro DSA 3D VRT reconstruction 1. A. carotis interna 2. A. vertebralis 3. A. cerebri anterior— segmentum A1 4. A. cerebri anterior— segmentum A2 5. A. cerebri media— segmentum M1 6. A. cerebri media— segmentum M2 7. Aneurysm 8. A. basilaris

Fig. 1.55  Neuro DSA 3D VRT colour reconstruction. The arrow indicates the aneurysm

Fig. 1.56  Neuro DSA 3D VRT colour reconstruction. The arrow indicates the aneurysm

22

1  Cerebral Angiography

Fig. 1.57 Neuro DSA 3D VRT reconstruction. The arrow indicates the aneurysm

Fig. 1.59  Cerebral angiography 3D VRT colour reconstruction, enlarged image. The arrow indicates the aneurysm

Fig. 1.58  Neuro DSA 3D VRT colour reconstruction, enlarged image. The arrow indicates the aneurysm

Fig. 1.60  Neuro DSA 3D VRT colour reconstruction, enlarged image. The arrow indicates the aneurysm

1.7 Arteria Cerebri Media Sinistra Aneurysm

Fig. 1.61  Neuro DSA 3D VRT colour reconstruction, enlarged image. The arrow indicates the aneurysm

23

1  Cerebral Angiography

24

1.8

 rteria Cerebri Media Dextra A Aneurysm

Fig. 1.62  Neuro DSA 3D VRT reconstruction 1. Arteria carotis interna 2. Arteria cerebri media—segmentum M1 3. Arteria cerebri media—segmentum M2 4. Aneurysm 5. Arteria cerebri anterior—segmentum A1 6. Arteria cerebri anterior—segmentum A2 7. Arteria basilaris 8. Arteria vertebralis

Fig. 1.63  Neuro DSA 3D VRT colour reconstruction, enlarged image. The arrow indicates the aneurysm Fig. 1.64  Neuro DSA 3D VRT colour reconstruction. The arrow indicates the aneurysm

1.8 Arteria Cerebri Media Dextra Aneurysm

25

Fig. 1.65  Neuro DSA 3D VRT colour reconstruction. The arrow indicates the aneurysm

Fig. 1.67  Cerebral angiography, 3D VRT colour reconstruction, intraventricular catheter for external drainage. The arrow indicates the aneurysm

Fig. 1.66  Arteria communicans anterior aneurysm 1. Aneurysm 2. Arteria callosomarginalis 3. Arteria pericallosa 4. Arteria cerebri anterior—segmentum (A1)

Fig. 1.68  Cerebral angiography, 3D VRT colour reconstruction, intraventricular catheter for external drainage. The arrow indicates the aneurysm

1  Cerebral Angiography

26

1.9

Aneurysm of Arteria Pericallosa Fig. 1.69  Neuro DSA, 3D VRT colour reconstruction 1. Arteria carotis interna 2. Aneurysm 3. Arteria frontobasalis medialis 4. Arteria pericallosa 5. Arteria callosomarginalis 6. Arteria cerebri media 7. Arteria basilaris

Fig. 1.70  Neuro DSA, 3D VRT colour reconstruction. The arrow indicates the aneurysm

Fig. 1.71 Neuro DSA, 3D MIP reconstruction. The arrow indicates the aneurysm

1.9 Aneurysm of Arteria Pericallosa

27

Fig. 1.72  Cerebral angiography 3D VRT colour reconstruction, aneurysm (arrow) of arteria pericallosa

Fig. 1.74  Cerebral angiography 3D VRT colour reconstruction, aneurysm (arrow) of arteria pericallosa

Fig. 1.73  Cerebral angiography 3D VRT colour reconstruction, aneurysm (arrow) of arteria pericallosa

Fig. 1.75  Cerebral angiography 3D VRT colour reconstruction, aneurysm (arrow) of arteria pericallosa

28

1  Cerebral Angiography

1.10 Aneurysm of Persistent Primitive Hypoglossal Artery Fig. 1.76 Arteria hypoglossi primitiva persistent aneurysm 1. Arteria carotis interna dextra 2. Arteria carotis interna sinistra 3. Arteria basilaris 4. Persistent arteria hypoglossi primitiva 5. Aneurysm 6. Doubled internal carotid artery which is tributary to the posterior circulation

Fig. 1.77  Neuro DSA 3D MIP reconstruction with the visualisation of the aneurysm. The full arrow indicates aneurysm

Fig. 1.78  Axial image with the visualisation of the persistent a. hypoglossi primitiva in the canalis nervi hypoglossi and presence of the aneurysm. The arrow with contour indicates a. hypoglossi + aneurysm

1.10 Aneurysm of Persistent Primitive Hypoglossal Artery

29

Fig. 1.79  The trajectory of a. hypoglossi in the canalis nervi hypoglossi with the visualisation of the aneurysm Full arrow = arteria basilaris Arrow with contour = aneurysm

Fig. 1.81  The trajectory of a. hypoglossi in the canalis nervi hypoglossi with the visualisation of the aneurysm Arrow with contour = aneurysm

Fig. 1.80  The trajectory of a. hypoglossi in the canalis nervi hypoglossi with visualisation of the aneurysm Arrow with contour = aneurysm

30

1  Cerebral Angiography

1.11 Aneurysm of Arteria Communicans Posterior Fig. 1.82  Neuro DSA, 3D VRT reconstruction 1. A. carotis interna 2. Aneurysm 3. A. cerebri media 4. A. cerebri anterior— segmentum A1 5. A. cerebri anterior— segmentum A2 6. A. vertebralis

Fig. 1.83  Neuro DSA, 3D VRT reconstruction. The arrow indicates the aneurysm

Fig. 1.84  Neuro DSA, 3D VRT reconstruction. The arrow indicates the aneurysm

1.11 Aneurysm of Arteria Communicans Posterior

31

Fig. 1.85  Cerebral angiography 3D VRT colour reconstruction. The arrow indicates the aneurysm

Fig. 1.87  Cerebral angiography 3D VRT colour reconstruction. The arrow indicates the aneurysm

Fig. 1.86  Cerebral angiography 3D VRT colour reconstruction. The arrow indicates the aneurysm

Fig. 1.88  Cerebral angiography 3D VRT colour reconstruction. The arrow indicates the aneurysm

32

1  Cerebral Angiography

1.12 A  neurysm of Left Arteria Communicans Posterior Fig. 1.89  Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of left arteria communicans posterior 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

1.12 Aneurysm of Left Arteria Communicans Posterior

33

Fig. 1.90 Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of left arteria communicans posterior 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

Fig. 1.92  3D VRT reconstruction. The arrow indicates aneurysm of left arteria communicans posterior 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris

Fig. 1.91 Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of left arteria communicans posterior 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

Fig. 1.93  3D VRT reconstruction. The arrow indicates aneurysm of left arteria communicans posterior 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris

34

1  Cerebral Angiography

Fig. 1.94  3D VRT reconstruction. The arrow indicates aneurysm of eft arteria communicans posterior 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris

Fig. 1.96  3D MIP reconstruction. The arrow indicates aneurysm of left arteria communicans posterior 1. Arteria cerebri anterior 2. Arteria cerebri media

Fig. 1.95  3D MIP reconstruction. The arrow indicates aneurysm of left arteria communicans posterior 1. Arteria cerebri anterior 2. Arteria cerebri media

Fig. 1.97  3D MIP reconstruction. The arrow indicates aneurysm of left arteria communicans posterior

1.13 Aneurysm of the Left Vertebral Artery: Partially Thrombosis

35

1.13 Aneurysm of the Left Vertebral Artery: Partially Thrombosis

Fig. 1.98  3D VRT reconstruction. The arrow indicates aneurysm of vertebral artery—partially thrombosis 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria basilaris 4. Arteria vertebralis

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1  Cerebral Angiography

Fig. 1.99  3D VRT reconstruction. The arrow indicates aneurysm of vertebral artery—partially thrombosis 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria basilaris 4. Arteria vertebralis

Fig. 1.101  3D MIP reconstruction. The arrow indicates aneurysm of vertebral artery—partially thrombosis

Fig. 1.100  3D VRT reconstruction. The arrow indicates aneurysm of vertebral artery—partially thrombosis 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria basilaris 4. Arteria vertebralis

Fig. 1.102  3D MIP reconstruction. The arrow indicates aneurysm of vertebral artery—partially thrombosis 1. Arteria vertebralis 2. Arteria basilaris

1.13 Aneurysm of the Left Vertebral Artery: Partially Thrombosis

Fig. 1.103  3D MIP reconstruction. The arrow indicates aneurysm of vertebral artery—partially thrombosis 1. Arteria vertebralis 2. Arteria basilaris

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1  Cerebral Angiography

1.14 Aneurysm of Posterior Inferior Cerebellar Artery Fig. 1.104  3D VRT reconstruction. The arrow indicates aneurysm of PICA 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria basilaris 4. Arteria vertebralis 5. Arteria inferior posterior cerebelli

1.14 Aneurysm of Posterior Inferior Cerebellar Artery

39

Fig. 1.105  Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of PICA 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna 6. Arteria inferior posterior cerebelli

Fig. 1.107  Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of PICA 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna 6. Arteria inferior posterior cerebelli

Fig. 1.106  Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of PICA 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna 6. Arteria inferior posterior cerebelli

Fig. 1.108  Neuro DSA 3D MIP reconstruction. The arrow indicates aneurysm of PICA 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna 6. Arteria inferior posterior cerebelli

40

Fig. 1.109  3D MIP reconstruction. The arrow indicates aneurysm of PICA

Fig. 1.110  3D MIP reconstruction. The arrow indicates aneurysm of PICA

1  Cerebral Angiography

Fig. 1.111  3D MIP reconstruction. The arrow indicates aneurysm of PICA

1.15 Aneurysm of Left Internal Carotid Artery: Partially Thrombosis

41

1.15 A  neurysm of Left Internal Carotid Artery: Partially Thrombosis Fig. 1.112  Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of left internal carotid artery—partially thrombosis 1. Arteria carotis interna 2. Arteria cerebri media 3. Arteria cerebri anterior 4. Arteria vertebralis 5. Arteria basilaris

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1  Cerebral Angiography

Fig. 1.113  Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of left internal carotid artery— partially thrombosis 1. Arteria carotis interna 2. Arteria cerebri media 3. Arteria cerebri anterior 4. Arteria vertebralis 5. Arteria basilaris

Fig. 1.115  Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of left internal carotid artery— partially thrombosis 1. Arteria carotis interna 2. Arteria cerebri media 3. Arteria cerebri anterior 4. Arteria vertebralis 5. Arteria basilaris

Fig. 1.114  Neuro DSA 3D VRT reconstruction. The arrow indicates aneurysm of left internal carotid artery— partially thrombosis 1. Arteria carotis interna 2. Arteria cerebri media 3. Arteria cerebri anterior 4. Arteria vertebralis 5. Arteria basilaris

Fig. 1.116  3D VRT reconstruction. The arrow indicates aneurysm of left internal carotid artery—partially thrombosis 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris

1.15 Aneurysm of Left Internal Carotid Artery: Partially Thrombosis

Fig. 1.117  3D VRT reconstruction. The arrow indicates aneurysm of left internal carotid artery—partially thrombosis 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris

Fig. 1.118  3D MIP reconstruction—axial. The arrow indicates aneurysm of left internal carotid artery—partially thrombosis

43

Fig. 1.119  3D MIP reconstruction—sagittal. The arrow indicates aneurysm of left internal carotid artery—partially thrombosis

Fig. 1.120  3D MIP reconstruction—coronal. The arrow indicates aneurysm of left internal carotid artery—partially thrombosis 1. Arteria cerebri anterior 2. Arteria cerebri media 3. Arteria vertebralis 4. Arteria basilaris

2

Cerebral Arteriovenous Malformation

Contents 2.1 2.2 2.3 2.4

 petzler-Martin Grade 1 Arteriovenous Malformation at the Level of S the Right Temporo-Parietal Lobe: Preoperator

 46

 petzler-Martin Grade 1 Arteriovenous Malformation at the Level of S the Right Temporo-Parietal Lobe: Postoperator

 49

 petzler-Martin Grade 2 Arteriovenous Malformation at the Level S of the Left Parietal Lobe

 52

 petzler-Martin Grade 3 Arteriovenous Malformation at the Level S of the Right Temporal Lobe

 56

2.5

 petzler-Martin Grade 4 Arteriovenous Malformation at the Level of S the Right Parieto-occipital and Aneurysm of the Arteria Communicans Anterior  60

2.6

 petzler-Martin Grade 4 Arteriovenous Malformation at the Level S of the Left Parietal Lobe: Preoperator

 64

 petzler-Martin Grade 4 Arteriovenous Malformation at the Level S of the Left Parietal Lobe: Postoperator

 68

 petzler-Martin Grade 5 Arteriovenous Malformation at the Level of S the Left Frontal Lobe: Preoperator

 72

 petzler-Martin Grade 5 Arteriovenous Malformation at the Level S of the Left Frontal Lobe: Postoperator

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2.7 2.8 2.9

2.10 Arteriovenous Malformation at the Level of Pars Precentralis Dextra

© Springer Nature Switzerland AG 2019 G. D. Miclaus, H. Ples, Atlas of CT Angiography, https://doi.org/10.1007/978-3-030-16095-1_2

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2  Cerebral Arteriovenous Malformation

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2.1

 petzler-Martin Grade 1 S Arteriovenous Malformation at the Level of the Right Temporo-Parietal Lobe: Preoperator Fig. 2.1  3D VRT reconstruction Arrow: arteriovenous malformation—nidus

2.1 Spetzler-Martin Grade 1 Arteriovenous Malformation at the Level of the Right Temporo-Parietal…

Fig. 2.2  Neuro DSA—VRT 2. Arteria cerebri media—segmentum M1 3. Sinus transversalis 4. Sinus sagittalis superior 5. Arteria vertebralis dextra Arrow: arteriovenous malformation—nidus

Fig. 2.3  Neuro DSA—VRT 1. Arteria carotis interna dextra 2. Arteria cerebri media—segmentum M1 3. Sinus transversalis 4. Sinus sagittalis superior 5. Arteria vertebralis dextra 6. Arteria cerebri anterior—segmentum A2 Arrow: arteriovenous malformation—nidus

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Fig. 2.4  Neuro DSA—VRT 1. Arteria carotis interna dextra 2. Arteria cerebri media—segmentum M1 3. Arteria cerebri anterior—segmentum A2 4. Arteria vertebralis dextra 5. Arteria basilaris Arrow: arteriovenous malformation—nidus

2  Cerebral Arteriovenous Malformation

Fig. 2.6  3D MIP reconstruction Maximum diameter of the nidus—Spetzler-Martin grade 1 AVM

Intraoperator image Arrowhead: arteriovenous malformation Star: normal brain

Fig. 2.5  3D MIP reconstruction 1. Arteria cerebri media—segmentum M1 2. Arteriovenous malformation—nidus

2.2  Spetzler-Martin Grade 1 Arteriovenous Malformation at the Level of the Right Temporo-Parietal…

2.2

 petzler-Martin Grade 1 S Arteriovenous Malformation at the Level of the Right Temporo-Parietal Lobe: Postoperator Fig. 2.7  3D VRT reconstruction Arrow: craniotomy

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Fig. 2.8  Neuro DSA—VRT 1. Arteria carotis interna dextra 2. Arteria cerebri media—segmentum M1 3. Sinus transversalis 4. Sinus sagittalis superior 5. Arteria vertebralis dextra

2  Cerebral Arteriovenous Malformation

Fig. 2.9  Neuro DSA—VRT 1. Arteria carotis interna dextra 2. Arteria cerebri media—segmentum M1 3. Sinus transversalis 4. Sinus sagittalis superior 5. Arteria vertebralis dextra 6. Arteria cerebri anterior—segmentum A2

2.2  Spetzler-Martin Grade 1 Arteriovenous Malformation at the Level of the Right Temporo-Parietal…

Fig. 2.11  3D MIP reconstruction 1. Arteria cerebri media—segmentum M1 Arrow - Vascular clip Fig. 2.10  Neuro DSA—VRT 1. Arteria carotis interna dextra 2. Arteria cerebri media—segmentum M1 3. Arteria cerebri anterior—segmentum A2 4. Arteria vertebralis dextra 5. Arteria basilaris

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2.3

 petzler-Martin Grade 2 S Arteriovenous Malformation at the Level of the Left Parietal Lobe Fig. 2.12  Neuro DSA— VRT 1. Arteria carotis interna 2. Arteria cerebri media—segmentum M1 3. Sinus sagittalis superior 4. Arteria vertebralis 5. Arteria basilaris Arrow: arteriovenous malformation—nidus

2.3  Spetzler-Martin Grade 2 Arteriovenous Malformation at the Level of the Left Parietal Lobe

Fig. 2.13  Neuro DSA—VRT 1. Arteria carotis interna 2. Arteria cerebri media—segmentum M1 3. Sinus sagittalis superior 4. Arteria vertebralis 5. Arteria basilaris 6. Arteria cerebri anterior—segmentum A2 7. Sinus rectus Arrow: arteriovenous malformation—nidus

Fig. 2.14  Neuro DSA—VRT 1. Arteria carotis interna 2. Arteria cerebri media—segmentum M1 3. Sinus sagittalis superior 4. Arteria vertebralis 5. Arteria basilaris 6. Arteria cerebri anterior—segmentum A2 7. Sinus rectus Arrow: arteriovenous malformation—nidus

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Fig. 2.15  Neuro DSA—VRT 1. Arteria carotis interna 2. Arteria cerebri media—segmentum M1 3. Sinus sagittalis superior 4. Arteria vertebralis 5. Arteria basilaris 6. Arteria cerebri anterior—segmentum A2 Arrow: arteriovenous malformation—nidus

Fig. 2.16  3D VRT reconstruction 1. Arteria cerebri media—segmentum M1 Arrow: arteriovenous malformation—nidus

2  Cerebral Arteriovenous Malformation

Fig. 2.17  3D MIP reconstruction 1. Arteria cerebri media—segmentum M1 Arrow: arteriovenous malformation—nidus

Fig. 2.18  3D MIP reconstruction Arrow: arteriovenous malformation—nidus

2.3  Spetzler-Martin Grade 2 Arteriovenous Malformation at the Level of the Left Parietal Lobe

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Fig. 2.19  3D MIP reconstruction 1. Arteria cerebri anterior—segmentum A2 2. Feeder artery from branches of the left posterior cerebral artery Arrow - Nidus

Fig. 2.20  3D MIP reconstruction Maximum diameter of the nidus—Spetzler-Martin grade 2 AVM

2  Cerebral Arteriovenous Malformation

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2.4

 petzler-Martin Grade 3 S Arteriovenous Malformation at the Level of the Right Temporal Lobe Fig. 2.21 Neuro DSA—VRT 1. Arteria carotis interna dextra 2. Arteria cerebri media—segmentum M1 3. Sinus sagittalis superior 4. Arteria vertebralis dextra 5. Arteria basilaris 6. Arteria cerebri anterior—segmentum A2 7. Sinus transversalis Arrow: arteriovenous malformation—nidus

2.4 Spetzler-Martin Grade 3 Arteriovenous Malformation at the Level of the Right Temporal Lobe

Fig. 2.22  Neuro DSA—VRT 1. Arteria carotis interna dextra 2. Arteria cerebri media—segmentum M1 3. Sinus sagittalis superior 4. Arteria vertebralis dextra 5. Arteria basilaris 6. Arteria cerebri anterior—segmentum A2 7. Sinus transversalis Arrow: arteriovenous malformation—nidus

Fig. 2.23  Neuro DSA—VRT 1. Arteria carotis interna dextra 2. Arteria cerebri media—segmentum M1 3. Sinus sagittalis superior 4. Arteria vertebralis dextra 5. Arteria basilaris 6. Arteria cerebri anterior—segmentum A2 7. Sinus transversalis Arrow: arteriovenous malformation—nidus

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Fig. 2.24  Neuro DSA—VRT 1. Arteria carotis interna dextra 2. Arteria cerebri media—segmentum M1 3. Sinus sagittalis superior 4. Sinus transversalis Arrow: arteriovenous malformation—nidus Arrowheads: cortical venous drainage

Fig. 2.25  3D VRT reconstruction 1. Arteria cerebri media—segmentum M1 Arrow: arteriovenous malformation—nidus

2  Cerebral Arteriovenous Malformation

Fig. 2.26  3D MIP reconstruction 1. Arteria cerebri media—segmentum M1 2. Arteriovenous malformation—nidus

Fig. 2.27  3D MIP reconstruction 1. Arteria cerebri media—segmentum M1 2. Arteriovenous malformation—nidus

2.4 Spetzler-Martin Grade 3 Arteriovenous Malformation at the Level of the Right Temporal Lobe

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Fig. 2.29  3D MIP reconstruction Maximum diameter of the nidus—Spetzler-Martin grade 3 AVM Fig. 2.28  3D MIP reconstruction 1. Arteria cerebri media—segmentum M1 2. Arteriovenous malformation—nidus 3. Arteria basilaris 4. Cortical venous drainage

2  Cerebral Arteriovenous Malformation

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2.5

 petzler-Martin Grade 4 S Arteriovenous Malformation at the Level of the Right Parieto-occipital and Aneurysm of the Arteria Communicans Anterior Fig. 2.30 Neuro DSA—VRT 1. Arteria carotis interna dextra 2. Arteria cerebri media—segmentum M1 3. Sinus sagittalis superior 4. Arteria vertebralis dextra 5. Arteria basilaris Arrow: arteriovenous malformation—nidus Arrowhead: aneurysm of the arteria communicans anterior

2.5  Spetzler-Martin Grade 4 Arteriovenous Malformation at the Level of the Right Parieto-occipital…

Fig. 2.31  Neuro DSA—VRT 1. Arteria carotis interna dextra 2. Arteria cerebri anterior—segmentum A2 3. Arteria vertebralis dextra 4. Sinus sagittalis superior 5. Sinus transversalis Arrow: arteriovenous malformation—nidus Arrowhead: aneurysm of the arteria communicans anterior

Fig. 2.32  Neuro DSA—VRT 1. Arteria carotis interna dextra 2. Arteria cerebri media—segmentum M1 3. Sinus sagittalis superior 4. Arteria vertebralis dextra 5. Arteria cerebri anterior—segmentum A2 Arrow: arteriovenous malformation—nidus Arrowhead: aneurysm of the arteria communicans anterior

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Fig. 2.35  3D VRT reconstruction 1. Arteria cerebri anterior—segmentum A2 2. Aneurysm of the arteria communicans anterior

Fig. 2.33  Neuro DSA—VRT 1. Arteria carotis interna dextra 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis dextra 4. Arteria basilaris 5. Arteria cerebri anterior—segmentum A2 Arrow: arteriovenous malformation—nidus Arrowhead: aneurysm of the arteria communicans anterior

Fig. 2.36  Neuro DSA—VRT 1. Arteria carotis interna dextra 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis dextra 4. Arteria basilaris 5. Arteria cerebri anterior—segmentum A2 Arrow: arteriovenous malformation—nidus Arrowhead: aneurysm of the arteria communicans anterior Fig. 2.34  3D VRT reconstruction Arrow: arteriovenous malformation—nidus Arrowhead: aneurysm of the arteria communicans anterior

2.5  Spetzler-Martin Grade 4 Arteriovenous Malformation at the Level of the Right Parieto-occipital…

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Fig. 2.37  3D MIP reconstruction 1. Arteria cerebri anterior—segmentum A2 2. Aneurysm of the arteria communicans anterior 3. Arteria basilaris

Fig. 2.39  3D MIP reconstruction Maximum diameter of the nidus—Spetzler-Martin grade 4 AVM

Fig. 2.38  3D MIP reconstruction 1. Arteria cerebri media—segmentum M1 2. Aneurysm of the arteria communicans anterior 3. Arteriovenous malformation—nidus

2  Cerebral Arteriovenous Malformation

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2.6

 petzler-Martin Grade 4 S Arteriovenous Malformation at the Level of the Left Parietal Lobe: Preoperator

Fig. 2.40  3D VRT reconstruction Arrow: arteriovenous malformation—nidus

2.6  Spetzler-Martin Grade 4 Arteriovenous Malformation at the Level of the Left Parietal Lobe: Preoperator

Fig. 2.41  Neuro DSA—3D VRT 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna 6. Sinus sagittalis superior 7. Sinus rectus Arrow: arteriovenous malformation—nidus

Fig. 2.42  Neuro DSA—3D MIP 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna 6. Sinus sagittalis superior 7. Sinus rectus Arrow: arteriovenous malformation—nidus

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Fig. 2.45  3D VRT reconstruction Arrow: arteriovenous malformation—nidus

Fig. 2.43  Neuro DSA—3D MIP 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Sinus sagittalis superior Arrow: arteriovenous malformation, nidus with venous drainage

Fig. 2.44  3D VRT reconstruction Arrow: arteriovenous malformation—nidus

Fig. 2.46  Neuro DSA—3D VRT 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna 6. Sinus sagittalis superior Arrow: arteriovenous malformation—nidus

2.6  Spetzler-Martin Grade 4 Arteriovenous Malformation at the Level of the Left Parietal Lobe: Preoperator

Fig. 2.47  Neuro DSA—3D VRT 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna 6. Sinus sagittalis superior 7. Sinus rectus Arrow: arteriovenous malformation—nidus

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Fig. 2.48  Neuro DSA—3D VRT 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna 6. Sinus sagittalis superior 7. Sinus rectus Arrow: arteriovenous malformation—nidus

Fig. 2.49  3D MIP reconstruction Maximum diameter of the nidus—Spetzler-Martin grade 4 AVM

2  Cerebral Arteriovenous Malformation

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2.7

 petzler-Martin Grade 4 S Arteriovenous Malformation at the Level of the Left Parietal Lobe: Postoperator Fig. 2.50  Neuro DSA— 3D VRT 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna 6. Sinus sagittalis superior 7. Sinus rectus

2.7  Spetzler-Martin Grade 4 Arteriovenous Malformation at the Level of the Left Parietal Lobe:…

Fig. 2.51  3D VRT reconstruction 1. Craniotomy Arrowhead: vascular clip

Fig. 2.53  Neuro DSA—3D MIP 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna 6. Sinus sagittalis superior 7. Sinus rectus

Fig. 2.52  3D VRT reconstruction 1. Sinus sagittalis superior 2. Sinus rectus 3. Cortical vein

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Fig. 2.54  Neuro DSA—3D VRT 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna 6. Sinus sagittalis superior Arrowheads: cortical veins

2  Cerebral Arteriovenous Malformation

Fig. 2.55  Neuro DSA—3D VRT 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna 6. Sinus sagittalis superior 7. Sinus rectus Arrowheads: cortical veins

2.7  Spetzler-Martin Grade 4 Arteriovenous Malformation at the Level of the Left Parietal Lobe:…

Fig. 2.56  Neuro DSA—3D VRT 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna 6. Sinus sagittalis superior 7. Sinus rectus Arrowheads: cortical veins

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2.8

 petzler-Martin Grade 5 S Arteriovenous Malformation at the Level of the Left Frontal Lobe: Preoperator

Fig. 2.57  3D VRT reconstruction Arrow: arteriovenous malformation—nidus

2.8  Spetzler-Martin Grade 5 Arteriovenous Malformation at the Level of the Left Frontal Lobe:…

Fig. 2.58  3D MIP reconstruction—axial Arrow: arteriovenous malformation—nidus

Fig. 2.59  Neuro DSA—3D VRT 1. Arteria carotis interna 2. Arteria vertebralis 3. Arteria basilaris 4. Sinus sagittalis Arrow: arteriovenous malformation—nidus Arrowheads: arterial feeder vessels

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Fig. 2.62  3D MIP reconstruction—sagittal Arrow: arteriovenous malformation—nidus

Fig. 2.60  3D VRT reconstruction Arrow: Arteriovenous malformation—nidus

Fig. 2.61  3D MIP reconstruction—coronal Arrow: arteriovenous malformation—nidus

Fig. 2.63  Neuro DSA—3D VRT 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna 6. Sinus sagittalis superior Arrow: arteriovenous malformation—nidus

2.8  Spetzler-Martin Grade 5 Arteriovenous Malformation at the Level of the Left Frontal Lobe:…

Fig. 2.64  Neuro DSA—3D VRT 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna 6. Sinus sagittalis superior 7. Sinus rectus 8. Sinus transversalis Arrow: arteriovenous malformation—nidus Arrowheads: arterial feeder vessels

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Fig. 2.65  3D MIP reconstruction Maximum diameter of the nidus—Spetzler-Martin grade 5 AVM

2  Cerebral Arteriovenous Malformation

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2.9

 petzler-Martin Grade 5 S Arteriovenous Malformation at the Level of the Left Frontal Lobe: Postoperator Fig. 2.66  3D MIP reconstruction—axial 1. Postsurgical Cavity 2. Craniotomy Arrow: vascular clip

2.9  Spetzler-Martin Grade 5 Arteriovenous Malformation at the Level of the Left Frontal Lobe:…

Fig. 2.67  3D MIP reconstruction—sagittal 1. Arteria cerebri anterior Arrow: vascular clip Fig. 2.69  3D MIP reconstruction—coronal 1. Arteria cerebri anterior—segmentum A2 2. Postsurgical Cavity 3. Craniotomy Arrows—vascular clip

Fig. 2.68  3D VRT reconstruction 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Craniotomy

Fig. 2.70  Neuro DSA—3D VRT 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

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Fig. 2.71  3D VRT reconstruction 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Craniotomy

Fig. 2.72  Neuro DSA—3D VRT 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

2  Cerebral Arteriovenous Malformation

Fig. 2.73  Neuro DSA—3D VRT 1. Arteria cerebri anterior—segmentum A2 2. Arteria cerebri media—segmentum M1 3. Arteria vertebralis 4. Arteria basilaris 5. Arteria carotis interna

2.10  Arteriovenous Malformation at the Level of Pars Precentralis Dextra

79

2.10 Arteriovenous Malformation at the Level of Pars Precentralis Dextra

Fig. 2.74 Arteriovenous malformation at the level of pars precentralis dextra 1. A. carotis interna 2. A. vertebralis 3. V. jugularis interna 4. A. basilaris 5. Partially embolised arteriovenous malformation 6. Drainage vein 7. Sinus sagittalis superior 8. Sinus transversalis 9. Sinus sigmoideus

H 7 6

5 8

R

L

9 1

4

2 3

F

80

Fig. 2.75  Cerebral angiography in the case of an arteriovenous malformation (arrow) (a. cerebra media) with accentuation of the vascularisation at the level of a. cerebra media (3D axial reconstruction)

Fig. 2.76  Cerebral angiography of a partially embolised arteriovenous malformation (arrow)

2  Cerebral Arteriovenous Malformation

Fig. 2.77  Neuro DSA 3D MIP reconstruction, anterior plan. The arrow indicates the arteriovenous malformation

Fig. 2.78  Neuro DSA 3D MIP reconstruction, posterior view

2.10  Arteriovenous Malformation at the Level of Pars Precentralis Dextra

Fig. 2.79  Neuro DSA 3D MIP reconstruction, lateral right plan. The arrow indicates the arteriovenous malformation

81

3

Carotid Angiography

Contents 3.1

Normal Carotid Angiography

 84

3.2

Anomalous Origin of Arteria Carotis Communis

 86

3.3

Calcified Atheromatous Plaques at the Level of Arteria Carotis

 88

3.4

 arotid Angiography: Nonobstructive Calcified Atheromatous C Plaques

 90

 arotid Angiography: Calcified Atheromatous Lesions C and Kinking of Arteria Carotis Interna Sinistra

 93

 hort Lesion: Moderate Stenosis of Arteria Carotis S Interna Sinistra

 96

 arotid Angiography Emphasising a Severe Stenotic Lesion C (Subocclusive) at the Level of Arteria Carotis Interna Dextra

 99

 arotid Angiography Emphasising a Subocclusive Lesion C at the Level of the Emerging Arteria Carotis Interna Sinistra

 102

 arotid Angiography Ostial Occlusive Lesion at the  C Level of Arteria Carotis Interna Sinistra

 104

3.5 3.6 3.7 3.8 3.9

3.10 C  arotid Angiography: Complete Occlusion of the Arteria Carotis Interna Dextra

 106

3.11 C  arotid Angiography: Severe Stenotic Lesion at the Level of the Pars Proximalis of Arteria Subclavia Sinistra

 108

3.12 C  arotid Angiography: Stent Occlusion at the Level of Arteria Subclavia Sinistra

 110

© Springer Nature Switzerland AG 2019 G. D. Miclaus, H. Ples, Atlas of CT Angiography, https://doi.org/10.1007/978-3-030-16095-1_3

83

3  Carotid Angiography

84

3.1

Normal Carotid Angiography Fig. 3.1  Normal carotid angiography 1. A. carotis communis dextra 2. A. vertebralis dextra 3. A. carotis interna dextra 4. A. carotis externa dextra 5. A. carotis externa sinistra 6. A. carotis interna sinistra 7. A. carotis communis sinistra

Fig. 3.2  Normal carotid angiography 3D VRT colour reconstruction anterior coronal plane

Fig. 3.3  Normal carotid angiography 3D VRT colour reconstruction oblique anterior plane

3.1 Normal Carotid Angiography

Fig. 3.4  Normal carotid angiography 3D VRT colour reconstruction left anterior oblique plane

Fig. 3.5  Normal carotid angiography 3D MIP reconstruction with visualisation of a. carotis communis sinistra and a. carotis interna sinistra

85

Fig. 3.6  Normal carotid angiography 3D MIP reconstruction with visualisation of a. carotis communis dextra and a. carotis interna dextra

3  Carotid Angiography

86

3.2

 nomalous Origin of Arteria A Carotis Communis Fig. 3.7 Anomalous origin of common carotid arteries 1. Aorta ascendens 2. A. carotis communis sinistra 3. Vena cava superior 4. A. carotis communis dextra 5. V. subclavia dextra 6. A. subclavia dextra 7. A. vertebralis dextra 8. A. vertebralis sinistra 9. Truncus brachiocephalicus 10. A. subclavia sinistra

Fig. 3.8  Colour reconstruction 3D VRT

Fig. 3.9  Colour reconstruction 3D VRT

3.2 Anomalous Origin of Arteria Carotis Communis

Fig. 3.10 Colour reconstruction 3D VRT, enlarged image, anterior plane

Fig. 3.11  Axial image, 3D MIP 1. Arcus aortae 2. Vena cava superior 3. A. carotis communis sinistra 4. Trachea 5.  A. subclavia sinistra with retrotracheal and retrooesophageal trajectory

87

Fig. 3.12  3D VRT reconstruction, posterior plane

3  Carotid Angiography

88

3.3

Calcified Atheromatous Plaques at the Level of Arteria Carotis Fig. 3.13 Normal carotid angiography. The arrow indicates calcified plaques 1. Aorta ascendens 2. Truncus brachiocephalicus 3. V. cava superior 4. A. carotis communis dextra 5. A. carotis externa dextra 6. A. carotis externa sinistra 7. A. carotis interna sinistra 8. A. vertebralis sinistra 9. A. subclavia sinistra 10. A. carotis communis sinistra

Fig. 3.14  3D VRT colour reconstruction, posterior plane. The arrows indicate calcified plaques

Fig. 3.15  3D VRT colour reconstruction, posterior plane. The arrows indicate calcified atheromatous plaques

3.3  Calcified Atheromatous Plaques at the Level of Arteria Carotis

Fig. 3.16  3D VRT reconstruction The arrows indicate calcified atheromatous plaques placed at the level of the emerging a. carotis interna

Fig. 3.17  3D VRT reconstruction The arrows indicate calcified atheromatous plaques placed at the level of the emerging a. carotis interna

89

Fig. 3.18  3D VRT reconstruction The arrows indicate calcified atheromatous plaques placed at the level of the emerging a. carotis interna

3  Carotid Angiography

90

3.4

Carotid Angiography: Nonobstructive Calcified Atheromatous Plaques Fig. 3.19 Reconstruc­ tion 3D VRT colour, frontal plane 1. Aorta ascendens 2. Truncus brachiocephalicus 3. A. carotis communis dextra 4. A. carotis interna dextra 5. A. vertebralis dextra 6. A. vertebralis sinistra 7. A. carotis interna sinistra 8. A. vertebralis sinistra

Fig. 3.20  3D VRT colour reconstruction, after removal of the bone structure

Fig. 3.21  3D VRT colour reconstruction, oblique and sagittal planes The arrow indicates calcified atheromatous plaques

3.4  Carotid Angiography: Nonobstructive Calcified Atheromatous Plaques

Fig. 3.22  3D VRT colour reconstruction, oblique and sagittal planes The arrow indicates calcified atheromatous plaques

Fig. 3.24  3D MPR reconstruction Full arrow = a. carotis communis sinistra Arrow with contour = a. carotis interna sinistra Tip of the arrow = atheromatous calcified plaque

Fig. 3.23  3D MIP reconstruction Full arrow = a. carotis communis sinistra Arrow with contour = a. carotis interna sinistra Tip of the arrow = atheromatous calcified plaque

Fig. 3.25  3D MIP reconstruction Full arrow = a. carotis communis dextra Arrow with contour = a. carotis interna dextra Tip of the arrow = atheromatous calcified plaque

91

92

Fig. 3.26  3D MPR reconstruction Full arrow = a. carotis communis dextra Arrow with contour = a. carotis interna dextra Tip of the arrow = atheromatous calcified plaque

3  Carotid Angiography

3.5  Carotid Angiography: Calcified Atheromatous Lesions and Kinking of Arteria Carotis Interna Sinistra

3.5

Carotid Angiography: Calcified Atheromatous Lesions and Kinking of Arteria Carotis Interna Sinistra Fig. 3.27  3D VRT colour reconstruction, after removal of the bone structure 1. Aorta ascendens 2. Truncus brachiocephalicus 3. A. carotis communis dextra 4. A. carotis interna dextra 5. A. carotis interna sinistra 6. A. carotis communis sinistra 7. A. subclavia sinistra

93

94

3  Carotid Angiography

Fig. 3.28  3D VRT colour reconstruction, anterior plane Yellow arrow = kinking of a. carotis interna sinistra Tip of the arrow = calcified atheromatous plaques

Fig. 3.30  3D VRT colour reconstruction, with bone structure, frontal plane Yellow arrow = kinking of a. carotis interna sinistra Tip of the arrow = calcified atheromatous plaques

Fig. 3.29  3D VRT colour reconstruction, posterior plane Yellow arrow = kinking of a. carotis interna sinistra Tip of the arrow = calcified atheromatous plaques

Fig. 3.31  Reconstruction 3D MIP Full arrow = a. carotis communis sinistra Arrow with contour = a. carotis interna sinistra Tip of the arrow = calcified atheromatous plaques

3.5  Carotid Angiography: Calcified Atheromatous Lesions and Kinking of Arteria Carotis Interna Sinistra

Fig. 3.32  Reconstruction 3D MIP Full arrow = a. carotis communis sinistra Arrow with contour = a. carotis interna sinistra Tip of the arrow = calcified atheromatous plaques Yellow arrow = kinking of a. carotis interna sinistra

Fig. 3.33  Reconstruction 3D MPR Full arrow = a. carotis communis dextra Arrow with contour = a. carotis interna dextra Tip of the arrow = calcified atheromatous plaques

Fig. 3.34  Reconstruction 3D MPR Full arrow = a. carotis communis sinistra Arrow with contour = a. carotis interna sinistra Tip of the arrow = calcified atheromatous plaques Yellow arrow = kinking of a. carotis interna sinistra

95

3  Carotid Angiography

96

3.6

 hort Lesion: Moderate S Stenosis of Arteria Carotis Interna Sinistra Fig. 3.35 Colour reconstruction 3D VRT oblique plane 1. Arcus aortae 2. Truncus brachiocephalicus 3. A. carotis communis dextra 4. A. carotis interna dextra 5. A. carotis interna sinistra 6. Moderate stenosis of a. carotis interna sinistra by mixed atheromatous plaques 7. A. carotis communis sinistra 8. A. subclavia sinistra

Fig. 3.36  Colour reconstruction 3D VRT, frontal plane

Fig. 3.37  3D VRT colour reconstruction, left oblique plane

3.6  Short Lesion: Moderate Stenosis of Arteria Carotis Interna Sinistra

97

Fig. 3.38  3D VRT colour reconstruction, left oblique plane

Fig. 3.40  3D MIP reconstruction Full arrow = a. carotis communis sinistra Arrow with contour = a. carotis interna sinistra Tip of the arrow = left calcified lesion moderate stenosis

Fig. 3.39  3D MIP reconstruction Full arrow = a. carotis communis sinistra Arrow with contour = a. carotis interna sinistra Tip of the arrow = left calcified lesion moderate stenosis

Fig. 3.41  3D MPR reconstruction Full arrow = a. carotis communis dextra Arrow with contour = a. carotis interna dextra Tip of the arrow = left moderate stenosis

98

Fig. 3.42  3D MPR reconstruction Full arrow = a. carotis communis dextra Arrow with contour = a. carotis interna dextra Tip of the arrow = left moderate stenosis

3  Carotid Angiography

3.7  Carotid Angiography Emphasising a Severe Stenotic Lesion (Subocclusive) at the Level of Arteria...

3.7

Carotid Angiography Emphasising a Severe Stenotic Lesion (Subocclusive) at the Level of Arteria Carotis Interna Dextra Fig. 3.43  3D VRT colour reconstruction after removal of the bone structure 1. Aorta 2. Truncus brachiocephalicus 3. A. carotis communis dextra 4. Subocclusive lesion 5. A. carotis interna dextra 6. A. carotis interna sinistra 7. A. carotis communis sinistra 8. A. subclavia sinistra

99

100

Fig. 3.44  3D VRT colour reconstruction after removal of the bone structure, posterior plane Full arrow = subocclusive lesion Arrow with contour = calcified plaques

Fig. 3.45  3D VRT colour reconstruction after removal of the bone structure, posterior oblique plane Full arrow = subocclusive lesion Arrow with contour = calcified plaques

3  Carotid Angiography

Fig. 3.46  3D VRT colour reconstruction after removal of the bone structure anterior oblique plane Full arrow = subocclusive lesion Arrow with contour = calcified plaques

Fig. 3.47  3D MIP reconstruction Full arrow = a. carotis interna dextra Arrow with contour = a. carotis communis dextra Tip of the arrow = subocclusive lesion a. carotis interna dextra

3.7  Carotid Angiography Emphasising a Severe Stenotic Lesion (Subocclusive) at the Level of Arteria...

Fig. 3.48  3D MPR reconstruction Full arrow = a. carotis interna dextra Arrow with contour = a. carotis communis dextra Tip of the arrow = subocclusive lesion a. carotis interna dextra

Fig. 3.49  3D MIP reconstruction Full arrow = a. carotis communis sinistra Arrow with contour = a. carotis interna sinistra Tip of the arrow = calcified plaques

Fig. 3.50  3D MPR reconstruction Full arrow = a. carotis communis sinistra Arrow with contour = a. carotis interna sinistra Tip of the arrow = calcified plaques

101

3  Carotid Angiography

102

3.8

Carotid Angiography Emphasising a Subocclusive Lesion at the Level of the Emerging Arteria Carotis Interna Sinistra Fig. 3.51  3D VRT colour reconstruction frontal plane 1. A. carotis communis dextra 2. A. carotis externa dextra 3. A. carotis interna dextra 4. A. carotis externa sinistra 5. A. carotis interna sinistra 6. Subocclusive lesion 7. A. carotis communis sinistra

Fig. 3.52  3D VRT colour reconstruction after removal of the bone structure, posterior plane Full arrow  =  subocclusive lesion a. carotis interna sinistra

Fig. 3.53  3D VRT colour reconstruction after removal of the bone structure, posterior oblique plane Full arrow  =  subocclusive lesion a. carotis interna sinistra

3.8  Carotid Angiography Emphasising a Subocclusive Lesion at the Level of the Emerging Arteria...

103

Fig. 3.54  3D VRT colour reconstruction after removal of the bone structure, sagittal plane Full arrow  =  subocclusive lesion a. carotis interna sinistra

Fig. 3.56  3D VRT colour reconstruction after removal of the bone structure, anterior oblique plane Full arrow = subocclusive lesion at the level of a. carotis interna sinistra

Fig. 3.55  3D VRT colour reconstruction after removal of the bone structure, anterior plane Full arrow = subocclusive lesion at the level of a. carotis interna sinistra

Fig. 3.57  3D VRT colour reconstruction after removal of the bone structure, posterior plane Full arrow = subocclusive lesion at the level of a. carotis interna sinistra

3  Carotid Angiography

104

3.9

 arotid Angiography Ostial C Occlusive Lesion at the Level of Arteria Carotis Interna Sinistra Fig. 3.58  3D VRT colour reconstruction, oblique plane 1. Aorta 2. Truncus brachiocephalicus 3. A. carotis communis dextra 4. A. carotis externa dextra 5. A. carotis interna dextra 6. A. carotis externa sinistra 7. A. carotis interna sinistra 8. Occlusive lesion 9. A. carotis communis sinistra

Fig. 3.59  3D VRT colour reconstruction frontal plane

Fig. 3.60  3D VRT colour reconstruction enlarged image Arrow with contour = a. carotis communis sinistra Full arrow = a. carotis interna sinistra Yellow arrow = ostial occlusive lesion

3.9  Carotid Angiography Ostial Occlusive Lesion at the Level of Arteria Carotis Interna Sinistra

Fig. 3.61  3D VRT colour reconstruction, oblique plane The yellow arrow indicates ostial occlusive lesion

Fig. 3.62  3D MIP colour reconstruction Arrow with contour = a. carotis communis dextra Full arrow = a. carotis interna dextra

Fig. 3.63  3D MIP colour reconstruction Arrow with contour = a. carotis communis sinistra Full arrow = a. carotis interna sinistra Yellow arrow = ostial occlusive lesion

105

106

3  Carotid Angiography

3.10 Carotid Angiography: Complete Occlusion of the Arteria Carotis Interna Dextra Fig. 3.64  3D VRT colour reconstruction, enlarged image, oblique plane 1. A. carotis communis dextra 2. A. carotis externa dextra 3. Occluded a. carotis interna 4. A. vertebralis dextra 5. A. carotis interna sinistra 6. A. carotis externa sinistra 7. A. vertebralis sinistra 8. A. carotis communis sinistra

Fig. 3.65  3D VRT colour reconstruction, sagittal plane, enlarged image Full arrow = a. carotis communis dextra Arrow with contour = a. carotis externa dextra At the tip of the arrow = a. carotis interna dextra, chronic occlusion

Fig. 3.66  3D VRT colour reconstruction, oblique plane

3.10  Carotid Angiography: Complete Occlusion of the Arteria Carotis Interna Dextra

Fig. 3.67  3D VRT colour reconstruction, frontal plane

Fig. 3.68  3D MIP reconstruction Full arrow = a. carotis communis sinistra Arrow with contour = a. carotis interna sinistra

107

Fig. 3.69  3D MIP reconstruction Full arrow = a. carotis communis dextra Arrow with contour = a. carotis interna dextra Tip of the arrow = ostium of a. carotis interna dextra with chronic occlusion

108

3  Carotid Angiography

3.11 C  arotid Angiography: Severe Stenotic Lesion at the Level of the Pars Proximalis of Arteria Subclavia Sinistra Fig. 3.70  3D VRT colour reconstruction, after removal of the bone structure 1. Aorta 2. Truncus brachiocephalicus 3. Vena cava superior 4. A. carotis communis dextra 5. A. carotis externa dextra 6. A. carotis interna dextra 7. A. carotis interna sinistra 8. A. carotis externa sinistra 9. A. subclavia sinistra 10. Severe stenotic lesion

Fig. 3.71  3D VRT colour reconstruction, after removal of the bone structure, posterior plane The full arrow indicates stenotic lesion

Fig. 3.72  3D VRT colour reconstruction, after removal of the bone structure, enlarged image, anterior plane The full arrow indicates stenotic lesion

3.11  Carotid Angiography: Severe Stenotic Lesion at the Level of the Pars Proximalis of Arteria...

Fig. 3.73  3D VRT colour reconstruction, after removal of the bone structure, enlarged image, posterior plane The full arrow indicates stenotic lesion

Fig. 3.74  3D MPR reconstruction, frontal plane Full arrow = stenotic lesion

Fig. 3.75  3D MIP reconstruction, frontal plane Full arrow = stenotic lesion

109

110

3  Carotid Angiography

3.12 C  arotid Angiography: Stent Occlusion at the Level of Arteria Subclavia Sinistra Fig. 3.76  3D VRT colour reconstruction, frontal plane, enlarged image 1. Aorta 2. A. carotis communis sinistra 3. A. carotis communis dextra 4. A. carotis interna sinistra 5. A. carotis externa sinistra 6. Stent 7. A. subclavia sinister

Fig. 3.77  3D VRT colour reconstruction, oblique plane, enlarged image. The full arrow indicates stent

Fig. 3.78  3D VRT colour reconstruction, posterior plane, enlarged image. The full arrow indicates stent

3.12  Carotid Angiography: Stent Occlusion at the Level of Arteria Subclavia Sinistra

Fig. 3.79  3D curved MPR reconstruction Full arrow = stent occlusion Arrow with contour = a. subclavia sinistra

111

4

Thoracic Angiography

Contents 4.1

Aneurysm of the Aorta Ascendens

 114

4.2

Supravalvular Aortic Stenosis

 117

4.3

Aneurysm of the Aorta Ascendens: Isthmic Stenosis

 119

4.4

Aneurysm of the Arcus Aortae

 121

4.5

Aneurysm of the Aorta Ascendens: Chronic Dissection of the Aorta

 123

4.6

Post-traumatic Aneurysm of the Aorta Descendens

 125

4.7

Gigantic Aneurysm at the Level of the Aorta Descendens

 128

4.8

Chronic Dissection of the Aorta Descendens

 130

4.9

Stenosis of A. Pulmonalis Dextra

 132

4.10

 neurysm and Dissection of the Aorta Ascendens After Valvular A Aortic Replacement

 134

4.11

Pulmonary Thromboembolism

 137

4.12

Right Partially Anomalous Venous Drainage

 139

4.13

Partially Aberrant Venous Drainage

 141

4.14

Interrupted Arcus Aortae

 143

© Springer Nature Switzerland AG 2019 G. D. Miclaus, H. Ples, Atlas of CT Angiography, https://doi.org/10.1007/978-3-030-16095-1_4

113

4  Thoracic Angiography

114

4.1

Aneurysm of the Aorta Ascendens Fig. 4.1  3D VRT colour reconstruction, after removal of the thoracic cage 1. Aorta ascendens. Aneurysmal dilatation 2. Truncus brachiocephalicus 3. A. carotis communis sinistra 4. A. subclavia sinistra 5. Arcus aortae 6. Truncus a. pulmonalis

Fig. 4.3  3D VRT colour reconstruction, anterior plane Fig. 4.2  3D VRT colour reconstruction, after removal of the thoracic cage 1. Aorta descendens thoracica 2. Arcus aortae 3. Aneurysm

4.1 Aneurysm of the Aorta Ascendens

Fig. 4.4  3D VRT colour reconstruction, right sagittal plane

Fig. 4.5  3D MIP reconstruction, coronal plane 1. Aneurysm 2. Truncus brachiocephalicus 3. A. carotis communis sinistra 4. A. subclavia sinistra 5. A. aorta descendens

115

Fig. 4.6  3D MIP reconstruction, coronal plane Full arrow = aneurysm Arrow with contour = ventriculus sinister

Fig. 4.7  3D MIP reconstruction, coronal plane

116

Fig. 4.8  3D MIP reconstruction, axial plane Full arrow = aneurysm Arrow with contour = aorta descendens Yellow arrow = ventriculus sinister Red arrow = atrium sinister

4  Thoracic Angiography

4.2 Supravalvular Aortic Stenosis

4.2

117

Supravalvular Aortic Stenosis Fig. 4.9  3D VRT colour reconstruction, after removal of the bone structure 1. A. ascendens 2. V. brachiocephalica dextra 3. Truncus brachio­cephalicus 4.  A. carotis communis sinistra 5. A. subclavia sinistra 6. Arcus aortae 7. Aorta descendens The full arrow indicates stenotic area

Fig. 4.10  3D VRT colour reconstruction, after removal of the bone structure, oblique anterior plane Full arrow = supravalvular stenotic area

Fig. 4.11  3D VRT colour reconstruction, after removal of the bone structure, posterior oblique plane Full arrow = supravalvular stenotic area

118

Fig. 4.12  3D VRT colour reconstruction, enlarged image

Fig. 4.13  3D MIP reconstruction, tract of ejection ventriculus sinister Full arrow = supravalvular stenotic area Arrow with contour = tract of ejection ventriculus sinister Tip of the arrow = ventriculus sinister

4  Thoracic Angiography

Fig. 4.14  3D MIP reconstruction Full arrow = supravalvular stenotic area Arrow with contour = atrium sinistrum Tip of the arrow = tract of ejection ventriculus sinister

Fig. 4.15  3D MIP reconstruction, axial plane Full arrow = aorta ascendens Arrow with contour = aorta descendens Tip of the arrow = truncus a. pulmonalis

4.3 Aneurysm of the Aorta Ascendens: Isthmic Stenosis

4.3

119

Aneurysm of the Aorta Ascendens: Isthmic Stenosis Fig. 4.16  3D VRT colour reconstruction, after removal of the bone structure, left anterior oblique plane 1. Aorta ascendens 2. Truncus brachiocephalicus 3. A. carotis communis sinistra 4. A. subclavia sinistra 5. Area of isthmic stenosis 6. Truncus a. pulmonalis 7. Aorta descendens

Fig. 4.17  3D VRT colour reconstruction, after removal of the bone structure, posterior oblique plane Full arrow = area of isthmic stenosis

Fig. 4.18  3D VRT colour reconstruction, after removal of the bone structure, posterior oblique plane Full arrow = dilated aneurysm at the aorta ascendens Arrow with contour = area of isthmic stenosis

120

Fig. 4.19  3D MIP reconstruction, sagittal plane Full arrow = aneurysm of the aorta ascendens Full red arrow = isthmic stenotic area At the tip of the red arrow = aorta thoracica Yellow arrow = truncus coeliacus and arteria mesenterica superior

Fig. 4.20  3D VRT colour reconstruction, right sagittal plane

4  Thoracic Angiography

Fig. 4.21  3D MIP reconstruction, sagittal plane Full arrow = aneurysm of the aorta ascendens Yellow arrow = ventriculus sinister At the tip of the red arrow = emerging vessels from the arcus aortae

4.4 Aneurysm of the Arcus Aortae

4.4

121

Aneurysm of the Arcus Aortae Fig. 4.22  3D VRT colour reconstruction, after removal of the bone structure, anterior view 1. Aorta ascendens 2. A. carotis communis dextra 3. A. subclavia dextra 4. A. subclavia sinistra 5. Aneurysm of arcus aortae 6. A. carotis communis sinistra 7. Aorta descendens

Fig. 4.23  3D VRT colour reconstruction, after removal of the bone structure, left anterior oblique view Full arrow = aneurysm of the arcus aortae At the tip of the arrow  =  abnormal emergence of the a. subclavia sinister from the level of the superior pole of the aneurysm

Fig. 4.24  3D VRT colour reconstruction, after removal of the bone structure, posterior view 1. Aorta thoracica 2. A. subclavia dextra 3. Aneurysm 4. A. subclavia sinistra 5. A. carotis communis sinistra 6. A. carotis communis dextra

122

Fig. 4.25  3D VRT colour reconstruction, after removal of the bone structure, posterior cranial view Full arrow = aneurysm Arrow with contour = emergence of a. subclavia sinistra from the cranial extremity of the aneurysm

Fig. 4.26  3D VRT colour reconstruction, after removal of the bone structure, anterior cranial view Full arrow = aneurysm Tip of the yellow arrow = a. carotis communis dextra Tip of the red arrow = a. carotis communis sinistra

4  Thoracic Angiography

Fig. 4.27  3D VRT colour reconstruction, after removal of the bone structure, posterior view The full arrow indicates aneurysm

4.5 Aneurysm of the Aorta Ascendens: Chronic Dissection of the Aorta

4.5

123

Aneurysm of the Aorta Ascendens: Chronic Dissection of the Aorta Fig. 4.28  3D VRT colour reconstruction, right oblique view 1. Aorta ascendens 2. Truncus brachiocephalicus 3. Aorta ascendens 4. Dissected aortic aneurysm 5. “True” lumen of aorta descendens Tip of the arrow  =  fold dissection

Fig. 4.29  3D VRT colour reconstruction, right oblique view The full arrow indicates fold dissection

Fig. 4.30  3D VRT colour reconstruction, lateral view with visualisation of the abdominal aorta

124

4  Thoracic Angiography

Fig. 4.31  3D VRT colour reconstruction, enlarged image of the aorta descendens Full arrow = false lumen Arrow with contour = true lumen Tip of the yellow arrow = dissection fold

Fig. 4.33  3D MIP reconstruction, axial plane Red arrow = dissection fold

Fig. 4.32  3D VRT colour reconstruction, enlarged image of the aorta descendens Full arrow = false lumen Arrow with contour = true lumen Tip of the yellow arrow = dissection fold

Fig. 4.34  3D MIP reconstruction, axial plane 1. False lumen 2. Dissection fold 3. True lumen of the aorta descendens 4. A. subclavia sinister with dissection

4.6 Post-traumatic Aneurysm of the Aorta Descendens

4.6

125

Post-traumatic Aneurysm of the Aorta Descendens

Fig. 4.35  3D VRT colour reconstruction, after removal of the bone structure, left anterior oblique view 1. Aorta ascendens 2. A. subclavia sinistra 3. Aneurysm of isthmic area 4. Aneurysmal dilatation of the aorta descendens 5. Truncus a. pulmonalis

126

Fig. 4.36  3D VRT colour reconstruction, after removal of the bone structure, right posterior oblique view Full arrow = dissection fold Arrow with contour = aneurysmal dilatation of the aorta descendens

Fig. 4.37  3D VRT colour reconstruction; left lateral view Full arrow = aneurysm

4  Thoracic Angiography

Fig. 4.38  3D MIP reconstruction, sagittal plane 1. Aorta ascendens 2. A. subclavia sinistra 3. Aneurysm with parietal thrombosis 4. Aneurysm of the aorta descendens with thrombosis and mural calcifications

Fig. 4.39  3D MIP reconstruction, frontal plane Red arrow = thrombosed aneurysm

4.6 Post-traumatic Aneurysm of the Aorta Descendens

Fig. 4.40  3D VRT reconstruction 1. Aorta ascendens 2. A. subclavia sinistra 3. Aneurysm with parietal thrombosis 4. Aneurysm of the aorta descendens with thrombosis and mural calcifications

127

4  Thoracic Angiography

128

4.7

 igantic Aneurysm at G the Level of the Aorta Descendens Fig. 4.41  3D VRT colour reconstruction, left anterior oblique view 1. Aorta ascendens 2. Arcus aortae 3. Aorta thoracica 4. Aorta abdominalis

Fig. 4.42  3D VRT colour reconstruction, right posterior oblique view The full arrow indicates gigantic aneurysm of aorta descendens

Fig. 4.43  3D VRT colour reconstruction, posterior view The full arrow indicates aorta descendens with a gigantic aneurysm

4.7 Gigantic Aneurysm at the Level of the Aorta Descendens

Fig. 4.44  3D VRT colour reconstruction, anterior view Full arrows = normal calibre of aorta ascendens and aorta abdominalis Arrow with contour = gigantic aneurysm

Fig. 4.45  3D VRT colour reconstruction, enlarged image The full arrow indicates aneurysm of aorta abdominalis with calcified parietal plaques

129

Fig. 4.46  3D VRT colour reconstruction, enlarged image Full arrow = aneurysm Arrow with contour = truncus coeliacus Yellow arrow  =  a. mesenterica superior with a severe ostial stenotic lesion Red arrow = normal calibre of aorta abdominalis

4  Thoracic Angiography

130

4.8

Chronic Dissection of the Aorta Descendens Fig. 4.47  3D VRT colour reconstruction, frontal plane 1. Aorta ascendens 2. Arcus aortae 3. Aorta thoracica dissected 4. Aorta abdominalis dissected

Fig. 4.48  3D VRT colour reconstruction, left anterior oblique plane Full arrow = false lumen Arrow with contour = true lumen

Fig. 4.49  3D VRT colour reconstruction, posterior plane Full arrow = false lumen Arrow with contour = true lumen Tip of the arrow = dissection fold

4.8 Chronic Dissection of the Aorta Descendens

Fig. 4.50  3D MIP reconstruction 1. Aorta ascendens 2. False lumen 3. True lumen 4. Dissection fold

Fig. 4.51  3D MIP reconstruction, axial plane Full arrow = false lumen Arrow with contour = true lumen Tip of the red arrow = dissection fold Tip of the yellow arrow = a. renalis dextra with proximal dissection

131

Fig. 4.52  3D MIP reconstruction, frontal plane at the level of aorta abdominalis, pars distalis Full arrow = false lumen Arrow with contour = true lumen At the tip of the red arrow = dissection fold

4  Thoracic Angiography

132

4.9

Stenosis of A. Pulmonalis Dextra Fig. 4.53  3D VRT colour reconstruction, after removal of the thoracic cage 1. A. pulmonalis sinistra 2. A. pulmonalis dextra 3. V. pulmonalis dextra 4. V. pulmonalis sinistra The full arrow indicates stenotic area at the emergence of the a. pulmonalis dextra

Fig. 4.54  3D VRT colour reconstruction, after removal of the thoracic cage, cranial view The full arrow indicates stenotic area

Fig. 4.55  3D VRT reconstruction, anterior view 1. A. pulmonalis dextra 2. A. pulmonalis sinistra The full arrow indicates stenotic area

4.9 Stenosis of A. Pulmonalis Dextra

Fig. 4.56  3D VRT reconstruction, anterior view 1. A. pulmonalis dextra 2. A. pulmonalis sinistra The full arrow indicates stenotic area

133

134

4  Thoracic Angiography

4.10 Aneurysm and Dissection of the Aorta Ascendens After Valvular Aortic Replacement Fig. 4.57  3D VRT colour reconstruction, after removal of the thoracic cage, frontal plane 1. Valvular aortic prosthesis 2. Aorta ascendens dilated 3. Dissection fold 4. Arcus aortae 5. Truncus brachiocephalicus 6. A. carotis communis sinistra 7. A. subclavia sinistra 8. A. coronaria dextra 9. Aorta descendens

4.10 Aneurysm and Dissection of the Aorta Ascendens After Valvular Aortic Replacement

135

Fig. 4.58  3D VRT colour reconstruction, lateral plane 1. Sternum 2. Aorta ascendens with aneurysm 3. Arcus aortae 4. Aorta descendens 5. A. coronaria dextra

Fig. 4.60  3D VRT colour reconstruction, cranial plane 1. Sternum 2. Aneurysm 3. Dissection fold 4. Arcus aortae 5. Atrium sinistrum

Fig. 4.59  3D VRT colour reconstruction, frontal plane 1. Sternum with metallic suture Full arrow = aneurysm

Fig. 4.61  3D VRT colour reconstruction, transversal plane 1. True lumen of the aorta ascendens 2. False lumen of the aorta ascendens 3. Dissection fold 4. Aorta descendens

136

Fig. 4.62  3D MIP reconstruction, transversal plane 1. True lumen of the aorta ascendens 2. Dissection fold 3. False lumen of the aorta ascendens 4. Aorta descendens

4  Thoracic Angiography

4.11 Pulmonary Thromboembolism

137

4.11 Pulmonary Thromboembolism Fig. 4.63  3D MIP reconstruction, frontal plane 1. A. pulmonalis sinistra 2. A. pulmonalis dextra 3. Thrombus in a. pulmonalis sinistra 4. Thrombus in a. pulmonalis dextra 5. Aorta 6. Atrium sinistrum

Fig. 4.64  3D MIP reconstruction, frontal plane 1. Atrium sinistrum 2. A. pulmonalis sinistra 3. Aorta 4. A. pulmonalis dextra The full arrow indicates thrombus

Fig. 4.65  3D MIP reconstruction, frontal plane The full arrow indicates thrombus

138

Fig. 4.66  3D MIP reconstruction, frontal plane The full arrow indicates thrombus

Fig. 4.67  3D MIP reconstruction, frontal plane 1. Aorta ascendens 2. Truncus brachiocephalicus 3. Thrombus at the level of the truncus brachiocephalicus 4. V. cava superior

4  Thoracic Angiography

Fig. 4.68  3D MIP reconstruction, frontal plane 1. Aorta 2. A. pulmonalis sinistra Full arrow indicates voluminous thrombus

4.12 Right Partially Anomalous Venous Drainage

139

4.12 R  ight Partially Anomalous Venous Drainage Fig. 4.69  3D VRT colour reconstruction, after removal of the thoracic cage, posterior plane 1. A. pulmonalis dextra 2. A. pulmonalis sinistra 3. Aorta ascendens 4. Arcus aortae 5. Aorta descendens 6. V. pulmonalis dextra superior 7. Aberrant collector with drainage in v. cava inferior 8. V. pulmonalis sinistra

Fig. 4.70  3D VRT colour reconstruction, after removal of the thoracic cage, right posterior oblique plane 1. Aberrant venous collector 2. V. pulmonalis dextra 3. Arcus aortae 4. Aorta descendens 5. A. pulmonalis dextra

Fig. 4.71  3D VRT colour reconstruction, frontal plane 1. Pulmonary aberrant venous collector 2. V. cava superior 3. A. pulmonalis dextra

140

Fig. 4.72  3D VRT colour reconstruction, right anterior oblique plane 1. Pulmonary aberrant venous collector 2. A. pulmonalis dextra 3. V. cava inferior

Fig. 4.73  3D VRT colour reconstruction, posterior plane 1. A. pulmonalis dextra 2. V. pulmonalis dextra 3. Pulmonary aberrant venous collector

4  Thoracic Angiography

Fig. 4.74  3D VRT colour reconstruction, posterior plane 1. A. pulmonalis dextra 2. Pulmonary aberrant venous collector 3. V. pulmonalis dextra

4.13 Partially Aberrant Venous Drainage

141

4.13 Partially Aberrant Venous Drainage Fig. 4.75  3D VRT colour reconstruction, after removal of the thoracic cage, posterior plane 1. Truncus a. pulmonalis 2. Aorta ascendens 3. Vena cava superior 4. Aberrant venous collector 5. Aorta descendens

Fig. 4.76  3D VRT colour reconstruction, after removal of the thoracic cage, posterior plane 1. Atrium sinistrum 2. V. pulmonalis dextra inferior 3. A. pulmonalis dextra 4. A. pulmonalis sinistra 5. Aorta descendens 6. V. cava superior 7. Aberrant venous collector

Fig. 4.77  3D VRT colour reconstruction, after removal of the thoracic cage, posterior oblique plane 1. Atrium sinistrum 2. V. pulmonalis sinistra superior 3. A. pulmonalis dextra 4. Arcus aortae 5. Aorta thoracica

142

Fig. 4.78  3D VRT colour reconstruction, after removal of the thoracic cage, posterior plane 1. Atrium sinistrum 2. V. pulmonalis dextra inferior 3. V. pulmonalis dextra superior 4. V. pulmonalis sinistra superior 5. V. pulmonalis sinistra inferior 6. A. pulmonalis dextra 7. A. pulmonalis sinistra 8. V. cava superior 9. Arcus aortae 10. Aberrant venous collector

Fig. 4.79  3D MIP reconstruction 1. Aberrant venous collector 2. Truncus brachiocephalicus dexter 3. V. cava superior 4. Aorta ascendens

4  Thoracic Angiography

Fig. 4.80  3D MIP reconstruction 1. Aberrant venous collector 2. V. brachiocephalica sinistra 3. A. pulmonalis sinistra 4. A. pulmonalis dextra 5. Atrium sinistrum 6. V. pulmonalis sinistra superior 7. V. pulmonalis sinistra inferior

4.14 Interrupted Arcus Aortae

143

4.14 Interrupted Arcus Aortae Fig. 4.81  3D VRT colour reconstruction, after removal of the thoracic cage 1. Atrium sinistrum 2. A. pulmonalis dextra 3. Aorta ascendens 4. A. pulmonalis sinistra 5. Aorta descendens 6. V. pulmonalis sinistra

Fig. 4.82  3D VRT colour reconstruction, after removal of the thoracic cage 1. Atrium sinistrum 2. A. pulmonalis dextra 3. Aorta ascendens 4. Persistent arterial channel 5. Aorta descendens 6. V. pulmonalis sinistra

Fig. 4.83  3D VRT colour reconstruction, after removal of the thoracic cage 1. Aorta ascendens 2. Truncus a. pulmonalis 3. Persistent arterial channel 4. Aorta descendens

144

Fig. 4.84  3D VRT colour reconstruction, after removal of the thoracic cage 1. Aorta ascendens 2. Persistent arterial channel 3. Aorta descendens The full arrow indicates the area in which the arcus aortae is not visualised

Fig. 4.85  3D MIP reconstruction, sagittal plane 1. Aorta ascendens 2. Persistent arterial channel 3. Aorta descendens

4  Thoracic Angiography

Fig. 4.86  3D MIP reconstruction, sagittal plane 1. Aorta ascendens 2. Persistent arterial channel 3. Aorta descendens

5

Coronary Angiography

Contents 5.1

Normal Arteriae Coronariae

 146

5.2

Abnormal Emergence of the R. Circumflexus

 149

5.3

 bnormal Emergence of the A. Coronaria Dextra Placed A on the Posterior Aortic Wall

 152

5.4

Emergence Through Separate Ostium of the Three A. Coronariae

 154

5.5

 bnormal A. Coronaria Dextra Emergence from the Truncus A A. Pulmonalis

 156

5.6

Coronary and Aortopulmonary Fistulas

 159

5.7

Coronary Calcification

 162

5.8

Monovascular Coronary Disease: A. Coronaria Dextra Occlusion

 165

5.9

 cclusive Lesion at the Middle Segment of the R. Interventricularis O Anterior: Collateral Circulation A. Coronaria Dextra: R. Interventricularis Anterior

 167

5.10

Bivascular Coronary Disease

 169

5.11

Trivascular Coronary Disease

 172

5.12

 neurysm of the Left Ventricle and R. Interventricularis Anterior A Occlusion

 175

 onovascular Coronary Disease Patent Stent in the Middle M Segment of R. Interventricularis Anterior

 178

5.14

Restenosis at Stent Level

 181

5.15

Occlusion of R. Interventricularis Anterior

 184

5.16

Coronary Bypass Evaluation

 187

5.17

Fallot Tetralogy

 189

5.18

Fallot Tetralogy in an Adult Patient

 192

5.13

© Springer Nature Switzerland AG 2019 G. D. Miclaus, H. Ples, Atlas of CT Angiography, https://doi.org/10.1007/978-3-030-16095-1_5

145

5  Coronary Angiography

146

5.1

Normal Arteriae Coronariae Fig. 5.1  Coronary CT angiography—3D VRT colour reconstruction 1. Aorta 2. A. coronaria sinistra 3. R. circumflexus 4. R. atrialis intermedius 5. A. interventricularis anterior 6. A. coronaria dextra 7. A. interventricularis posterior 8. Ventriculus sinister

5.1 Normal Arteriae Coronariae

147

Fig. 5.2  Coronary CT angiography reconstruction 1. Aorta 2. A. coronaria sinistra 3. R. circumflexus 4. R. atrialis intermedius 5. R. marginalis sinister 6. R. interventricularis anterior 7. A. coronaria dextra

3D

VRT

Fig. 5.4  Coronary CT angiography reconstruction 1. Aorta 2. A. coronaria sinistra 3. R. circumflexus 4. R. interventricularis anterior 5. R. marginalis anterior

3D

VRT

Fig. 5.3  Coronary CT angiography reconstruction 1. Auricula sinister 2. R. circumflexus 3. R. marginalis sinister 4. R. interventricularis anterior 5. R. lateralis

3D

VRT

Fig. 5.5  Coronary CT angiography reconstruction 1. A. coronaria dextra 2. R. interventricularis anterior 3. R. diagonalis 4. Arteria marginalis dexter

3D

VRT

5  Coronary Angiography

148

Fig. 5.6  Coronary CT angiography reconstruction 1. Aorta 2. A. coronaria dextra 3. R. marginalis dexter 4. R. interventricularis anterior 5. A. coronaria sinistra 6. R. circumflexus

3D

VRT

Fig. 5.7  Coronary CT reconstruction 1. Aorta 2. A. coronaria sinistra 3. R. marginalis sinister 4. R. atrialis intermedius 5. R. circumflexus 6. R. marginalis sinister 7. R. marginalis sinister

angiography

3D

VRT

5.2 Abnormal Emergence of the R. Circumflexus

5.2

149

Abnormal Emergence of the R. Circumflexus Fig. 5.8  Coronary CT angiography 3D VRT colour reconstruction 1. Aorta 2. Truncus a. pulmonalis cut out during post-­ processing operation 3. R. interventricularis anterior 4. A. coronaria dextra 5. R. circumflexus with retroaortic course 6. Atrium sinistrum

150

Fig. 5.9 Coronary CT angiography 3D VRT colour reconstruction 1. Aorta 2. R. interventricularis anterior 3. R. circumflexus 4. Atrium sinistrum 5. R. interventricularis anterior

Fig. 5.10  Coronary CT angiography 3D VRT colour reconstruction 1. Aorta 2. Arteria coronaria dextra 3. R. circumflexus 4. Atrium sinistrum 5. R. interventricularis anterior

5  Coronary Angiography

Fig. 5.11  Coronary CT angiography 3D VRT colour reconstruction 1. Aorta 2. R. interventricularis anterior 3. R. lateralis 4. A. coronaria dextra 5. R. circumflexus 6. Atrium sinistrum

Fig. 5.12  Angiography 3D MIP reconstruction 1. Aorta 2. R. circumflexus with retroaortic course anterior from the atrium sinistrum 3. Atrium sinistrum 4. A. pulmonalis

5.2 Abnormal Emergence of the R. Circumflexus

Fig. 5.13  Angiography 3D MIP reconstruction 1. Aorta 2. Atrium sinistrum 3. A. coronaria dextra 4. R. circumflexus 5. R. interventricularis anterior 6. Separate ostium of the two arteriae coronariae (a. coronaria dextra and r. circumflexus)

151

5  Coronary Angiography

152

5.3

Abnormal Emergence of the A. Coronaria Dextra Placed on the Posterior Aortic Wall

Fig. 5.14  Coronary CT angiography 3D VRT colour reconstruction 1. Aorta 2.  Truncus a. coronaria sinistra 3. R. circumflexus 4. R. atrialis intermedius 5. R. marginalis sinister 6. R. interventricularis anterior 7. R. lateralis 8. A. coronaria dextra 9. R. marginalis dexter 10. Truncus a. pulmonalis

5.3 Abnormal Emergence of the A. Coronaria Dextra Placed on the Posterior Aortic Wall

153

Fig. 5.15  Coronary CT angiography 3D VRT colour reconstruction 1. Aorta 2. Emergent a. coronaria dextra sided on the posterior aortic wall above the sinus aortae

Fig. 5.17  Coronary CT angiography 3D VRT colour reconstruction 1. Aorta 2. A. coronaria dextra

Fig. 5.16  Coronary CT angiography 3D VRT colour reconstruction 1. Aorta 2. Emergent a. coronaria dextra sided on the posterior aortic wall above the sinus aortae 3. R. marginalis dexter

Fig. 5.18  Coronary CT angiography 3D VRT colour reconstruction 1. Aorta 2. A. coronaria dextra 3. Non-coronary cusps of the sinus aortae 4. Right coronary cusps, in this case a non-coronary cusps due to the abnormal emergence of the a. coronaria dextra

5  Coronary Angiography

154

5.4

Emergence Through Separate Ostium of the Three A. Coronariae Fig. 5.19  Coronary CT angiography 3D VRT colour reconstruction 1. Aorta 2. A. coronaria sinistra 3. A. pulmonalis 4. R. lateralis 5. R. circumflexus 6. R. marginalis sinister 7. R. marginalis sinister

5.4 Emergence Through Separate Ostium of the Three A. Coronariae

Fig. 5.20  Coronary CT angiography 3D VRT colour reconstruction 1. Aorta 2. A. pulmonalis 3. A. coronaria dextra 4. R. interventricularis anterior 5. R. lateralis 6. R. circumflexus 7. R. marginalis sinister

Fig. 5.21  Coronary CT angiography 3D VRT colour reconstruction 1. Aorta 2. A. coronaria dextra 3. R. interventricularis anterior 4. R. lateralis 5. R. circumflexus 6. R. marginalis sinister 7. A pulmonalis

155

Fig. 5.22  Coronary CT angiography 3D VRT colour reconstruction 1. The aorta with three separated ostium emergencies of the a. coronaria 2. A. coronaria dextra 3. R. interventricularis anterior 4. R. circumflexus

5  Coronary Angiography

156

5.5

Abnormal A. Coronaria Dextra Emergence from the Truncus A. Pulmonalis Fig. 5.23  Coronary CT angiography 3D VRT colour reconstruction 1. Aorta 2. Truncus a. pulmonalis 3. A. coronaria dextra 4. A. coronaria sinistra 5. Auricula dextra 6. Vena cava superior 7. Auricula sinistra

5.5  Abnormal A. Coronaria Dextra Emergence from the Truncus A. Pulmonalis

Fig. 5.24  3D VRT colour reconstruction 1. Aorta 2. Truncus a. pulmonalis 3. A. coronaria dextra 4. A. coronaria sinistra 5. Auricula dextra 6. Vena cava superior

Fig. 5.25  3D VRT colour reconstruction Full arrow = a. coronaria dextra Arrow with contour = r. interventricularis posterior The tip of the arrow = r. posterolateralis dexter

Fig. 5.26  3D VRT colour reconstruction 1. Truncus a. pulmonalis 2. A. coronaria sinistra 3. A. interventricularis anterior 4. Aorta 5. R. circumflexus

Fig. 5.27  3D VRT colour reconstruction 1. Truncus a. pulmonalis 2. A. coronaria sinistra 3. A. interventricularis anterior 4. R. circumflexus 5. Aorta 6. A. coronaria dextra

157

158

5  Coronary Angiography

Fig. 5.28  3D MPR reconstruction 1.  Truncus a. coronaria sinistra  +  r. interventricularis anterior 2. A. pulmonalis 3. Aorta

Fig. 5.30  3D MIP reconstruction 1. Aorta 2. Truncus a. pulmonalis 3. Truncus a. coronaria sinistra

Fig. 5.29  3D MIP reconstruction 1. Aorta 2. Truncus a. pulmonalis 3. Truncus a. coronaria sinistra

Fig. 5.31  3D MIP reconstruction 1. Aorta 2. A. coronaria dextra 3. A. pulmonalis 4. Truncus a. coronaria sinistra

5.6 Coronary and Aortopulmonary Fistulas

5.6

159

Coronary and Aortopulmonary Fistulas Fig. 5.32  Coronary CT angiography 3D VRT 1. Aorta 2. Truncus a. pulmonalis 3. A. coronaria dextra 4. R. interventricularis 5. R. lateralis 6. Fistulous course between r. interventricularis anterior and a. pulmonalis 7. Aneurysmal dilatation at the confluence level of the fistulas’ course

160

5  Coronary Angiography

Fig. 5.33  Coronary CTA 3D VRT 1. Auricula sinistra 2. Fistula 3. Aneurysm 4. R. interventricularis anterior 5. R. lateralis 6. R. circumflexus 7. R. marginalis sinister 8. R. marginalis sinister

Fig. 5.35  Coronary CTA 3D VRT 1. Aorta 2. From the aorta emergent fistulous course 3. Aneurysmal dilatation 4. From the a. coronaria sinistra emergent fistulous course communicating with a. pulmonalis 5. R. interventricularis anterior 6. R. circumflexus 7. A. coronaria dextra 8. R. interventricularis posterior 9. R. posterolateralis dexter

Fig. 5.34  Coronary CTA 3D VRT 1. Aorta 2. A. coronaria dextra 3. R. marginalis dexter 4. Frontal aorta emergent fistulous course 5. R. interventricularis anterior

Fig. 5.36  Coronary CTA 3D VRT 1. Aorta 2. From the r. interventricularis anterior emergent fistulous course communicating with a. pulmonalis 3. Aneurysmal dilatation 4. R. circumflexus 5. R. marginalis sinister 6. R. interventricularis anterior 7. A. coronaria dextra

5.6 Coronary and Aortopulmonary Fistulas

Fig. 5.37  Coronary CTA 3D VRT 1. A. coronaria dextra 2. Fistulous course 3. Aneurysmal dilatation 4. Fistulous course 5. R. interventricularis anterior 6. R. circumflexus

161

Fig. 5.38  Coronary CTA 3D VRT 1. Aorta 2. Aneurysmal dilatation 3. Fistulous course 4. R. interventricularis anterior, pars proximalis 5. R. circumflexus 6. R. marginalis sinister 7. R. marginalis sinister 8. R. interventricularis anterior 9. R. lateralis

5  Coronary Angiography

162

5.7

Coronary Calcification Fig. 5.39 Coronary CTA 3D VRT 1. Auricula sinistra 2. R. interventricularis anterior 3. R. circumflexus

5.7 Coronary Calcification

163

Fig. 5.40  Coronary CTA 3D VRT 1. Aorta 2. Truncus a. coronaria sinistra 3. R. interventricularis anterior 4. Calcified plaques located on the three a. coronariae

Fig. 5.42  Coronary CT angiography 3D VRT The full arrow indicates calcified atheromatous plaques

Fig. 5.41  Coronary CTA 3D VRT 1. Aorta 2. Auricula sinistra 3. Calcified plaques located on the three a. coronariae 4. A. coronaria dextra 5. A. interventricularis anterior 6. R. circumflexus

Fig. 5.43  Coronary CT angiography 3D VRT The full arrow indicates calcified atheromatous plaques

164

Fig. 5.44  Coronary CT angiography 3D VRT The full arrow indicates calcified atheromatous plaques

5  Coronary Angiography

5.8 Monovascular Coronary Disease: A. Coronaria Dextra Occlusion

5.8

165

Monovascular Coronary Disease: A. Coronaria Dextra Occlusion Fig. 5.45  Coronary CT angiography 3D VRT 1. Aorta 2.  Truncus a. coronaria sinister 3. R. interventricularis sinister 4. R. circumflexus

166

5  Coronary Angiography

Fig. 5.46  Coronary CTA 3D VRT 1. Aorta 2. Truncus a. coronaria sinister 3. R. circumflexus 4. R. lateralis 5. R. interventricularis anterior 6. A. coronaria dextra The full arrow indicates occlusive lesion at the middle segment of a. coronaria dextra

Fig. 5.48  Coronary CTA 3D MIP 1. Aorta 2. A. coronaria dextra White arrow = occlusion area at the middle segment of the a. coronaria dextra Yellow arrow = occlusion area at the distal segment of the a. coronaria dextra

Fig. 5.47  Coronary CTA 3D VRT 1. Aorta 2. Truncus a. coronaria sinister 3. R. circumflexus 4. R. interventricularis anterior 5. A. coronaria dextra White arrow = occlusion area at the middle segment of the a. coronaria dextra

Fig. 5.49  Coronary CTA 3D MIP 1. Aorta 2. A. coronaria dextra 3 and 4. Occlusion areas at the middle segment and distal segment of a. coronaria dextra

5.9 Occlusive Lesion at the Middle Segment of the R. Interventricularis Anterior: Collateral Circulation…

5.9

167

 cclusive Lesion at O the Middle Segment of the R. Interventricularis Anterior: Collateral Circulation A. Coronaria Dextra: R. Interventricularis Anterior Fig. 5.50 Coronary CTA 3D VRT 1. Aorta 2. Truncus a. pulmonalis 3.  Truncus a. coronaria sinistra 4. R. circumflexus 5. Auricula sinistra 6. R. lateralis 7. R. interventricularis anterior—pars media White arrow  =  collateral arteries Empty arrow  =  occlusive/ subocclusive lesion

168

Fig. 5.51  Coronary CTA 3D VRT 1. Aorta 2. Truncus a. pulmonalis 3. A. coronaria dextra 4.  Colateralis a. coronaria dextra—r. interventricularis anterior 5. R. interventricularis anterior—pars distalis 6. R. lateralis

Fig. 5.52  Coronary CTA 3D VRT 1. Aorta 2. Truncus a. coronaria sinistra 3. R. circumflexus 4. R. lateralis 5. R. interventricularis anterior 6. A. coronaria dextra 7.  Colateralis a. coronaria dextra—r. interventricularis anterior The full arrow indicates occlusion area of the r. interventricularis anterior pars media

5  Coronary Angiography

Fig. 5.53  Coronary CTA 3D VRT 1. R. interventricularis anterior 2. R. circumflexus The full arrow indicates colateralis a. coronaria dextra r. interventricularis anterior

5.10 Bivascular Coronary Disease

169

5.10 Bivascular Coronary Disease Fig. 5.54 Coronary CTA 3D VRT 1. Aorta 2. A. pulmonalis 3. Auricula sinistra 4. R. circumflexus 5. R. lateralis 6. R. interventricularis anterior

Fig. 5.55  Coronary CTA 3D VRT 1. Aorta 2. Truncus a. coronaria sinistra 3. R. interventricularis anterior 4. R. lateralis 5. R. circumflexus

Fig. 5.56  Coronary CTA 3D VRT Full arrow = stenotic area at the middle segment level Arrow with contour = a. coronaria dextra

170

5  Coronary Angiography

Fig. 5.57  Coronary CTA 3D VRT 1. A. coronaria dextra—pars distalis 2. R. interventricularis posterior 3. R. posterolateralis dexter 4. R. marginalis sinister

Fig. 5.59  Coronary CTA 3D MPR 1. R. lateralis The full arrow indicates severe stenotic lesions

Fig. 5.58  Coronary CTA 3D MPR 1. Truncus a. coronaria sinistra 2.  At the pars proximalis patent r. interventricularis anterior 3. Patent r. interventricularis anterior—pars distalis The full arrow indicates occlusal lesion at the level of middle segment

Fig. 5.60  Coronary CTA 3D MPR 1. A. coronaria dextra Full arrow: occlusal lesion at the level of a. coronaria dextra Arrow with contour  =  moderate stenotic atheromatous plaques

5.10 Bivascular Coronary Disease

Fig. 5.61  Coronary CTA 3D MPR 1. R. circumflexus + r. marginalis sinister without evident stenotic lesions

171

172

5  Coronary Angiography

5.11 Trivascular Coronary Disease Fig. 5.62 Coronary CTA 3D VRT 1. Aorta 2. Truncus a. pulmonalis 3. R. interventricularis anterior 4. R. lateralis 5. A. coronaria dextra

5.11 Trivascular Coronary Disease

173

Fig. 5.63  Coronary CTA 3D VRT 1. Aorta 2. Truncus a. pulmonalis 3. R. interventricularis anterior 4. A. coronaria dextra 5. Auricula dextra

Fig. 5.65  Coronary CTA 3D VRT 1. Aorta 2. A. coronaria dextra 3. R. interventricularis anterior 4. R. circumflexus 5. Truncus a. coronaria sinistra

Fig. 5.64  Coronary CTA 3D VRT 1. Aorta 2. Truncus a. coronaria sinistra 3. A. coronaria dextra The full arrow indicates stenotic area at the level of a. coronaria dextra pars proximalis

Fig. 5.66  Coronary CTA 3D MPR 1. A. coronaria sinistra 2. R. interventricularis anterior The full arrow indicates severe stenotic lesion The Empty arrow indicates severe stenotic lesion

174

5  Coronary Angiography

Fig. 5.67  Coronary CTA 3D MPR 1. A. coronaria sinistra 2. R. interventricularis anterior Full arrow  =  significant stenotic lesion ostial located at the r. interventricularis anterior Arrow with contour = ranged non-­calcified atherosclerotic plaques located in the middle and distal segments

Fig. 5.69  Coronary angiography 3D MPR 1. R. marginalis sinister The full arrow indicates non-calcified significantly stenotic plaques located at pars proximalis of r. marginalis sinister

Fig. 5.68  Coronary angiography 3D MPR 1. R. circumflexus The full arrow indicates non-calcified mild stenotic plaques located at pars proximalis of r. circumflexus

Fig. 5.70  Coronary angiography 3D MPR 1. A. coronaria dextra 2. R. interventricularis posterior The full arrow indicates non-calcified eccentric plaques, subocclusive located at the pars proximalis of a. coronaria dextra

5.12 Aneurysm of the Left Ventricle and R. Interventricularis Anterior Occlusion

175

5.12 Aneurysm of the Left Ventricle and R. Interventricularis Anterior Occlusion Fig. 5.71 Coronary CTA 3D VRT 1. Aorta 2.  Truncus a. coronaria sinistra 3. Occluded a interventricularis anterior in middle and distal segment 4. A. coronaria dextra 5. Ventriculus sinister aneurysm

176

5  Coronary Angiography

Fig. 5.72  Coronary CTA 3D VRT 1. Aorta 2. A. coronaria dextra 3. Significantly stenotic lesion of a. coronaria sinistra 4. R. interventricularis anterior with occlusion in the middle part

Fig. 5.74  Coronary CTA VRT The full arrow indicates aneurysm

Fig. 5.73  Coronary CTA 3D VRT 1. Aorta 2. Truncus coronaria sinistra 3. R. interventricularis anterior 4. A. coronaria dextra 5. Ventriculus sinister aneurysm

Fig. 5.75  Coronary CTA VRT 1. Aorta 2. A. coronaria dextra 3. Ventriculus sinister aneurysm 4. Sever stenotic ostial lesion of truncus a. coronaria sinistra 5. R. interventricularis anterior

5.12 Aneurysm of the Left Ventricle and R. Interventricularis Anterior Occlusion

Fig. 5.76  Coronary CTA 3D VRT 1. Aorta 2. A. coronaria dextra 3. Truncus a. coronaria sinistra

Fig. 5.77  Coronary CTA 3D MPR 1. Aorta 2. R. interventricularis anterior Full arrow  =  significantly stenotic lesion of ostium a. coronaria sinistra Arrow with contour  =  r. interventricularis anterior with occlusion in the middle part

177

Fig. 5.78  Coronary CTA 3D MPR 1. Truncus a. coronaria sinistra 2. Aorta Full arrow = severe stenotic lesion of ostium a. coronaria sinistra Arrow with contour  =  r. interventricularis anterior with occlusion in the middle part

178

5  Coronary Angiography

5.13 Monovascular Coronary Disease Patent Stent in the Middle Segment of R. Interventricularis Anterior Fig. 5.79  3D VRT colour reconstruction 1. Aorta 2. Truncus a. pulmonalis 3. R. interventricularis anterior—pars proximalis 4. R. circumflexus 5. R. lateralis 6. Auricula sinistra The full arrow indicates stent

5.13 Monovascular Coronary Disease Patent Stent in the Middle Segment of R. Interventricularis Anterior

179

Fig. 5.80  3D VRT colour reconstruction 1. Aorta 2. Truncus a. pulmonalis 3. Auricula sinistra 4. R. interventricularis anterior—pars proximalis 5. R. interventricularis anterior—pars distalis 6. R. lateralis The full arrow indicates stent

Fig. 5.82  3D VRT colour reconstruction 1. Aorta 2. Truncus a. coronaria sinistra 3. R. circumflexus 4. R. interventricularis anterior—pars proximalis 5. Patent stent on r. interventricularis anterior, middle part 6. R. interventricularis anterior—pars distalis 7. R. lateralis 8. ACD

Fig. 5.81  3D VRT colour reconstruction 1. Aorta 2. A. coronaria dextra 3. Truncus a. coronaria sinistra 4. R. circumflexus

Fig. 5.83  3D MPR reconstruction 1. Truncus a. coronaria sinistra 2. R. interventricularis anterior—pars proximalis 3. Patent stent 4. Stent 5. R. interventricularis anterior—pars distalis

180

Fig. 5.84  3D MPR reconstruction 1. Truncus a. coronaria sinistra 2. R. interventricularis anterior—pars proximalis 3. Patent stent 4. Stent 5. R. interventricularis anterior—pars distalis The full arrow indicates calcified atheromatous plaque

Fig. 5.85  3D MPR reconstruction The full arrow indicates permeable stent at the middle segment of r. interventricularis anterior

5  Coronary Angiography

Fig. 5.86  3D MPR reconstruction The full arrow indicates permeable stent at the middle segment of r. interventricularis anterior

5.14 Restenosis at Stent Level

181

5.14 Restenosis at Stent Level Fig. 5.87  3D VRT colour reconstruction 1. Aorta 2. Truncus coronaria sinistra 3. R. circumflexus 4. R. interventricularis anterior 5. A. coronaria dextra 6.  Stent at the level of a. coronaria dextra proximal from crux cordis

182

5  Coronary Angiography

Fig. 5.88  3D VRT colour reconstruction 1. Aorta 2. R. circumflexus 3. R. atrialis intermedius 4. R. interventricularis anterior 5. R. lateralis

Fig. 5.90  3D VRT colour reconstruction 1. Aorta 2. Truncus a. coronaria sinistra 3. R. circumflexus 4. R. intermedius 5. R. interventricularis anterior

Fig. 5.89  3D VRT colour reconstruction 1. Aorta 2. R. interventricularis anterior 3. A. coronaria dextra

Fig. 5.91  3D MPR reconstruction 1. Aorta 2. A. coronaria dextra 3. Stent 4. Bifurcation The full arrow indicates restenosis area in stent

5.14 Restenosis at Stent Level

Fig. 5.92  3D MPR reconstruction 1. Aorta 2. A. coronaria dextra 3. Stent 4. Bifurcation The full arrow indicates restenosis area in stent

Fig. 5.93  3D MPR reconstruction The full arrow indicates restenosis area in stent

183

Fig. 5.94  3D MPR reconstruction The full arrow indicates restenosis area in stent

184

5  Coronary Angiography

5.15 Occlusion of R. Interventricularis Anterior Fig. 5.95  3D VRT colour reconstruction 1. Aorta 2. R. circumflexus 3. A. coronaria dextra 4. Ventriculus sinister

5.15 Occlusion of R. Interventricularis Anterior

185

Fig. 5.96  3D VRT colour reconstruction 1. Aorta 2. A. coronaria dextra Full arrow = calcified atherosclerotic plaque Arrow with contour = stent

Fig. 5.98  3D VRT colour reconstruction 1. Aorta 2. A. coronaria dextra 3. R. circumflexus The full arrow indicates stents at the level of a. coronaria dextra and r. circumflexus

Fig. 5.97  3D VRT colour reconstruction Full arrow = stent at the level of r. circumflexus Arrow with contour = r. marginalis sinister

Fig. 5.99  3D MPR reconstruction 1. Stents at the level of r. circumflexus 2. R. marginalis sinister The full arrow indicates stent restenotic area

186

Fig. 5.100  3D MPR reconstruction 1. Aorta 2. A. coronaria dextra Full arrow = stenotic lesion proximal stent Arrow with contour = stenotic area in stent At the tip of the arrow = dissection area distally located from the stent confirmed by invasive angiography

5  Coronary Angiography

5.16 Coronary Bypass Evaluation

187

5.16 Coronary Bypass Evaluation Fig. 5.101  3D VRT colour reconstruction after removal of the thoracic cage 1. Aorta 2. A. thoracica interna grafted at the level of r. interventricularis anterior 3. A. thoracica interna dextra grafted in the middle parts of a. coronaria dextra 4. Truncus a. pulmonalis 5. Post-anastomotic segment of a. coronaria dextra 6. Post-anastomotic segment of r. interventricularis posterior 7. Pars proximalis et media of a. coronaria dextra with occlusive lesions

188

Fig. 5.102  3D VRT colour reconstruction after removal of the costal grill 1. Aorta 2. Truncus a. pulmonalis 3. A. thoracica interna sinistra 4.  Post-anastomotic segment of r. interventricularis anterior 5. R. marginalis sinister 6. R. lateralis

Fig. 5.103  3D VRT colour reconstruction after removal of the thoracic cage 1. Aorta 2. Truncus a. pulmonalis 3. A. thoracica interna sinistra grafted to r. interventricularis anterior 4. Pars distalis of r. interventricularis anterior 5. R. lateralis 6. R. marginalis sinister

5  Coronary Angiography

Fig. 5.104  3D VRT colour reconstruction after removal of the thoracic cage 1. Aorta 2.  A. thoracica interna dextra grafted to a. coronaria dextra 3. Saphenous venous graft to r. circumflexus 4. Pars distalis of a. coronaria dextra 5. R. marginalis sinister

5.17 Fallot Tetralogy

189

5.17 Fallot Tetralogy Fig. 5.105  3D VRT colour reconstruction 1. Aorta 2. Vena cava superior 3. Auricula dextra

190

5  Coronary Angiography

Fig. 5.106  3D VRT colour reconstruction 1. Arcus aortae 2. Colateralis aorto-pulmonalis 3. Atrium sinistrum 4. Aorta descendens

Fig. 5.108  3D VRT colour reconstruction 1. Arcus aortae with emergent vessels 2. Aorta descendens 3. Colateralis aorto-pulmonalis

Fig. 5.107  3D VRT colour reconstruction 1. Arcus aortae 2. Colateralis aorto-pulmonalis 3. Atrium sinistrum 4. Aorta descendens

Fig. 5.109  3D MIP reconstruction 4CV 1. Aorta “riding” on the septum with predominant ventriculus dexter loading 2. Atrium sinistrum 3. Ventriculus sinister 4. Ventriculus dexter 5. Septum interventricularis 6. Aorta descendens 7. Vena pulmonalis

5.17 Fallot Tetralogy

Fig. 5.110  3D MIP reconstruction, axial plane 1. Aorta ascendens 2. Aorta descendens 3. Colateralis aorto-pulmonalis

191

Fig. 5.111  3D MIP reconstruction 1. Ventriculus sinister 2. Ventriculus dexter 3. A. pulmonalis with severe stenosis over and under the valvae

192

5  Coronary Angiography

5.18 Fallot Tetralogy in an Adult Patient Fig. 5.112  3D MIP reconstruction 1.  Aorta “riding” on the septum 2. Ventriculus dexter 3. Atrium sinistrum 4. Ventriculus sinister 5. Vena pulmonalis 6. Aorta descendens 7. Atrium dextrum 8. Septum interventricularis

5.18 Fallot Tetralogy in an Adult Patient

Fig. 5.113  3D MIP colour reconstruction 1. Vena cava superior 2. Atrium dextrum 3. Aorta 4. Truncus a. pulmonalis 5. A. pulmonalis dextra 6. A. pulmonalis sinistra 7. Valva trunci pulmonalis 8. Stenosis area under the valvae

Fig. 5.114  3D MIP colour reconstruction 1. Vena cava superior 2. Atrium dextrum 3. Aorta 4. Truncus a. pulmonalis 5. Valva trunci pulmonalis 6. Stenotic area under the valve

193

Fig. 5.115  3D VRT colour reconstruction 1. Aorta 2. A. pulmonalis 3. R. interventricularis anterior 4. A. coronaria dextra

6

Abdominal Angiography

Contents 6.1

Normal Abdominal Angiography

 196

6.2

 neurysm of Truncus Coeliacus and Stenotic Lesion of A. Hepatica A Communis

 199

6.3

Left Renal Arteriovenous Fistula

 201

6.4

Aorta Abdominalis Aneurysm with Aortoduodenal Fistula

 204

6.5

Operated Aorta Abdominalis Aneurysm: Postoperatory Complications 207

6.6

Stenosis of A. Renalis Sinistra

 210

6.7

 ight A. Renalis Dextra Occlusion Collateral Circulation for Renal R Parenchyma

 213

6.8

Dissection of Aorta Abdominalis

 216

6.9

 eparate Emergence of A. Hepatica Communis and A. Splenica S Additional Polar Left Superior A. Renalis Sinistra

 218

6.10 M  ultiple Aneurysms of A. Splenica Associated with Aneurysm of A. Renalis Dexter

© Springer Nature Switzerland AG 2019 G. D. Miclaus, H. Ples, Atlas of CT Angiography, https://doi.org/10.1007/978-3-030-16095-1_6

 221

195

6  Abdominal Angiography

196

6.1

Normal Abdominal Angiography Fig. 6.1  3D VRT colour reconstruction frontal plane 1. Aorta abdominalis 2. Truncus coeliacus 3. A. splenica 4. A. hepatica communis 5. A. renalis dextra 6. A. renalis sinistra 7. A. iliaca communis dextra 8. A. iliaca communis sinistra

6.1 Normal Abdominal Angiography

Fig. 6.2  3D VRT colour reconstruction right, anterior oblique plane 1. Aorta abdominalis 2. Truncus coeliacus 3. A. renalis dextra 4. A. mesenterica superior 5. A. iliaca communis dextra 6. A. iliaca communis sinistra

Fig. 6.3  3D VRT colour reconstruction left, anterior oblique plane 1. Aorta abdominalis 2. Truncus coeliacus 3. A. renalis sinistra 4. A. mesenterica superior 5. A. iliaca communis dextra 6. A. iliaca communis sinistra

197

Fig. 6.4  3D VRT colour reconstruction left, after removal of the bone structure 1. A. abdominalis 2. Truncus coeliacus 3. A. hepatica communis 4. A. splenica 5. A. mesenterica superior 6. A. renalis dextra 7. A. renalis sinistra 8. A. mesenterica inferior 9. A. iliaca communis 10. A. iliaca communis

198

Fig. 6.5  3D VRT colour reconstruction left, after removal of the bone structure 1. A. abdominalis 2. Truncus coeliacus 3. A. mesenterica superior 4. A. splenica 5. A. renalis sinistra 6. A. mesenterica inferior 7. A. iliaca communis 8. A. iliaca communis

6  Abdominal Angiography

Fig. 6.6  3D VRT colour reconstruction left, after removal of the bone structure, posterior plane 1. A. abdominalis 2. A. splenica 3. A. hepatica communis 4. A. renalis sinistra 5. A. renalis dextra 6. A. iliaca communis 7. A. iliaca communis

6.2 Aneurysm of Truncus Coeliacus and Stenotic Lesion of A. Hepatica Communis

6.2

199

Aneurysm of Truncus Coeliacus and Stenotic Lesion of A. Hepatica Communis Fig. 6.7  3D VRT reconstruction frontal view 1. Aorta 2. A. splenica 3. A. hepatica communis 4. A. mesenterica superior 5. A. renalis dexter 6. A. renalis sinister 7. V. renalis sinister 8. V. renalis dexter 9. V. cava inferior 10. Hepatic haemangiomas

200

Fig. 6.8  3D VRT reconstruction anterolateral view 1. Aorta 2. Truncus coeliacus 3. Aneurysm of truncus coeliacus 4. A. gastrica sinistra 5. A. splenica 6. A. hepatica communis 7. A. mesenterica superior 8. A. renalis sinistra 9. V. renalis sinistra 10. Haemangiomas of the liver 11. V. cava inferior

6  Abdominal Angiography

Fig. 6.9  3D MIP reconstruction, sagittal plane 1. Aorta 2. Truncus coeliacus 3. Aneurysm of truncus coeliacus, with calcified plaques 4. A. gastrica sinistra 5. A. splenica 6. A. hepatica communis 7. A. mesenterica superior 8. A. mesenterica inferior

Fig. 6.10  3D MIP reconstruction, transversal plane 1. Aorta 2. Truncus coeliacus 3. Aneurysm of truncus coeliacus 4. A. hepatica communis 5. A. splenica 6. Haemangiomas of the liver The full arrow indicates stenotic lesion of a. hepatica communis

6.3 Left Renal Arteriovenous Fistula

6.3

201

 eft Renal Arteriovenous L Fistula Fig. 6.11  3D VRT colour reconstruction 1. Aorta abdominalis 2. A. mesenterica superior 3. A. renalis dextra 4. Vena cava inferior 5. A. renalis sinistra 6. Vena renalis sinistra 7. Aneurysmal dilatations on the renal arteriovenous fistula’s course 8. Normal vascularisation of the right kidney— absence of vascularisation of the left renal parenchyma which can be observed

202

Fig. 6.12  3D VRT colour reconstruction after removal of the bone structure 1. Aorta 2. Vena cava inferior 3. Truncus coeliacus 4. A. splenica 5. A. hepatica 6. A. mesenterica superior 7. A. renalis dextra 8. A. renalis sinistra 9. A. mesenterica inferior 10. Vena renalis sinistra with retroaortic course 11. Aneurysmal dilatations on the left renal arteriovenous fistula’s course

6  Abdominal Angiography

Fig. 6.13  3D VRT colour reconstruction after removal of the bone structure, posterior plane 1. Aorta 2. Vena cava inferior 3. A. hepatica 4. A. splenica 5. A. renalis dextra 6. A. renalis sinistra 7. Vena renalis sinistra with retroaortic course 8. A. mesenterica superior 9. Aneurysmal dilatations on the fistula’s course Full arrow indicates calcification of fistula wall

6.3 Left Renal Arteriovenous Fistula

Fig. 6.14  3D VRT colour reconstruction after removal of the bone structure 1. Aorta 2. Vena cava inferior 3. Truncus coeliacus 4. A. mesenterica superior 5. A. renalis sinistra 6. Vena renalis sinistra 7. A. renalis dextra The full arrow indicates aneurysmal dilated fistula course

Fig. 6.15  3D VRT colour reconstruction anterior frontal plane (enlarged image) 1. Aorta 2. Vena cava inferior 3. A. mesenterica superior 4. A. renalis dextra 5. A. renalis sinistra 6. Vena renalis sinistra 7. Aneurysmal dilatations on the fistula’s course

203

Fig. 6.16  3D VRT colour reconstruction posterior frontal plane (enlarged image) 1. Aorta 2. A. hepatica 3. A. splenica 4. A. renalis dextra 5. A. renalis sinistra 6. V. renalis sinistra 7. Aneurysmal dilatations of fistula with calcified plaques marked through full arrows

6  Abdominal Angiography

204

6.4

Aorta Abdominalis Aneurysm with Aortoduodenal Fistula Fig. 6.17  3D MIP reconstruction frontal plane 1. Aneurysmal dilated aortic lumen 2. Thrombosis area of the aneurysm The full arrow indicates aneurysm with parietal calcifications

6.4 Aorta Abdominalis Aneurysm with Aortoduodenal Fistula

205

Fig. 6.18  3D MIP reconstruction frontal plane 1. Aneurysmal dilated aortic lumen 2. Emergence and pars proximalis a. renalis dextra 3. Thrombotic area 4. A. iliaca communis 5. A. iliaca communis

Fig. 6.20  3D MIP reconstruction sagittal plane 1. Aneurysmal dilated aorta 2. Mural thrombosis of aneurysm 3. A. iliaca communis

Fig. 6.19  3D MIP reconstruction sagittal plane 1. Aorta abdominalis 2. A. mesenterica superior 3. Aneurysm dilated at the level of aorta abdominalis 4. Mural thrombosis area

Fig. 6.21  3D MIP reconstruction sagittal plane 1. Aneurysmal dilated aorta 2. Parietal thrombosis 3. Fistulas course at the aneurysm level which communicated with duodenum

206

Fig. 6.22  3D MIP reconstruction sagittal plane 1. Aneurysmal dilated aorta 2. Parietal thrombosis 3. Fistulas course

6  Abdominal Angiography

6.5 Operated Aorta Abdominalis Aneurysm: Postoperatory Complications

6.5

207

 perated Aorta Abdominalis O Aneurysm: Postoperatory Complications Fig. 6.23  3D MIP reconstruction axial plane 1. Lumen of aortic graft 2. Periprosthetic haematoma Full arrow = calcified plaques of the aortic wall The tip of the arrows = indicate presence of gas bubbles at the level of periprosthetic haematoma suggesting over-infection

208

6  Abdominal Angiography

Fig. 6.24  3D MIP reconstruction axial plane 1. Lumen of aortic graft 2. Periprosthetic haematoma Full arrow = calcified plaques of the aortic wall The tip of the arrows = indicate presence of gas bubbles at the level of periprosthetic haematoma suggesting over-infection

Fig. 6.26  3D MIP reconstruction frontal plane 1. Lumen of aortic graft 2. Periprosthetic haematoma Full arrow = calcified plaques of the aortic wall The tip of the arrows = indicate presence of gas bubbles at the level of periprosthetic haematoma suggesting over-infection

Fig. 6.25  3D MIP reconstruction frontal plane 1. Lumen of aortic graft 2. Periprosthetic haematoma Full arrow = calcified plaques of the aortic wall The tip of the arrows = indicate presence of gas bubbles at the level of periprosthetic haematoma suggesting over-infection

Fig. 6.27  3D MIP reconstruction sagittal plane 1. Lumen of aortic graft 2. Periprosthetic haematoma Full arrow = calcified plaques of the aortic wall The tip of the arrows = indicate presence of gas bubbles at the level of periprosthetic haematoma suggesting over-infection

6.5 Operated Aorta Abdominalis Aneurysm: Postoperatory Complications

Fig. 6.28  3D MIP reconstruction sagittal plane 1. Lumen of aortic graft 2. Periprosthetic haematoma Full arrow = calcified plaques of the aortic wall The tip of the arrows = indicate presence of gas bubbles at the level of periprosthetic haematoma suggesting over-infection

209

6  Abdominal Angiography

210

6.6

Stenosis of A. Renalis Sinistra Fig. 6.29  3D VRT colour reconstruction after removal of the bone structure 1. Aorta abdominalis 2. Truncus coeliacus 3. A. splenica 4. A. hepatica 6. A. renalis dextra 7. A. renalis sinistra 8. A. iliacae comunae 9. A. iliacae comunae The tip of the arrows indicate severe ostial stenotic area

6.6 Stenosis of A. Renalis Sinistra

211

Fig. 6.30  3D VRT colour reconstruction after removal of the bone structure 1. Aorta abdominalis 2. Truncus coeliacus 3. A. splenica 4. A. hepatica 6. A. renalis dextra 7. A. renalis sinistra 8. A. iliacae comunae 9. A. iliacae comunae The tip of the arrows indicate severe ostial stenotic area

Fig. 6.32  3D MIP reconstruction after removal of the bone structure 1. Aorta abdominalis 2. Truncus coeliacus 3. A. splenica 4. A. hepatica 6. A. renalis dextra 7. A. renalis sinistra 8. A. iliacae comunae 9. A. iliacae comunae The tip of the arrows indicate severe ostial stenotic area

Fig. 6.31  3D VRT colour reconstruction after removal of the bone structure 1. Aorta abdominalis 2. Truncus coeliacus 3. A. splenica 4. A. hepatica 6. A. renalis dextra 7. A. renalis sinistra 8. A. iliacae comunae 9. A. iliacae comunae The tip of the arrows indicate severe ostial stenotic area

Fig. 6.33  3D VRT reconstruction The full arrow indicates severe stenosis of a. renalis sinistra

212

Fig. 6.34  3D MIP reconstruction, frontal plane 1. Aorta 2. A. renalis dextra 3. A. renalis sinistra The tip of the arrows indicate severe stenotic area

Fig. 6.35  3D MIP reconstruction, frontal plane 1. Aorta 2. A. renalis dextra 3. A. renalis sinistra The tip of the arrows indicate severe stenotic area

6  Abdominal Angiography

Fig. 6.36  Determination of stenosis grade

6.7 Right A. Renalis Dextra Occlusion Collateral Circulation for Renal Parenchyma

6.7

213

 ight A. Renalis Dextra R Occlusion Collateral Circulation for Renal Parenchyma Fig. 6.37  3D VRT colour reconstruction 1. Aorta 2. Truncus coeliacus 3. A. mesenterica superior 4. A. renalis sinistra 5. Ren dextra 6. Ren sinistra 7. A. intercostalis from which hilum renale irrigating collateral develops The full arrow indicates ren dextra vascularised through collateral arteries

214

6  Abdominal Angiography

Fig. 6.38  3D VRT colour reconstruction, after removal of the bone structure 1. Aorta 2. Truncus coeliacus 3. A. hepatica communis 4. A. splenica 5. A. renalis sinistra 6. A. mesenterica superior The arrow indicates ren dextra vascularised through collateral arteries

Fig. 6.40  3D MIP reconstruction, coronal plane 1. Aorta 2. A. renalis sinistra Full arrow = vascularised hilum renale dextra Arrow with contour = a. renalis dextra with chronic occlusion from the emergence

Fig. 6.39  3D VRT colour reconstruction, transversal plane 1. Aorta 2. Truncus coeliacus 3. A. hepatica communis 4. A. splenica 5. A. renalis sinistra 6. A. mesenterica superior The arrow indicates ren dextra vascularised through collateral arteries

Fig. 6.41  3D MIP reconstruction, coronal plane 1. Aorta Full arrow = collateral with ascending course to hilum renale dextra Arrow with contour = vascularised hilum renale dextra The tip of the arrow = a. intercostalis from which collateral develops

6.7 Right A. Renalis Dextra Occlusion Collateral Circulation for Renal Parenchyma

Fig. 6.42  3D MIP reconstruction, coronal plane 1. Aorta The arrows indicate collateral course to hilum renale dextra

215

6  Abdominal Angiography

216

6.8

Dissection of Aorta Abdominalis Fig. 6.43  3D VRT colour reconstruction after removal of the bone structure 1. Aorta ascendens 2. Arcus aortae 3. Aorta descendens 4. A. splenica 5. A. hepatica 6. A. mesenterica superior 7. A. renalis dextra 8. A. renalis sinistra 9. A. iliaca communis dextra 10. A. iliaca communis sinistra with dissection fold 11. True lumen

6.8 Dissection of Aorta Abdominalis

Fig. 6.44  3D VRT colour reconstruction 1. Aorta ascendens 2. Arcus aortae 3. Aorta thoracica 4. True lumen of aorta abdominalis 5. False lumen 6. Dissection fold

Fig. 6.45  3D VRT colour reconstruction 1. Aorta abdominalis 2. False lumen 3. From the lumen emerges the iliac trunk 4. A. mesenterica superior 5. From the true lumen emerges a. renalis dextra 6. Dissection fold

217

Fig. 6.46  3D VRT colour reconstruction 1. Aorta ascendens 2. Aorta descendens 3. False lumen 4. True lumen of aorta abdominalis 5. A. mesenterica superior 6. A. renalis dextra 7. True lumen

6  Abdominal Angiography

218

6.9

Separate Emergence of A. Hepatica Communis and A. Splenica Additional Polar Left Superior A. Renalis Sinistra Fig. 6.47  3D VRT colour reconstruction 1. Aorta 2. A. splenica 3. A. hepatica communis 4. A. mesenterica superior 5. A. renalis dextra 6. Additional a. renalis sinistra 7. A. renalis sinistra

6.9 Separate Emergence of A. Hepatica Communis and A. Splenica Additional Polar Left Superior…

Fig. 6.48  3D VRT colour reconstruction 1. Aorta 2. Separate emergence of a. splenica from the aorta abdominalis 3. A. hepatica communis with independent aortic emergence 4. A. mesenterică superior 5. Additional polar left inferior a. renalis 6. A. renalis sinistra 7. A. renalis dextra 8. A. iliaca communa 9. A. iliaca communa 10. A. iliaca externa 11. A. iliaca interna

Fig. 6.50  3D MIP reconstruction, sagittal plane 1. Aorta 2. A. splenica 3. A. hepatica communis 4. A. mesenterica superior

Fig. 6.49  3D MIP reconstruction, transversal plane 1. Aorta 2. A. hepatica communis 3. A. splenica

Fig. 6.51  3D MIP reconstruction, axial plane 1. Aorta 2. A. renalis dextra 3. Additional polar left inferior a. renalis 4. A. renalis sinistra

219

220

Fig. 6.52  3D MIP reconstruction, axial plane 1. Aorta 2. A. renalis dextra 3. Additional polar left inferior a. renalis 4. A. renalis sinistra

6  Abdominal Angiography

6.10 Multiple Aneurysms of A. Splenica Associated with Aneurysm of A. Renalis Dexter

221

6.10 Multiple Aneurysms of A. Splenica Associated with Aneurysm of A. Renalis Dexter Fig. 6.53  3D VRT reconstruction, frontal plane 1. Aorta 2. Truncus coeliacus 3. A. hepatica communis 4. A. splenica 5. A. mesenterica superior 6. A. renalis dextra 7. A. renalis sinistra 8. Aneurysm of a. splenica

222

Fig. 6.54  3D VRT reconstruction, frontal plane, after removal of bony structures 1. Aorta 2. Truncus coeliacus 3. A. hepatica communis 4. A. splenica 5. A. gastrica sinistra 6. A. mesenterica superior 7. A. renalis dextra 8. A. renalis sinistra 9. Aneurysms of a. splenica

Fig. 6.55  3D VRT reconstruction, anterolateral view 1. Aneurysms of a. splenica 2. Aneurysms of a. splenica 3. Aneurysms of a. splenica 4. Aneurysm of a. renalis dextra

6  Abdominal Angiography

Fig. 6.56  3D VRT reconstruction, posterior view 1. Aneurysms of a. splenica 2. Aneurysms of a. splenica 3. Aneurysms of a. splenica 4. Aneurysm of a. renalis dextra

7

Peripheral Angiography

Contents 7.1

Normal Peripheral Angiography

 224

7.2

Leriche Syndrome

 229

7.3

Leriche Syndrome Axillobifemoral Bypass

 232

7.4

Leriche Syndrome Aortobifemoral and Femoropopliteal Graft 

 234

7.5

Aortobifemoral Graft and Aneurysms at the Level of Anastomosis

 238

7.6

Right Arm Occlusion of the Aortobifemoral Graft

 241

7.7

 ight Femoro-Fibular Graft: Occlusion of the Left Lower Limb R Arteries

 244

7.8

Iliac and Femoral Stents: In-Stent Restenosis 

 247

7.9

Iliac and Femoral Stents: Occluded Iliac Stents

 250

7.10 Autoimmune Vasculitis

 253

7.11 Tumour of the Leg

 256

7.12 Giant Tumour of the Thigh

 258

7.13 C  T Angiography of the Right Upper Limb: Occlusion of the Arteria Radialis Dextra

 260

7.14 Arteriovenous Malformation in Deltoid Region 

 262

7.15 CTA Run-Off: Incidental Finding

 265

© Springer Nature Switzerland AG 2019 G. D. Miclaus, H. Ples, Atlas of CT Angiography, https://doi.org/10.1007/978-3-030-16095-1_7

223

7  Peripheral Angiography

224

7.1

Normal Peripheral Angiography Fig. 7.1  3D VRT colour reconstruction, enlarged image 1. A. mesenterica superior 2. A. renalis sinistra 3. A. renalis dextra 4. Aorta abdominalis 5. A. iliacae communae 6. A. iliacae communae 7. A. iliacae internae 8. A. iliacae externae

Fig. 7.2 3D VRT colour reconstruction, bifurcatio aortae

Fig. 7.3  3D VRT colour reconstruction 1. A. iliacae externae 2. A. profunda femoris 3. A. femoralis

7.1 Normal Peripheral Angiography

225

Fig. 7.4 3D VRT reconstruction, a. femoralis pars distalis

Fig. 7.6  3D VRT reconstruction 1. A. tibialis anterior 2. A. peronea 3. A. tibialis posterior 4. A. dorsalis pedis

Fig. 7.5  3D VRT reconstruction 1. A. tibialis anterior 2. A. peronea

Fig. 7.7  3D VRT reconstruction at the level of dorsum pedis 1. A. tibialis anterior pars distalis 2. A. dorsalis pedis

226

7  Peripheral Angiography

Fig. 7.8  3D VRT reconstruction with visualisation of regio dorsalis pedis

Fig. 7.10  3D VRT reconstruction regio cruris and fossa poplitea 1. A. poplitea 2. A. tibialis posterior sinistra 3. A. peronea sinistra 4. A. tibialis anterior sinistra 5. A. peronea dextra 6. A. tibialis anterior dextra

Fig. 7.9  3D VRT colour reconstruction posterior image at the level of regio cruris 1. A. tibialis posterior sinistra 2. A. peronea sinistra 3. A. tibialis anterior sinistra 4. A. tibialis anterior dextra 5. A. peronea magna 6. Hypoplastic a. tibialis posterior dextra

Fig. 7.11  3D VRT reconstruction at the level of fossa poplitea, enlarged image

7.1 Normal Peripheral Angiography

227

Fig. 7.12  3D VRT reconstruction at the level of fossa poplitea and 1/3 distal part of crus with visualisation of a. femoralis

Fig. 7.14  3D VRT reconstruction after removal of the bone structure, visualisation of a. femoralis and a. profunda femoris

Fig. 7.13  3D VRT reconstruction at the level of 1/3 medialis part of crus with visualisation of a. profunda femoris

Fig. 7.15  3D VRT reconstruction after removal of the bone structure, at the level of abdomen with visualisation of bifurcation aortae and a. iliacae and a. femoralis

228

Fig. 7.16  3D VRT reconstruction after removal of the bone structure

7  Peripheral Angiography

7.2 Leriche Syndrome

7.2

229

Leriche Syndrome Fig. 7.17  3D VRT colour reconstruction 1. Aorta abdominalis + pars proximalis 2. Truncus coeliacus 3. A. renalis sinistra 4. A. renalis dextra 5. A. mesenterica superior 6. Aorta abdominalis pars distalis + thrombosis and calcification 7. A. iliacae comunae et externae thrombosed and calcified 8. A. iliacae comunae et externae thrombosed and calcified 9. A. mesenterica superior

230

7  Peripheral Angiography

Fig. 7.18  3D VRT colour reconstruction 1. Aorta abdominalis 2. A. mesenterica superior 3. A. mesenterica inferior 4. Collateral through a. mesenterica inferior is vascularised 5. A. iliaca communis calcified and thrombosed

Fig. 7.20  3D VRT colour reconstruction 1. A. mesenterica inferior 2. Collateral 3. A. iliacae communae thrombosed and calcified

Fig. 7.19  3D VRT colour reconstruction 1. Truncus coeliacus 2. Aorta abdominalis 3. Ar. mesenterica superior 4. Collateral 5. A. mesenterica inferior 6. A. iliacae communae thrombosed and calcified

Fig. 7.21  3D MIP reconstruction 1. Aorta abdominalis 2. A. renalis sinistra 3. A. renalis dextra 4. A. abdominalis, pars distalis thrombosed and calcified 5. A. mesenterica inferior

7.2 Leriche Syndrome

Fig. 7.22  3D MIP reconstruction, sagittal plane 1. A. abdominalis 2. Truncus coeliacus 3. A. mesenterica superior 4. A. abdominalis pars distalis thrombosed and calcified

231

7  Peripheral Angiography

232

7.3

Leriche Syndrome Axillobifemoral Bypass Fig. 7.23  3D VRT colour reconstruction 1. Aorta abdominalis 2. Extraanatomic axillofemoral graft 3. Occluded stent at the level of a. iliaca communis 4. A. femoralis

Fig. 7.24  3D VRT colour reconstruction right oblique incidence 1. Axillofemoral grafts 2. Occluded iliac stent 3. Anastomosis of a. femoralis graft

Fig. 7.25  3D VRT colour reconstruction right oblique incidence 1. Axillofemoral grafts 2. Aorta abdominalis 3. Anastomosis of a. femoralis

7.3 Leriche Syndrome Axillobifemoral Bypass

Fig. 7.26  3D VRT colour reconstruction 1. Extraanatomic grafts 2. Graft anastomosis + a. femoralis 3. A. femoralis

Fig. 7.27  3D MIP reconstruction 1. Aorta abdominalis 2. A. renalis sinistra 3. A. renalis dextra 4. Occluded iliac stent

233

Fig. 7.28  3D MIP reconstruction 1. Axillofemoral grafts 2. Graft anastomosis 3. A. femoralis

7  Peripheral Angiography

234

7.4

Leriche Syndrome Aortobifemoral and Femoropopliteal Graft Fig. 7.29  3D VRT reconstruction 1. Aorta abdominalis pars distalis 2. Aortobifemoral graft 3. Arm of aortobifemoral graft 4. Femoropopliteal graft 5. A. profunda femoris

7.4 Leriche Syndrome Aortobifemoral and Femoropopliteal Graft

235

Fig. 7.30  3D VRT reconstruction, left oblique incidence 1. Aorta abdominalis 2. Truncus coeliacus 3. A. mesenterica superior 4. Aorta abdominalis pars distalis 5. Aortobifemoral graft 6. Arms of aortobifemoral graft

Fig. 7.32 3D VRT reconstruction, right oblique incidence 1. Arm of aortobifemoral graft 2. A. profunda femoris 3. Femoropopliteal graft

Fig. 7.31 3D VRT reconstruction, right oblique incidence

Fig. 7.33  3D VRT reconstruction, left oblique incidence

236

7  Peripheral Angiography

Fig. 7.34  3D VRT reconstruction, sagittal plane 1. A. profunda femoris 2. Femoropopliteal graft

Fig. 7.36  3D MIP reconstruction frontal plane 1. Arm of aortobifemoral graft 2. A. profunda femoris 3. Femoropopliteal graft

Fig. 7.35  3D MIP reconstruction sagittal plane 1. Aorta abdominalis 2. Truncus coeliacus 3. A. mesenterica superior 4. Pars proximalis of aortobifemoral graft

Fig. 7.37  3D MIP reconstruction frontal plane 1. Arm of aortobifemoral graft 2. Femoropopliteal graft

7.4 Leriche Syndrome Aortobifemoral and Femoropopliteal Graft

Fig. 7.38  3D MIP reconstruction frontal plane 1. Femoropopliteal graft 2. Femoropopliteal anastomosis 3. A. popliteal

237

7  Peripheral Angiography

238

7.5

Aortobifemoral Graft and Aneurysms at the Level of Anastomosis Fig. 7.39  3D VRT colour reconstruction 1. Aorta abdominalis pars distalis with aneurysm at the level of the graft’s anastomosis 2. Aneurysm at the level of a. femoralis dextra 3. Aneurysm at the level of a. femoralis sinistra 4. A. femoralis dextra

7.5 Aortobifemoral Graft and Aneurysms at the Level of Anastomosis

Fig. 7.40  3D VRT colour reconstruction coronary plane, enlarged image 1. Aorta abdominalis 2. Aneurysm at the level of aortobifemoral graft anastomosis 3. Left arm of graft 4. Right arm of graft 5. Aneurysm at the level of anastomosis with a. femoralis dextra 6. Aneurysm at the level of anastomosis with a. femoralis sinistra 7. A. femoralis dextra

Fig. 7.41  3D VRT colour reconstruction 1. Aneurysm 2. Left arm of graft 3. Right arm of graft 4. Aneurysmal dilatations at the level of anastomosis 5. Aneurysmal dilatations at the level of anastomosis 6. A. femoralis dextra

Fig. 7.42  3D VRT colour reconstruction 1. Aneurysm 2. Left arm of graft 3. Right arm of graft 4. Aneurysmal dilatations at the level of anastomosis 5. Aneurysmal dilatations at the level of anastomosis 6. A. femoralis dextra

Fig. 7.43  3D VRT colour reconstruction 1. Aorta abdominalis 2. A. mesenterica superior 3. Aneurysm 4. Right arm of graft 5. Aneurysm at the level of anastomosis 6. A. femoralis dextra 7. Left arm of graft 8. Aneurysm

239

240

Fig. 7.44  3D MIP reconstruction 1. Aorta abdominalis 2. A. renalis sinistra 3. Aneurysm 4. Right arm of graft with aneurysmal dilatation on the level of anastomosis (5) 6. Aneurysmal dilatation at the level of left arm anastomosis

7  Peripheral Angiography

Fig. 7.45  3D MIP reconstruction, sagittal plane 1. Aorta abdominalis 2. Truncus coeliacus 3. A. mesenterica superior 4. Aneurysmal dilatation

7.6 Right Arm Occlusion of the Aortobifemoral Graft

7.6

241

 ight Arm Occlusion R of the Aortobifemoral Graft Fig. 7.46  3D VRT reconstruction 1. Proximal part of the graft 2. Left arm of the graft 3. Left arm anastomosis with arteria femoralis 4. Arteria profunda femoris sinistra 5. Arteria femoralis sinistra 6. Arteria femoralis dextra 7. Arteria profunda femoris dextra 8. Arteria femoralis dextra

242

7  Peripheral Angiography

Fig. 7.47  3D VRT reconstruction, oblique view 1. Proximal part of the graft 2. Left arm of the graft 3. Left arm anastomosis with arteria femoralis 4. Arteria profunda femoris sinistra 5. Arteria femoralis sinistra 6. Arteria femoralis dextra

Fig. 7.49  3D VRT reconstruction, oblique view 1. Proximal part of the graft 2. Left arm of the graft 3. Left arm anastomosis with arteria femoralis 4. Arteria profunda femoris sinistra 5. Arteria femoralis sinistra 6. Arteria femoralis dextra

Fig. 7.48  3D VRT reconstruction, oblique view 1. Proximal part of the graft 2. Left arm of the graft 3. Left arm anastomosis with arteria femoralis 4. Arteria profunda femoris sinistra 5. Arteria femoralis sinistra 6. Arteria femoralis dextra

Fig. 7.50  3D MIP reconstruction 1. Aorta abdominalis 2. Arteria renalis sinistra 3. Arteria renalis dextra 4. Aortic graft 5. Left arm of the aortobifemoral graft

7.6 Right Arm Occlusion of the Aortobifemoral Graft

Fig. 7.51  3D MIP reconstruction 1. Aorta 2. Left arm of the graft 3. Arteria femoralis sinistra 4. Arteria profunda femoralis sinistra 5. Arteria femoralis sinistra 6. Arteria femoralis dextra

243

7  Peripheral Angiography

244

7.7

 ight Femoro-Fibular Graft: R Occlusion of the Left Lower Limb Arteries Fig. 7.52  3D VRT reconstruction, coronal view 1. Arteria femoralis dextra 2. Arteria femoralis sinistra 3. Arteria profunda femoris sinistra 4. Arteria profunda femoris dextra 5. Right femoro-­fibular venous graft

7.7 Right Femoro-Fibular Graft: Occlusion of the Left Lower Limb Arteries

245

Fig. 7.53  3D VRT reconstruction, oblique view 1. Arteria iliaca externa dextra 2. Arteria iliaca externa sinistra 3. Arteria profunda femoris sinistra 4. Anastomosis of the venous graft at the distal level of the arteria iliaca externa dextra

Fig. 7.55  3D VRT reconstruction, posterior view, at the level of the popliteal fossa 1. Venous graft 2. Collateral arteries

Fig. 7.54  3D VRT reconstruction, posterior view 1. Right femoro-fibular venous graft 2. Arteria profunda femoris dextra 3. Arteria profunda femoris sinistra

Fig. 7.56  3D VRT reconstruction, posterior view at the level of the calf 1. Arteria fibularis dextra with multiple occlusive lesions 2. Right femoro-fibular venous graft 3. Venous graft anastomosis with arteria fibularis dextra 4. Arteria fibularis dextra

246

Fig. 7.57  3D VRT reconstruction, posterior view at the level of the calf 1. Arteria fibularis sinistra 2. Anastomosis 3. Arteria fibularis dextra

7  Peripheral Angiography

7.8 Iliac and Femoral Stents: In-Stent Restenosis

7.8

247

I liac and Femoral Stents: In-Stent Restenosis Fig. 7.58  3D VRT reconstruction in coronal plane 1. Aorta abdominalis 2. Arteria mesenterica superior 3. Arteria iliaca communis 4. Arteria iliaca externa 5. Stent at the level of the arteria iliaca externa 6. Arteria femoralis

248

7  Peripheral Angiography

Fig. 7.59  3D VRT reconstruction in coronal plane 1. Arteria iliaca communis dextra 2. Arteria iliaca communis sinistra 3. Stent in the arteria iliaca externa dextra 4. Stent in the arteria iliaca externa sinistra 5. Arteria femoralis 6. Arteria femoralis

Fig. 7.61  Curved 3D MPR 1. Arteria iliaca externa dextra 2. Patent in-stent lumen 3. Proximal in-stent restenosis 4. Stent

Fig. 7.60  3D VRT reconstruction 1. Arteria femoralis dextra 2. Stent in arteria femoralis dextra 3. Arteria femoralis sinistra

Fig. 7.62  Axial 3D MPR 1. Stent 2. Patent lumen 3. Neointimal proliferation (restenosis)

7.8 Iliac and Femoral Stents: In-Stent Restenosis

Fig. 7.63  3D MPR at the femoral level 1. Patent lumen at the level of arteria femoralis dextra 2. Stent 3. Area with neointimal hyperplasia

249

Fig. 7.64  3D MPR, axial plane 1. Stent 2. Patent lumen 3. Neointimal hyperplasia

7  Peripheral Angiography

250

7.9

I liac and Femoral Stents: Occluded Iliac Stents Fig. 7.65  3D VRT reconstruction 1. Aorta abdominalis 2. Arteria mesenterica superior 3. Thrombosis at the level of arteria iliaca communis and arteria iliaca externa dextra 4. Thrombosis at the level of arteria iliaca communis and arteria iliaca externa sinistra 5. Thrombosis of a. iliaca communis

7.9 Iliac and Femoral Stents: Occluded Iliac Stents

251

Fig. 7.66  3D VRT reconstruction 1. Aorta abdominalis 2. Occlusion at the level of arteria iliaca communis sinistra 3. Occluded stent at the level of arteria iliaca externa sinistra 4. Occluded stent at the level of arteria iliaca externa dextra 5. Arteria femoralis dextra 6. Arteria femoralis sinistra

Fig. 7.68  3D MIP reconstruction 1. Aorta abdominalis 2. and 3. Occluded stents 4. Occlusion at the level of arteria iliaca communis sinistra

Fig. 7.67  Reconstruction 3D VRT 1. Occluded stents at the level of arteria iliaca communis and arteria iliaca externa dextra 2. Occluded stent at the level of arteria iliaca externa sinistra 3. Arteria femoralis 4. Arteria femoralis

Fig. 7.69  3D MIP reconstruction at the thigh level 1. Arteria iliaca externa 2. and 4. Arteria femoralis 3. Patent stent at the level of arteria femoralis dextra

252

Fig. 7.70  3D MPR reconstruction 1. Occluded stents 2. Occluded stents

7  Peripheral Angiography

7.10 Autoimmune Vasculitis

253

7.10 Autoimmune Vasculitis Fig. 7.71  3D VRT reconstruction 1. Arteria iliaca externa 2. Arteria femoralis 3. Arteria femoralis

Fig. 7.72  3D VRT reconstruction 1. Arteria femoralis 2. Arteria profunda femoris

Fig. 7.73  3D VRT reconstruction 1. Arteria tibialis posterior 2. Arteria fibularis

254

7  Peripheral Angiography

Fig. 7.74  3D VRT reconstruction of the distal segment of the calf with absence of arteria tibialis anterior and arteria dorsalis pedis

Fig. 7.76  3D VRT reconstruction, posterior view 1. Arteria tibialis posterior 2. Arteria fibularis

Fig. 7.75  3D VRT reconstruction of the distal segment of the calf with absence of arteria tibialis anterior and arteria dorsalis pedis

Fig. 7.77  3D MIP reconstruction 1. Arteria tibialis posterior 2. Arteria tibialis posterior 3. Arteria fibularis

7.10 Autoimmune Vasculitis

Fig. 7.78  3D MIP reconstruction 1. Arteria tibialis anterior (artery can be visible only to the middle third of the leg)

255

256

7  Peripheral Angiography

7.11 Tumour of the Leg Fig. 7.79  3D VRT reconstruction, arterial phase 1. Arteria tibialis posterior sinistra 2. Arteria tibialis anterior sinistra 3. Hypervascular tumour

Fig. 7.80  3D VRT reconstruction, arterial phase 1. Arteria tibialis anterior sinistra 2. Hypervascular tumour 3. Arteria plantaris 4. Arteria tibialis posterior sinistra

Fig. 7.81  3D VRT reconstruction, venous phase 1. Tumoural mass 2. Superficial and profound venous system

7.11 Tumour of the Leg

Fig. 7.82  3D VRT reconstruction, venous phase 1. Tumoural mass 2. Superficial and profound venous system

257

258

7  Peripheral Angiography

7.12 Giant Tumour of the Thigh Fig. 7.83  3D VRT reconstruction, pelvis and thigh 1. Arteria iliaca externa 2. Arteria iliaca externa 3. Arteria profunda femoris dextra 4. Arteria femoralis dextra 5. Arteria profunda femoris sinistra 6. Arteria femoralis sinistra 7. Tumoural mass with calcification and vascularisation, without embedding of the vascular package

7.12 Giant Tumour of the Thigh

Fig. 7.84  3D VRT reconstruction, pelvis and thigh 1. Arteria iliaca externa 2. Arteria iliaca externa 3. Arteria profunda femoris dextra 4. Arteria femoralis dextra 5. Arteria profunda femoris sinistra 6. Arteria femoralis sinistra 7. Tumoural mass with calcification and vascularisation, without embedding of the vascular package

Fig. 7.85  3D VRT reconstruction 1. Arteria iliaca communis 2. Arteria iliaca externa 3. Arteria iliaca externa 4. Tumoural mass with calcification 5. Arteria profunda femoris dextra 6. Arteria femoralis dextra 7. Arteria profunda femoris sinistra 8. Arteria femoralis sinistra

259

Fig. 7.86  3D VRT reconstruction 1. Arteria iliaca communis 2. Arteria iliaca externa 3. Arteria iliaca externa 4. Tumoural mass with calcification and invasion in the pelvis 5. Arteria profunda femoris dextra 6. Arteria femoralis dextra

260

7  Peripheral Angiography

7.13 C  T Angiography of the Right Upper Limb: Occlusion of the Arteria Radialis Dextra Fig. 7.87  3D VRT reconstruction 1. Arteria brachialis dextra 2. Arteria axillaris dextra

7.13  CT Angiography of the Right Upper Limb: Occlusion of the Arteria Radialis Dextra

Fig. 7.88  3D VRT reconstruction 1. Arteria ulnaris dextra 2. Arteria radialis dextra (occluded)

Fig. 7.89  3D MIP reconstruction 1. Arteria subclavia dextra 2. Arteria axillaris dextra 3. Arteria brachialis dextra 4. Arteria carotis communis

Fig. 7.90  3D MIP reconstruction 1. Arteria brachialis dextra 2. Arteria ulnaris dextra

261

262

7  Peripheral Angiography

7.14 Arteriovenous Malformation in Deltoid Region Fig. 7.91  3D VRT reconstruction, coronal view 1. Arteria subclavia sinistra 2. Arteria axillaris sinistra 3. Arteria brachialis sinistra 4. Arteriovenous malformation

7.14  Arteriovenous Malformation in Deltoid Region

263

Fig. 7.92  3D VRT reconstruction, posterior view 1. Arteriovenous malformation 2. Arteria brachialis sinistra

Fig. 7.94  3D MIP reconstruction 1. Arteria subclavia sinistra 2. Arteria brachialis sinistra 3. Arteriovenous malformation

Fig. 7.93  3D VRT reconstruction, after removing the thoracic cage 1. Arteria subclavia and arteria axillaris sinistra 2. Arteria brachialis sinistra 3. Arteriovenous malformation 4. Arcus aortae 5. Aorta descendens

Fig. 7.95  3D MIP reconstruction 1. Arteria axillaris sinistra 2. Arteriovenous malformation

264

Fig. 7.96  3D MIP reconstruction Arteriovenous malformation

7  Peripheral Angiography

7.15  CTA Run-Off: Incidental Finding

265

7.15 C  TA Run-Off: Incidental Finding Fig. 7.97  3D VRT reconstruction 1. Aorta abdominalis 2. Arteria iliaca communis 3. Arteria iliaca externa 4. Stones in the urinary bladder

8

Congenital Cardiac Malformations in Children

Contents 8.1 Pulmonary Atresia with MAPCA

 269

8.2 Atrial Septal Defect with Pulmonary Hypertension

 274

8.3 R  ight Aortic Arch with Aberrant Left Subclavian Artery Arising from Kommerell Diverticulum

 278

8.4 S  itus Inversus. Single Atrium. Atrial Septal Defect. Severe Pulmonary Subvalvular Stenosis. Polisplenia

 280

8.5 A  ortic Arch Hypoplasia. Agenezia of the Right Superior Vena Cava. Aberrant Left Superior Vena Cava with Drainage in Coronary Sinus

 285

8.6 Patent Ductus Arteriosus

 288

8.7 Kawasaki Disease 8.7.1  Kawasaki Disease: Baseline Examination 8.7.2  Kawasaki Disease: Same Patient, After Therapy

 291  291  294

8.8 P  ulmonary Arteriovenous Malformation. Left Aortic Arch with Aberrant Right Subclavian Artery

 298

8.9 D  ouble-Outlet Right Ventricle. Pulmonary Stenosis. Systemic-­ Pulmonary Shunt. Aberrant Left Superior Vena Cava with Drainage in Coronary Sinus

 303

8.10 Single Lateral Ventricle. Dextrocardia. Cavo-pulmonary Shunt (Glenn Procedure)

 309

8.11 Dextrocardia. Aberrant Left Superior Vena Cava Drainage in Coronary Sinus. Left Aortic Arch with Aberrant Right Subclavian Artery  316 8.12 Aortic Coarctation

 320

8.13 Right Aortic Arch with Aberrant Brachiocephalic Artery with NonKommerell Diverticulum. Tracheal Stenosis

 323

8.14 Patent Ductus Arteriosus Connected with Right Pulmonary Artery. Severe Stenosis of Pulmonary Trunk

 328

© Springer Nature Switzerland AG 2019 G. D. Miclaus, H. Ples, Atlas of CT Angiography, https://doi.org/10.1007/978-3-030-16095-1_8

267

8  Congenital Cardiac Malformations in Children

268

8.15 Operated Pentalogy of Fallot. Pulmonary Artery Aneurysm

 331

8.16 Tetralogy of Fallot 8.16.1  Tetralogy of Fallot: Preoperator 8.16.2  Tetralogy of Fallot: Postoperation

 336  336  340

8.17 Single Atrium. Pulmonary Artery Aneurysm. Complete Situs Inversus. Dextrocardia. Left Superior Vena Cava. Left Aortic Arch with Aberrant Right Subclavian Artery Arising from Kommerell Diverticulum  344 8.18 Severe Hypoplastic Aortic Arch. Patent Ductus Arteriosus

 349

8.19 Anomalous Right Pulmonary Venous Return (Sinus Venosus)

 352

8.20 Total Anomalous Pulmonary Venous Return in Coronary Sinus 8.20.1  Total Anomalous Pulmonary Venous Return in Coronary Sinus: Preoperator 8.20.2  Total Anomalous Pulmonary Venous Return in Coronary Sinus: Postoperator

 355

8.21 Common Arterial Trunk. Pulmonary Trunk and Right Pulmonary Artery Stenosis. Left Pulmonary Artery from Aorta. Right Aortic Arch with Aberrant Left Subclavian Artery 8.21.1  Common Arterial Trunk. Pulmonary Trunk and Right Pulmonary Artery Stenosis. Left Pulmonary Artery from Aorta. Right Aortic Arch with Aberrant Left Subclavian Artery: Preoperator 8.21.2  Common Arterial Trunk. Pulmonary Trunk and Right Pulmonary Artery Stenosis. Left Pulmonary Artery from Aorta. Right Aortic Arch with Aberrant Left Subclavian Artery: Postoperator 8.22 Giant Left Atrial Aneurysm

 355  358

 362  362  366  369

8.1 Pulmonary Atresia with MAPCA

8.1

269

Pulmonary Atresia with MAPCA Fig. 8.1  3D VRT reconstruction (anterior view) 1. Atrium cordis dextrum 2. Ventriculus dexter cordis 3. Aorta ascendens 4. Vena cava superior 5. Aorta descendens 6. Truncus brachiocephalicus 7. Arteria carotis communis dextra 8. Arteria carotis communis sinistra 9. Arteria subclavia sinistra 10. MAPCA 11. Arteria pulmonalis sinistra 12. Vena cava inferior

270

Fig. 8.2  3D VRT reconstruction (oblique anterior view) 1. Atrium cordis dextrum 2. Ventriculus dexter cordis 3. Aorta ascendens 4. Vena cava superior 5. Aorta descendens 6. MAPCA 7. Arteria pulmonalis sinistra 8. Vena cava inferior 9. Ventriculus sinister cordis

8  Congenital Cardiac Malformations in Children

Fig. 8.3  3D VRT reconstruction (posterior view) 1. Aorta descendens 2. Vena cava inferior 3. Vena cava superior 4. Arteria subclavia dextra 5. Arteria carotis communis dextra 6. Arteria subclavia sinistra 7. Arteria pulmonalis sinistra Arrow - MAPCAs

8.1 Pulmonary Atresia with MAPCA

Fig. 8.4  3D VRT reconstruction (head view) 1. Aorta descendens 2. Ramus arteria pulmonalis dextra 3. Arteria subclavia dextra 4. Arteria carotis communis dextra 5. Arteria carotis communis sinistra 6. Ventriculus dexter cordis 7. Arteria subclavia sinistra 8. Ventriculus sinister cordis 9. Arteria pulmonalis sinistra Arrow: MAPCA

271

Fig. 8.5  3D VRT reconstruction 1. Aorta descendens 2. Ramus arteria pulmonalis dextra 3. Arteria subclavia dextra 4. Arteria carotis communis dextra 5. Arcus aortae 6. Auricula atrii dextra 7. Aorta ascendens 8. Ventriculus dexter cordis 9. Ventriculus sinister cordis Arrow: MAPCA

272

Fig. 8.6  3D MPR reconstruction 1. Ventriculus sinister cordis 2. Septum interventriculare 3. Ventriculus dexter cordis 4. Aorta ascendens 5. Auricula atrii dextra 6. Atrium cordis sinistrum 7. Ventricular septal defect

Fig. 8.7  3D MIP reconstruction 1. Atrium cordis sinistrum 2. Aorta descendens 3. Arcus aortae 4. Arteria carotis communis dextra 5. Aorta ascendens 6. Atrium cordis dextrum 7. Ventriculus dexter cordis Arrow: MAPCAs

8  Congenital Cardiac Malformations in Children

Fig. 8.8  3D MIP reconstruction 1. Aorta descendens 2. Ramus arteria pulmonalis sinistra 3. Arcus aortae Arrow: MAPCA

Fig. 8.9  3D MIP reconstruction 1. Ventriculus dexter cordis 2. Septum interventriculare 3. Ventriculus sinister cordis 4. Ramus arteria pulmonalis sinistra 5. Aorta descendens Arrow: MAPCA

8.1 Pulmonary Atresia with MAPCA

Fig. 8.10  3D MIP reconstruction 1. Aorta ascendens 2. Aorta descendens 3. Ramus arteria pulmonalis dextra 4. Vena cava superior Arrow: MAPCA

Fig. 8.11  3D MIP reconstruction Arrow: MAPCA

273

Fig. 8.12  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Ramus arteria pulmonalis sinistra 3. Aorta descendens 4. Ramus arteria pulmonalis dextra 5. Atrium cordis sinistrum Arrow: MAPCA

8  Congenital Cardiac Malformations in Children

274

8.2

 trial Septal Defect A with Pulmonary Hypertension Fig. 8.13  3D VRT reconstruction 1. Atrium cordis dextrum 2. Aorta descendens 3. Ventriculus dexter cordis 4. Truncus pulmonalis 5. Arcus aortae 6. Vena jugularis interna sinistra 7. Arteria carotis communis sinistra 8. Arteria carotis communis dextra 9. Vena cava superior 10. Ramus arteria pulmonalis dextra

8.2 Atrial Septal Defect with Pulmonary Hypertension

Fig. 8.14  3D VRT reconstruction 1. Atrium cordis dextrum 2. Aorta descendens 3. Ventriculus dexter cordis 4. Truncus pulmonalis 5. Ramus arteria pulmonalis sinistra 6. Arteria carotis communis sinistra 7. Vena jugularis interna sinistra 8. Truncus brachiocephalicus 9. Vena cava superior 10. Ramus arteria pulmonalis dextra 11. Aorta ascendens 12. Arcus aortae

275

Fig. 8.15  3D VRT reconstruction 1. Aorta descendens 2. Ramus arteria pulmonalis sinistra 3. Ramus arteria pulmonalis dextra 4. Atrium cordis sinistrum 5. Vena pulmonalis sinistra inferior

Fig. 8.16  3D VRT reconstruction 1. Atrium cordis dextrum 2. Ventriculus dexter cordis 3. Truncus pulmonalis 4. Ramus arteria pulmonalis sinistra 5. Ramus arteria pulmonalis dextra

276

Fig. 8.17  3D VRT reconstruction 1. Truncus pulmonalis 2. Ramus arteria pulmonalis sinistra 3. Ramus arteria pulmonalis dextra 4. Aorta descendens 5. Vena pulmonalis dextra inferior 6. Vena pulmonalis sinistra inferior

Fig. 8.18  3D MIP reconstruction 1. Truncus pulmonalis (dilated) 2. Aorta ascendens 3. Aorta descendens 4. Vena cava superior

8  Congenital Cardiac Malformations in Children

Fig. 8.19  3D MIP reconstruction 1. Truncus pulmonalis (dilated) 2. Ramus arteria pulmonalis dextra 3. Ramus arteria pulmonalis sinistra 4. Aorta ascendens 5. Aorta descendens

Fig. 8.20  3D MIP reconstruction 1. Ventriculus dexter cordis 2. Ventriculus sinister cordis 3. Atrium cordis sinistrum 4. Aorta descendens 5. Vena pulmonalis dextra inferior 6. Atrium cordis dextrum Arrow: ASD (atrial septal defect)

8.2 Atrial Septal Defect with Pulmonary Hypertension

Fig. 8.21  3D MIP reconstruction 1. Truncus pulmonalis 2. Auricula atrii sinistra 3. Vena pulmonalis sinistra inferior 4. Vena pulmonalis dextra inferior 5. Aorta descendens 6. Atrium cordis sinistrum 7. Atrium cordis dextrum 8. Ventriculus dexter cordis 9. Aorta ascendens

277

8  Congenital Cardiac Malformations in Children

278

8.3

 ight Aortic Arch R with Aberrant Left Subclavian Artery Arising from Kommerell Diverticulum Fig. 8.22  3D VRT reconstruction 1. Aorta descendens 2. Vena cava inferior 3. Ventriculus dexter cordis 4. Atrium cordis dextrum 5. Arteria subclavia sinistra 6. Arteria carotis communis sinistra 7. Arteria carotis communis dextra 8. Arteria subclavia dextra 9. Aorta ascendens

8.3 Right Aortic Arch with Aberrant Left Subclavian Artery Arising from Kommerell Diverticulum

Fig. 8.23  3D VRT reconstruction 1. Aorta descendens 2. Vena cava inferior 3. Arteria subclavia dextra 4. Arteria carotis communis sinistra 5. Arteria carotis communis dextra 6. Arteria subclavia sinistra Arrow: Kommerell diverticulum

Fig. 8.24  3D VRT reconstruction (head view) 1. Arteria carotis communis sinistra 2. Arteria carotis communis dextra 3. Arteria subclavia dextra 4. Arteria subclavia sinistra 5. Arcus aortae 6. Aorta descendens

Fig. 8.25  3D MIP reconstruction 1. Arteria carotis communis sinistra 2. Arteria carotis communis dextra 3. Arteria subclavia dextra 4. Arteria subclavia sinistra 5. Aorta descendens 6. Arcus aortae

Fig. 8.26  3D MIP reconstruction 1. Aorta descendens 2. Arcus aortae 3. Arteria carotis communis dextra 4. Arteria subclavia sinistra Arrow: Kommerell diverticulum

279

8  Congenital Cardiac Malformations in Children

280

8.4

 itus Inversus. Single S Atrium. Atrial Septal Defect. Severe Pulmonary Subvalvular Stenosis. Polisplenia Fig. 8.27  3D VRT reconstruction 1. Aorta descendens 2. Vena cava inferior 3. Ventriculus sinister cordis 4. Single atrium 5. Vena cava superior sinistra 6. Vena cava superior dextra 7. Aorta ascendens

8.4 Situs Inversus. Single Atrium. Atrial Septal Defect. Severe Pulmonary Subvalvular Stenosis. Polisplenia

Fig. 8.28  3D VRT reconstruction 1. Aorta descendens 2. Vena cava superior sinistra 3. Vena cava superior dextra 4. Aorta ascendens 5. Single atrium 6. Sinus coronarius 7. Vena hepatica dextra et sinistra

Fig. 8.29  3D VRT reconstruction 1. Aorta descendens 2. Vena cava inferior 3. Vena cava superior sinistra 4. Vena cava superior dextra 5. Arteria subclavia dextra 6. Arteria carotis communis dextra 7. Arteria carotis communis sinistra 8. Arteria subclavia sinistra

281

282

Fig. 8.30  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Single atrium 3. Ventriculus dexter cordis 4. Aorta ascenders 5. Vena cava superior sinistra 6. Vena cava superior dextra 7. Truncus pulmonalis

8  Congenital Cardiac Malformations in Children

Fig. 8.31  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Single atrium 3. Vena cava superior sinistra 4. Arteria carotis communis sinistra 5. Arteria carotis communis dextra 6. Common trunk of the carotid arteries 7. Vena cava superior dextra 8. Truncus pulmonalis 9. Aorta ascendens

8.4 Situs Inversus. Single Atrium. Atrial Septal Defect. Severe Pulmonary Subvalvular Stenosis. Polisplenia

Fig. 8.32  3D VRT reconstruction 1. Aorta descendens 2. Vena cava inferior 3. Single atrium 4. Ventriculus sinister cordis 5. Vena cava superior dextra 6. Vena cava superior sinistra 7. Arteria subclavia sinistra 8. Arteria carotis communis sinistra 9. Arteria carotis communis dextra 10. Arteria subclavia dextra Arrow: ductus arteriosus

Fig. 8.33  3D MIP reconstruction 1. Single atrium 2. Ventriculus sinister cordis 3. Ventriculus dexter cordis 4. Vena pulmonalis dextra 5. Vena pulmonalis sinistra

Fig. 8.34  3D MIP reconstruction 1. Single atrium 2. Ventriculus sinister cordis 3. Liver on the left side of the body (complete situs inversus) 4. Vena cava superior sinistra 5. Vena cava superior dextra 6. Arteria carotis communis sinistra 7. Arteria carotis communis dextra 8. Arteria subclavia dextra 9. Arcus aortae 10. Truncus pulmonalis

Fig. 8.35  3D MIP reconstruction 1. Vena pulmonalis superior dextra 2. Vena pulmonalis inferior dextra 3. Vena pulmonalis sinistra 4. Single atrium

283

284

Fig. 8.36  3D MIP reconstruction 1. Single atrium 2. Ventriculus sinister cordis 3. Ventriculus dexter cordis 4. Vena pulmonalis dextra 5. Vena pulmonalis sinistra 6. Aorta descendens

Fig. 8.37  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Truncus pulmonalis 4. Aorta ascendens

8  Congenital Cardiac Malformations in Children

Fig. 8.38  3D MIP reconstruction 1. Single atrium 2. Ventriculus sinister cordis 3. Ventriculus dexter cordis 4. Aorta descendens

Fig. 8.39  3D MIP reconstruction 1. Aorta ascendens 2. Truncus pulmonalis 3. Arteria pulmonalis sinistra 4. Aorta descendens 5. Arteria pulmonalis dextra

8.5 Aortic Arch Hypoplasia. Agenezia of the Right Superior Vena Cava. Aberrant Left Superior Vena Cava… 285

8.5

 ortic Arch Hypoplasia. A Agenezia of the Right Superior Vena Cava. Aberrant Left Superior Vena Cava with Drainage in Coronary Sinus Fig. 8.40  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Truncus pulmonalis 4. Aorta ascendens 5. Arteria carotis communis dextra 6. Arteria carotis communis sinistra 7. Arteria subclavia sinistra 8. Arcus aortae (hypoplastic aortic arch) 9. Aorta descendens

286

Fig. 8.41  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Aorta descendens 3. Arcus aortae (hypoplastic aortic arch) 4. Aorta ascendens 5. Truncus pulmonalis Arrow: metallic clip

Fig. 8.42  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Atrium cordis sinistrum 3. Aorta descendens 4. Arcus aortae

8  Congenital Cardiac Malformations in Children

Fig. 8.43  3D VRT reconstruction 1. Aorta descendens 2. Arcus aortae (hypoplastic aortic arch) 3. Arteria subclavia sinistra 4. Arteria carotis communis sinistra 5. Arteria carotis communis dextra 6. Aorta ascendens 7. Arteria pulmonalis dextra 8. Atrium cordis sinistrum

8.5 Aortic Arch Hypoplasia. Agenezia of the Right Superior Vena Cava. Aberrant Left Superior Vena Cava… 287

Fig. 8.44  3D MIP reconstruction 1. Aorta ascendens 2. Ventriculus dexter cordis 3. Atrium cordis dextrum 4. Atrium cordis sinistrum

Fig. 8.45  3D MIP reconstruction 1. Aorta ascendens 2. Arcus aortae (hypoplastic aortic arch) 3. Aorta descendens 4. Truncus pulmonalis 5. Ventriculus dexter cordis 6. Vena cava superior sinistra 7. Sinus coronaries

Fig. 8.46  3D MIP reconstruction 1. Vena subclavia dextra 2. Vena cava superior sinistra 3. Vena cava superior sinistra 4. Sinus coronaries 5. Aorta descendens 6. Arcus aortae (hypoplastic aortic arch) 7. Aorta ascendens 8. Truncus pulmonalis 9. Ventriculus dexter cordis 10. Ventriculus sinister cordis

8  Congenital Cardiac Malformations in Children

288

8.6

Patent Ductus Arteriosus Fig. 8.47  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Aorta descendens 3. Arcus aortae 4. Patent ductus arteriosus 5. Truncus pulmonalis

8.6 Patent Ductus Arteriosus

Fig. 8.48  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Truncus pulmonalis 3. Arcus aortae 4. Arteria pulmonalis sinistra 5. Patent ductus arteriosus 6. Aorta descendens 7. Arteria subclavia sinistra

289

Fig. 8.49  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Atrium cordis sinistrum 3. Aorta descendens 4. Arcus aortae 5. Arteria subclavia sinistra 6. Truncus pulmonalis 7. Patent ductus arteriosus

Fig. 8.50  3D MIP reconstruction 1. Truncus pulmonalis 2. Patent ductus arteriosus 3. Aorta descendens 4. Aorta ascendens

290

Fig. 8.51  3D MIP reconstruction 1. Truncus pulmonalis 2. Patent ductus arteriosus 3. Aorta descendens 4. Aorta ascendens

Fig. 8.52  3D MIP reconstruction 1. Ventriculus dexter cordis 2. Truncus pulmonalis 3. Arteria pulmonalis sinistra 4. Aorta descendens 5. Arteria pulmonalis dextra 6. Aorta ascendens 7. Atrium cordis dextrum

8  Congenital Cardiac Malformations in Children

Fig. 8.53  3D MIP reconstruction 1. Atrium cordis sinistrum 2. Atrium cordis dextrum 3. Aorta descendens 4. Aorta ascendens 5. Arcus aortae

8.7 Kawasaki Disease

8.7

291

Kawasaki Disease

8.7.1 K  awasaki Disease: Baseline Examination Fig. 8.54  3D VRT reconstruction 1. Aorta ascendens 2. Arteria coronaria sinistra 3. Ramus interventricularis anterior (LAD proximal segment—dilated) 4. Ramus interventricularis anterior (LAD middle segment—dilated) 5. Ventriculus sinister cordis 6. Ventriculus dexter cordis

292

Fig. 8.55  3D VRT reconstruction 1. Aorta ascendens 2. Ramus interventricularis anterior (LAD proximal segment—dilated) 3. Ventriculus sinister cordis 4. Ventriculus dexter cordis 5. Atrium cordis dexter

Fig. 8.56  3D VRT reconstruction 1. Aorta ascendens 2. Ramus interventricularis anterior (LAD proximal segment—dilated) 3. Ventriculus sinister cordis

8  Congenital Cardiac Malformations in Children

Fig. 8.57  3D MIP reconstruction 1. Atrium cordis sinistrum 2. Ramus interventricularis anterior (LAD proximal segment—dilated) 3. Ventriculus dexter cordis 4. Aorta ascendens 5. Arteria coronaria sinistra

Fig. 8.58  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Ramus circumflexus 4. Ramus interventricularis anterior (LAD proximal segment—dilated) 5. Aorta ascendens

8.7 Kawasaki Disease

Fig. 8.59  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Atrium cordis sinistrum 3. Ventriculus dexter cordis 4. Atrium cordis dextrum 5. Aorta descendens 6. Arteria coronaria dextra

293

Fig. 8.60  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Atrium cordis sinistrum 3. Arteria coronaria sinistra 4. Ramus interventricularis anterior (LAD proximal segment—dilated)

294

8  Congenital Cardiac Malformations in Children

8.7.2 K  awasaki Disease: Same Patient, After Therapy

Fig. 8.61  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Arteria coronaria dextra 4. Atrium cordis dextrum

8.7 Kawasaki Disease

Fig. 8.62  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Aorta ascendens 3. Truncus pulmonalis (removed) 4. Ventriculus dexter cordis 5. Arteria coronaria sinistra 6. Ramus interventricularis anterior

Fig. 8.63  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Aorta ascendens 3. Ventriculus dexter cordis 4. Arteria coronaria sinistra 5. Ramus interventricularis anterior

295

Fig. 8.64  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Aorta ascendens 3. Ventriculus dexter cordis 4. Arteria coronaria sinistra 5. Ramus interventricularis anterior

Fig. 8.65  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Aorta ascendens 3. Ventriculus dexter cordis 4. Arteria coronaria sinistra 5. Ramus interventricularis anterior

296

8  Congenital Cardiac Malformations in Children

Fig. 8.66  3D MIP reconstruction 1. Arteria coronaria sinistra 2. Ramus interventricularis anterior 3. Atrium cordis sinistrum 4. Atrium cordis dextrum 5. Ventriculus dexter cordis

Fig. 8.68  3D MIP reconstruction 1. Arteria coronaria sinistra 2. Ramus interventricularis anterior 3. Arteria coronaria dextra

Fig. 8.67  3D MIP reconstruction 1. Arteria coronaria sinistra 2. Arteria coronaria dextra 3. Atrium cordis sinistrum 4. Atrium cordis dextrum 5. Ventriculus dexter cordis

Fig. 8.69  3D MIP reconstruction 1. Ramus interventricularis anterior 2. Ramus circumflexus

8.7 Kawasaki Disease

Fig. 8.70  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Atrium cordis sinistrum 3. Arteria coronaria sinistra 4. Ramus interventricularis anterior (normal diameter of the coronary artery)

297

8  Congenital Cardiac Malformations in Children

298

8.8

Pulmonary Arteriovenous Malformation. Left Aortic Arch with Aberrant Right Subclavian Artery

Fig. 8.71  3D VRT reconstruction 1. Aorta descendens 2. Ventriculus sinister cordis 3. Arcus aortae 4. Common carotid trunk 5. Arteria subclavia sinistra 6. Arteria carotis communis sinistra 7. Arteria carotis communis dextra 8. Arteria subclavia dexter (anomalous origin from aorta descendens) 9. Aorta ascendens Arrow: AVM (arteriovenous malformation)

8.8  Pulmonary Arteriovenous Malformation. Left Aortic Arch with Aberrant Right Subclavian Artery

Fig. 8.72  3D VRT reconstruction 1. Aorta descendens 2. Arteria pulmonalis dexter 3. A. segmentalis basalis 4. Arteria subclavia dexter (anomalous origin from aorta descendens) 5. Arteria subclavia sinistra 6. Arteria carotis communis sinistra 7. Arteria carotis communis dextra Arrow: AVM (arteriovenous malformation)

299

Fig. 8.73  3D VRT reconstruction 1. Aorta descendens 2. Arteria pulmonalis dexter 3. A. segmentalis basalis 4. Arteria subclavia dexter (anomalous origin from aorta descendens) 5. Arteria subclavia sinistra 6. Arteria carotis communis sinistra 7. Arteria carotis communis dextra 8. Arcus aortae Arrow: AVM (arteriovenous malformation)

300

Fig. 8.74  3D VRT reconstruction 1. Aorta descendens 2. Arteria pulmonalis dexter 3. A. segmentalis basalis 4. Ventriculus dexter cordis 5. Vena cava superior 6. Arteria mammaria interna dextra Arrow: AVM (arteriovenous malformation)

8  Congenital Cardiac Malformations in Children

Fig. 8.75  3D VRT reconstruction 1. Aorta descendens 2. Arteria pulmonalis dextra 3. A. segmentalis basalis 4. Arteria subclavia dexter (anomalous origin from aorta descendens) 5. Arteria subclavia sinistra 6. Arteria carotis communis sinistra 7. Arteria carotis communis dextra 8. AVM (arteriovenous malformation) 9. Arteria pulmonalis sinistra 10. Ventriculus sinister cordis 11. Atrium cordis sinistrum 12. Vena pulmonalis inferior dextra

8.8  Pulmonary Arteriovenous Malformation. Left Aortic Arch with Aberrant Right Subclavian Artery

Fig. 8.76  3D MIP reconstruction 1. Aorta descendens 2. Atrium cordis sinistrum 3. Vena pulmonalis superior sinistra 4. Truncus pulmonalis 5. Arcus aortae 6. AVM (arteriovenous malformation)

Fig. 8.77  3D MIP reconstruction 1. Vena pulmonalis dextra, superior et inferior 2. Arteria pulmonalis dextra 3. Arcus aortae 4. Arteria subclavia dexter (anomalous origin from aorta descendens) 5. A. segmentalis basalis 6. AVM (arteriovenous malformation) 7. Atrium cordis sinistrum 8. Vena pulmonalis inferior dextra

Fig. 8.78  3D MIP reconstruction 1. AVM (arteriovenous malformation) 2. Arteria pulmonalis dextra 3. A. segmentalis basalis

Fig. 8.79  3D MIP reconstruction 1. Aorta descendens 2. Arteria pulmonalis sinistra 3. Arteria pulmonalis dextra 4. Arcus aortae 5. Arteria carotis communis dextra 6. AVM (arteriovenous malformation)

301

302

Fig. 8.80  3D MIP reconstruction 1. Aorta descendens 2. Vena pulmonalis dextra, superior et inferior 3. Atrium cordis sinistrum 4. Truncus pulmonalis 5. Arcus aortae 6. Arteria pulmonalis dextra 7. A. segmentalis basalis 8. V. pulmonalis inferior dextra 9. AVM (arteriovenous malformation)

8  Congenital Cardiac Malformations in Children

8.9 Double-Outlet Right Ventricle. Pulmonary Stenosis. Systemic-­Pulmonary Shunt. Aberrant Left…

8.9

303

Double-Outlet Right Ventricle. Pulmonary Stenosis. Systemic-­ Pulmonary Shunt. Aberrant Left Superior Vena Cava with Drainage in Coronary Sinus Fig. 8.81  3D VRT reconstruction 1. Ventriculus dexter cordis 2. Aorta ascendens 3. Vena cava superior dextra 4. Truncus brachiocephalicus 5. Arteria subclavia dextra 6. Arteria carotis communis dextra 7. Arteria carotis communis sinistra 8. Arteria subclavia sinistra 9. Atrium cordis dextrum Arrow: Systemic-­ pulmonary shunt

304

Fig. 8.82  3D VRT reconstruction 1. Ventriculus dexter cordis 2. Aorta ascendens 3. Arteria subclavia sinistra 4. Arcus aortae 5. Aorta descendens Arrow: Systemic-pulmonary shunt

8  Congenital Cardiac Malformations in Children

Fig. 8.83  3D VRT reconstruction 1. Aorta descendens 2. Arteria subclavia sinistra 3. Arteria carotis communis sinistra 4. Arteria carotis communis dextra 5. Arteria subclavia dextra 6. Vena cava superior dextra 7. Arcus aortae 8. Arteria pulmonalis dextra 9. Arteria pulmonalis sinistra 10. Atrium cordis sinistrum Arrow: Systemic-pulmonary shunt

8.9 Double-Outlet Right Ventricle. Pulmonary Stenosis. Systemic-­Pulmonary Shunt. Aberrant Left…

Fig. 8.84  3D VRT reconstruction 1. Ventriculus dexter cordis 2. Aorta ascendens 3. Vena cava superior sinistra 4. Vena cava superior dextra 5. Aorta descendens

Fig. 8.85  3D VRT reconstruction 1. Ventriculus dexter cordis 2. Atrium cordis dextrum 3. Vena cava superior sinistra 4. Vena cava superior dextra 5. Aorta ascendens

Fig. 8.86  3D MIP reconstruction 1. Ventriculus dexter cordis 2. Atrium cordis dextrum 3. Vena cava superior sinistra 4. Vena cava superior dextra 5. Aorta ascendens 6. Arteria pulmonalis dextra

Fig. 8.87  3D MIP reconstruction 1. Arteria subclavia dextra 2. Arteria subclavia sinistra 3. Systemic-pulmonary shunt 4. Arcus aortae 5. Arteria pulmonalis sinistra 6. Arteria pulmonalis dextra

305

306

Fig. 8.88  3D MIP reconstruction 1. Arteria subclavia dextra 2. Arteria subclavia sinistra 3. Systemic-pulmonary shunt 4. Arcus aortae 5. Arteria pulmonalis sinistra 6. Arteria pulmonalis dextra 7. Atrium cordis dextrum

Fig. 8.89  3D MIP reconstruction 1. Aorta ascendens 2. Aorta descendens 3. Truncus pulmonalis 4. Arteria pulmonalis dextra 5. Arteria pulmonalis sinistra

8  Congenital Cardiac Malformations in Children

Fig. 8.90  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Atrium cordis dextrum 4. Atrium cordis sinistrum 5. Aorta ascendens

Fig. 8.91  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Atrium cordis dextrum 4. Atrium cordis sinistrum 5. Aorta descendens 6. Ventricular septal defect

8.9 Double-Outlet Right Ventricle. Pulmonary Stenosis. Systemic-­Pulmonary Shunt. Aberrant Left…

Fig. 8.92  3D MIP reconstruction 1. Aorta ascendens 2. Aorta descendens 3. Atrium cordis dextrum 4. Atrium cordis sinistrum 5. Septum interatriale 6. Atrial septal defect

Fig. 8.93  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Aorta ascendens 4. Aorta descendens 5. Atrium cordis dextrum 6. Ventricular septal defect

Fig. 8.94  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Atrium cordis dextrum 3. Vena cava superior sinister 4. Vena cava superior dextra 5. Arcus aortae 6. Truncus brachiocephalicus 7. Vena jugularis interna dextra 8. Arteria carotis communis dextra 9. Arteria carotis communis sinistra

Fig. 8.95  3D MPR reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Aorta ascendens 4. Truncus pulmonalis 5. Double-outlet

307

308

Fig. 8.96  3D MIP reconstruction 1. Ventriculus dexter cordis 2. Aorta descendens 3. Aorta ascendens 4. Truncus pulmonalis 5. Double-outlet

8  Congenital Cardiac Malformations in Children

8.10 Single Lateral Ventricle. Dextrocardia. Cavo-pulmonary Shunt (Glenn Procedure)

309

8.10 Single Lateral Ventricle. Dextrocardia. Cavopulmonary Shunt (Glenn Procedure)

Fig. 8.97  3D VRT reconstruction

310

Fig. 8.98  3D VRT reconstruction 1. Ventriculus dexter cordis (single ventricle) 2. Atrium cordis dextrum 3. Arteria pulmonalis sinistra 4. Aorta ascendens 5. Arteria subclavia dextra 6. Arteria carotis communis dextra 7. Arteria carotis communis sinistra 8. Arteria subclavia sinistra 9. Vena subclavia sinistra

8  Congenital Cardiac Malformations in Children

Fig. 8.99  3D VRT reconstruction 1. Aorta descendens 2. Vena cava inferior 3. Vena azygos 4. Ventriculus dexter cordis (single ventricle) 5. Atrium cordis dextrum 6. Vena pulmonalis inferior sinistra 7. Vena pulmonalis inferior dextra 8. Arteria pulmonalis dextra 9. Arteria pulmonalis sinistra 10. Arteria subclavia dextra 11. Arteria carotis communis dextra 12. Arteria carotis communis sinistra 13. Arteria subclavia sinistra

8.10 Single Lateral Ventricle. Dextrocardia. Cavo-pulmonary Shunt (Glenn Procedure)

Fig. 8.100  3D VRT reconstruction 1. Ventriculus dexter cordis (single ventricle) 2. Aorta ascendens 3. Arteria carotis communis sinistra 4. Arteria carotis communis dextra 5. Arteria subclavia dextra

Fig. 8.101  3D VRT reconstruction 1. Aorta descendens 2. Ventriculus dexter cordis (single ventricle) 3. Atrium cordis dextrum 4. Aorta ascendens 5. Arteria pulmonalis sinistra 6. Truncus pulmonalis 7. Cavo-pulmonary shunt 8. Vena jugularis interna sinistra 9. Vena brachiocephalica dextra 10. Vena jugularis interna dextra 11. Arteria carotis communis dextra 12. Arteria carotis communis sinistra 13. Arteria subclavia sinistra

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Fig. 8.102  3D VRT reconstruction 1. Aorta descendens 2. Atrium cordis dextrum 3. Ventriculus dexter cordis (single ventricle) 4. Vena azygos (azygos vein arch) 5. Vena jugularis interna dextra 6. Vena brachiocephalica dextra 7. Vena jugularis interna sinistra 8. Cavo-pulmonary shunt 9. Arteria pulmonalis dextra 10. Arteria pulmonalis sinistra 11. Arteria subclavia dextra 12. Arteria carotis communis dextra 13. Arteria carotis communis sinistra 14. Arcus aortae 15. Atrium cordis sinistrum 16. Vena pulmonalis inferior sinistra 17. Vena pulmonalis inferior dextra

8  Congenital Cardiac Malformations in Children

Fig. 8.103  3D VRT reconstruction 1. Ventriculus dexter cordis (single ventricle) 2. Atrium cordis dextrum 3. Aorta ascendens 4. Vena subclavia sinistra 5. Vena jugularis interna sinistra 6. Cavo-pulmonary shunt 7. Vena brachiocephalica dextra 8. Vena jugularis interna dextra 9. Vena azygos (azygos vein arch) 10. Arteria carotis communis sinistra 11. Arteria carotis communis dextra 12. Arteria subclavia dextra 13. Arcus aortae

8.10 Single Lateral Ventricle. Dextrocardia. Cavo-pulmonary Shunt (Glenn Procedure)

Fig. 8.104  3D VRT reconstruction 1. Vena azygos (azygos vein arch) 2. Vena jugularis interna dextra 3. Vena brachiocephalica dextra 4. Vena jugularis interna sinistra 5. Cavo-pulmonary shunt 6. Vena pulmonalis inferior sinistra 7. Arteria pulmonalis sinistra

Fig. 8.105  3D MIP reconstruction 1. Ventriculus dexter cordis (single ventricle) 2. Atrium cordis dextrum 3. Truncus pulmonalis 4. Cavo-pulmonary shunt 5. Vena jugularis interna sinistra 6. Vena jugularis interna dextra 7. Vena brachiocephalica dextra 8. Arcus aortae

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Fig. 8.106  3D MIP reconstruction 1. Ventriculus dexter cordis (single ventricle) 2. Atrium cordis dextrum 3. Cavo-pulmonary shunt 4. Arcus aortae 5. Arteria carotis communis sinistra 6. Arteria carotis communis dextra 7. Arteria subclavia sinistra

Fig. 8.107  3D MIP reconstruction 1. Ventriculus dexter cordis (single ventricle) 2. Atrium cordis dextrum 3. Arcus aortae 4. Arteria subclavia dextra 5. Arteria carotis communis dextra 6. Cavo-pulmonary shunt 7. Arteria pulmonalis sinistra 8. Arteria pulmonalis dextra

8  Congenital Cardiac Malformations in Children

Fig. 8.108  3D MIP reconstruction 1. Ventriculus dexter cordis (single ventricle) 2. Aorta ascendens 3. Truncus pulmonalis 4. Atrium cordis sinistrum 5. Aorta descendens 6. Vena pulmonalis sinistra 7. Vena pulmonalis dextra

Fig. 8.109  3D MIP reconstruction 1. Ventriculus dexter cordis (single ventricle) 2. Atrium cordis dextrum

8.10 Single Lateral Ventricle. Dextrocardia. Cavo-pulmonary Shunt (Glenn Procedure)

Fig. 8.110  3D MIP reconstruction 1. Ventriculus dexter cordis (single ventricle) 2. Atrium cordis dextrum 3. Truncus pulmonalis 4. Cavo-pulmonary shunt 5. Vena brachiocephalica dextra 6. Vena jugularis interna dextra 7. Vena jugularis interna sinistra 8. Arcus aortae

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8  Congenital Cardiac Malformations in Children

8.11 D  extrocardia. Aberrant Left Superior Vena Cava Drainage in Coronary Sinus. Left Aortic Arch with Aberrant Right Subclavian Artery

Fig. 8.111  3D VRT reconstruction

8.11  Dextrocardia. Aberrant Left Superior Vena Cava Drainage in Coronary Sinus. Left Aortic Arch…

Fig. 8.112  3D VRT reconstruction 1. Ventriculus dexter cordis 2. Atrium cordis dextrum 3. Sinus coronarius 4. Vena cava superior sinistra 5. Vena cava superior dextra 6. Truncus pulmonalis 7. Aorta descendens 8. Arteria carotis communis dextra 9. Arteria carotis communis sinistra 10. Arteria subclavia sinistra 11. Arteria subclavia dextra (aberrant right subclavian artery)

Fig. 8.113  3D VRT reconstruction 1. Aorta descendens 2. Vena brachiocephalica dextra 3. Vena cava superior sinistra 4. Arteria subclavia dextra (aberrant right subclavian artery) 5. Arteria carotis communis dextra 6. Arteria carotis communis sinistra 7. Arteria subclavia sinistra

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Fig. 8.114  3D VRT reconstruction 1. Aorta descendens 2. Vena pulmonalis inferior dextra 3. Vena pulmonalis inferior sinistra 4. Arteria pulmonalis dextra 5. Arteria pulmonalis sinistra 6. Arteria subclavia dextra (aberrant right subclavian artery) 7. Arteria carotis communis dextra 8. Arteria carotis communis sinistra 9. Arteria subclavia sinistra

Fig. 8.115  3D MIP reconstruction 1. Arteria subclavia dextra (aberrant right subclavian artery) 2. Arteria subclavia sinistra 3. Arteria carotis communis sinistra 4. Arteria carotis communis dextra

8  Congenital Cardiac Malformations in Children

Fig. 8.116  3D MIP reconstruction 1. Vena cava superior sinistra 2. Truncus pulmonalis 3. Arcus aortae 4. Arteria subclavia dextra (aberrant right subclavian artery)

Fig. 8.117  3D MIP reconstruction 1. Sinus coronarius 2. Vena cava superior sinistra 3. Vena jugularis interna sinistra 4. Vena jugularis interna dextra 5. Vena cava superior dextra 6. Arteria carotis communis dextra 7. Arteria carotis communis sinistra 8. Arcus aortae

8.11  Dextrocardia. Aberrant Left Superior Vena Cava Drainage in Coronary Sinus. Left Aortic Arch…

Fig. 8.118  3D MIP reconstruction 1. Atrium cordis sinistrum 2. Vena cava superior sinistra 3. Vena cava superior dextra 4. Arteria carotis communis dextra 5. Arteria carotis communis sinistra 6. Arteria vertebralis dextra

Fig. 8.119  3D MIP reconstruction 1. Arteria subclavia dextra (aberrant right subclavian artery) 2. Arteria subclavia sinistra 3. Arteria vertebralis sinistra 4. Aorta descendens

Fig. 8.120  3D MIP reconstruction 1. Truncus pulmonalis 2. Aorta ascendens 3. Aorta descendens 4. Vena cava superior sinistra 5. Vena cava superior dextra 6. Arteria pulmonalis dextra 7. Arteria pulmonalis sinistra

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8  Congenital Cardiac Malformations in Children

8.12 Aortic Coarctation

Fig. 8.121  3D VRT reconstruction

8.12 Aortic Coarctation

Fig. 8.122  3D VRT reconstruction 1. Aorta ascendens 2. Arteria mammaria interna sinistra (dilated) 3. Arteria mammaria interna dextra (dilated) 4. Aorta descendens 5. Ventriculus sinister cordis

Fig. 8.123  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Aorta descendens 3. Isthmus aortae (stenosis) 4. Arcus aortae 5. Arteria subclavia sinistra 6. Arteria carotis communis sinistra 7. Arteria mammaria interna sinistra (dilated)

321

Fig. 8.124  3D VRT reconstruction 1. Aorta descendens 2. Isthmus aortae (stenosis) 3. Collateral arteries (substenotic) 4. Collateral arteries (suprastenotic) 5. Arcus aortae 6. Aorta ascendens 7. Arteria subclavia sinistra 8. Arteria carotis communis sinistra 9. Truncus brachiocephalicus 10. Arteria mammaria interna sinistra (dilated)

322

Fig. 8.125  3D VRT reconstruction 1. Aorta descendens 2. Isthmus aortae (stenosis) 3. Collateral arteries (substenotic) 4. Collateral arteries (suprastenotic) 5. Aorta ascendens 6. Truncus brachiocephalicus 7. Arteria subclavia sinistra

Fig. 8.126  3D MIP reconstruction 1. Aorta descendens 2. Isthmus aortae (stenosis) 3. Arcus aortae 4. Collateral arteries (substenotic)

8  Congenital Cardiac Malformations in Children

Fig. 8.127  3D MIP reconstruction 1. Aorta ascendens 2. Arcus aortae 3. Truncus brachiocephalicus 4. Arteria carotis communis dextra 5. Arteria subclavia sinistra 6. Isthmus aortae (stenosis) 7. Aorta descendens 8. Atrium cordis sinistrum 9. Ventriculus dexter cordis

8.13 Right Aortic Arch with Aberrant Brachiocephalic Artery with Non-Kommerell Diverticulum. Tracheal… 323

8.13 R  ight Aortic Arch with Aberrant Brachiocephalic Artery with Non-Kommerell Diverticulum. Tracheal Stenosis Fig. 8.128  3D VRT reconstruction 1. Aorta descendens (right-sided descending aorta) 2. Vena cava inferior 3. Ventriculus dexter cordis 4. Atrium cordis dextrum 5. Aorta ascendens (right-sided ascending aorta) 6. Vena cava superior 7. Truncus brachiocephalicus 8. Arteria subclavia dextra 9. Arteria carotis communis dextra 10. Arteria carotis communis sinistra 11. Arteria subclavia sinistra 12. Non-Kommerell diverticulum

324

Fig. 8.129  3D VRT reconstruction 1. Aorta descendens (right-sided descending aorta) 2. Vena cava inferior 3. Ventriculus dexter cordis 4. Atrium cordis dextrum 5. Truncus pulmonalis 6. Aorta ascendens (right-sided ascending aorta) 7. Vena jugulars interna dextra 8. Arteria carotis communis dextra 9. Arteria carotis communis sinistra 10. Arteria subclavia sinistra 11. Non-Kommerell diverticulum 12. Arteria pulmonalis sinistra

8  Congenital Cardiac Malformations in Children

Fig. 8.130  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Truncus pulmonalis 4. Aorta ascendens (right-sided ascending aorta) 5. Arteria carotis communis dextra 6. Arteria carotis communis sinistra 7. Non-Kommerell diverticulum

Fig. 8.131  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Truncus pulmonalis 4. Arteria carotis communis sinistra 5. Arteria subclavia sinistra 6. Arteria carotis communis dextra 7. Arteria subclavia dextra 8. Non-Kommerell diverticulum 9. Aorta descendens (right-sided descending aorta) 10. Vena cava inferior

8.13 Right Aortic Arch with Aberrant Brachiocephalic Artery with Non-Kommerell Diverticulum. Tracheal… 325

Fig. 8.132  3D VRT reconstruction 1. Aorta descendens (right-sided descending aorta) 2. Vena cava inferior 3. Arteria subclavia sinistra 4. Arteria carotis communis sinistra 5. Truncus brachiocephalicus sinister 6. Arteria carotis communis dextra 7. Arteria subclavia dextra 8. Arcus aortae 9. Non-Kommerell diverticulum 10. Atrium cordis sinistrum 11. Truncus pulmonalis 12. Arteria pulmonalis sinistra 13. Arteria pulmonalis dextra

Fig. 8.133  3D VRT reconstruction 1. Aorta descendens (right-sided descending aorta) 2. Vena cava inferior 3. Arcus aortae (right sided aortic arch) 4. Truncus brachiocephalicus sinister 5. Arteria subclavia sinistra 6. Arteria carotis communis sinistra 7. Arteria carotis communis dextra 8. Arteria subclavia dextra 9. Non-Kommerell diverticulum 10. Truncus pulmonalis 11. Arteria pulmonalis sinistra

326

Fig. 8.134  3D MIP reconstruction 1. Aorta ascendens (right-sided ascending aorta) 2. Arteria carotis communis sinistra 3. Arcus aortae 4. Ligamentum arteriosum 5. Non-Kommerell diverticulum

Fig. 8.135  3D MIP reconstruction 1. Aorta descendens (right-sided descending aorta) 2. Arteria subclavia dextra 3. Truncus brachiocephalicus sinister 4. Atrium cordis sinister 5. Arteria subclavia sinistra 6. Arteria vertebralis dextra 7. Arteria vertebralis sinistra 8. Ligamentum arteriosum 9. Non-Kommerell diverticulum

8  Congenital Cardiac Malformations in Children

Fig. 8.136  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Aorta ascendens (Valsalva sinus) 3. Vena cava superior 4. Atrium cordis dextrum 5. Aorta ascendens (right-sided ascending aorta) 6. Truncus brachiocephalicus sinister 7. Arteria carotis communis dextra 8. Arteria carotis communis sinistra

Fig. 8.137  3D MIP reconstruction 1. Trachea 2. Stenotic lesion of the trachea 3. Arcus aortae (right-sided aortic arch) 4. Truncus brachiocephalicus sinister

8.13 Right Aortic Arch with Aberrant Brachiocephalic Artery with Non-Kommerell Diverticulum. Tracheal… 327

Fig. 8.138  3D MIP reconstruction 1. Trachea 2. Stenotic lesion of the trachea 3. Arcus aortae (right-sided aortic arch) 4. Vena cava superior 5. Arteria carotis communis dextra 6. Arteria carotis communis sinistra

328

8  Congenital Cardiac Malformations in Children

8.14 P  atent Ductus Arteriosus Connected with Right Pulmonary Artery. Severe Stenosis of Pulmonary Trunk

Fig. 8.139  3D VRT reconstruction 1. Aorta ascendens 2. Arteria pulmonalis sinistra 3. Arcus aortae 4. Arteria subclavia sinistra 5. Arteria carotis communis sinistra 6. Truncus brachiocephalicus sinister 7. Arteria carotis communis dextra 8. Arteria subclavia dextra 9. Aorta descendens 10. Patent ductus arteriosus

8.14 Patent Ductus Arteriosus Connected with Right Pulmonary Artery. Severe Stenosis of Pulmonary…

Fig. 8.140  3D VRT reconstruction 1. Aorta ascendens 2. Arteria pulmonalis sinistra 3. Patent ductus arteriosus 4. Aorta descendens

Fig. 8.141  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Arcus aortae 3. Vena cava superior 4. Arteria pulmonalis sinistra 5. Aorta descendens 6. Arteria carotis communis dextra 7. Arteria carotis communis sinistra 8. Arteria subclavia sinistra

Fig. 8.142  3D VRT reconstruction 1. Aorta ascendens 2. Vena cava superior 3. Arteria carotis communis dextra 4. Truncus brachiocephalicus sinister 5. Arteria carotis communis sinistra 6. Arteria subclavia sinistra 7. Arcus aortae

Fig. 8.143  3D MIP reconstruction 1. Arteria pulmonalis dextra 2. Arteria pulmonalis sinistra 3. Arcus aortae 4. Patent ductus arteriosus

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Fig. 8.144  3D MIP reconstruction 1. Vena pulmonalis inferior sinistra 2. Vena pulmonalis inferior dextra 3. Arteria pulmonalis dextra 4. Arteria pulmonalis sinistra 5. Patent ductus arteriosus

8  Congenital Cardiac Malformations in Children

Fig. 8.146  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Ventricular septal defect

Fig. 8.147  3D MIP reconstruction 1. Truncus pulmonalis 2. Arteria pulmonalis dextra 3. Arteria pulmonalis sinistra Arrow: severe pulmonary trunk stenosis Fig. 8.145  3D MIP reconstruction 1. Bulbus aortae 2. Arcus aortae 3. Arteria subclavia dextra 4. Arteria carotis communis dextra 5. Truncus brachiocephalicus sinister 6. Arteria carotis communis sinistra

8.15 Operated Pentalogy of Fallot. Pulmonary Artery Aneurysm

331

8.15 Operated Pentalogy of Fallot. Pulmonary Artery Aneurysm

Fig. 8.148  3D VRT reconstruction Sternal dehiscence

332

8  Congenital Cardiac Malformations in Children

Fig. 8.150  3D VRT reconstruction 1. Aorta descendens 2. Vena cava inferior 3. Ventriculus sinister cordis 4. Ventriculus dexter cordis 5. Truncus pulmonalis (aneurysmal dilatation of pulmonary artery) 6. Aorta ascendens Fig. 8.149  3D VRT reconstruction Arrow: sternal dehiscence and bulging of sternum

8.15 Operated Pentalogy of Fallot. Pulmonary Artery Aneurysm

Fig. 8.151  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Right outflow tract 4. Aorta ascendens 5. Truncus pulmonalis (aneurysmal dilatation of pulmonary artery) 6. Arteria pulmonalis sinister

Fig. 8.152  3D VRT reconstruction 1. Right outflow tract 2. Truncus pulmonalis (aneurysmal dilatation of pulmonary artery) 3. Post-stenotic aneurismal dilatation at the origin of the arteria pulmonalis sinister 4. Arteria pulmonalis sinister 5. Aorta ascendens

333

Fig. 8.153  3D VRT reconstruction 1. Truncus pulmonalis (aneurysmal dilatation of pulmonary artery) 2. Arteria pulmonalis dextra 3. Arteria pulmonalis sinister 4. Post-stenotic aneurysmal dilatation at the origin of the arteria pulmonalis sinister 5. Atrium cordis dextrum 6. Vena cava superior

334

Fig. 8.154  3D VRT reconstruction 1. Ventriculus dexter cordis 2. Atrium cordis dextrum 3. Vena cava superior 4. Arteria pulmonalis dextra 5. Arteria pulmonalis sinistra 6. Post-stenotic aneurysmal dilatation at the origin of the arteria pulmonalis sinister 7. Truncus pulmonalis (aneurysmal dilatation of pulmonary artery)

8  Congenital Cardiac Malformations in Children

Fig. 8.155  3D VRT reconstruction 1. Arteria pulmonalis dextra 2. Arteria pulmonalis sinistra 3. Post-stenotic aneurysmal dilatation at the origin of the arteria pulmonalis sinister 4. Vena cava superior 5. Vena cava inferior 6. Atrium cordis dextrum 7. Ventriculus dexter cordis

8.15 Operated Pentalogy of Fallot. Pulmonary Artery Aneurysm

Fig. 8.156  3D MIP reconstruction 1. Aorta ascendens 2. Aorta descendens 3. Right outflow tract 4. Truncus pulmonalis (aneurysmal dilatation of pulmonary artery) 5. Post-stenotic aneurysmal dilatation at the origin of the arteria pulmonalis sinister 6. Sternal dehiscence and bulging of sternum

Fig. 8.157  3D MIP reconstruction 1. Aorta ascendens 2. Vena cava superior 3. Aorta descendens 4. Arteria pulmonalis dextra 5. Post-stenotic aneurysmal dilatation at the origin of the arteria pulmonalis sinister 6. Right outflow tract

Fig. 8.158  3D MIP reconstruction 1. Ventriculus dexter cordis 2. Aorta ascendens 3. Arcus aortae 4. Aorta descendens 5. Right outflow tract

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8  Congenital Cardiac Malformations in Children

8.16 Tetralogy of Fallot 8.16.1 Tetralogy of Fallot: Preoperator Fig. 8.159  3D VRT reconstruction

8.16 Tetralogy of Fallot

Fig. 8.160  3D VRT reconstruction 1. Aorta descendens 2. Vena cava inferior 3. Ventriculus sinister cordis 4. Aorta ascendens 5. Arcus aortae 6. Arteria subclavia sinister 7. Arteria carotis communis sinister 8. Truncus brachiocephalicus 9. Arteria carotis communis dextra 10. Arteria subclavia dextra 11. Vena cava superior 12. Vena brachiocephalica sinistra

337

Fig. 8.161  3D VRT reconstruction 1. Aorta descendens 2. Vena cava inferior 3. Ventriculus sinister cordis 4. Arteria subclavia sinistra 5. Arteria vertebralis sinistra 6. Arteria carotis communis sinister 7. Truncus brachiocephalicus 8. Arteria carotis communis dextra 9. Arteria subclavia dextra 10. Atrium cordis sinistrum 11. Vena cava superior 12. Vena brachiocephalica sinistra 13. Arcus aortae

338

8  Congenital Cardiac Malformations in Children

Fig. 8.164  3D MIP reconstruction 1. Ventricular septal defect 2. Aorta descendens 3. Bulbus aortae Fig. 8.162  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Atrium cordis dextrum 4. Right outflow tract 5. Stenosis at the supravalvular region of pulmonary trunk 6. Truncus pulmonalis 7. Arteria pulmonalis sinistra 8. Arcus aortae

Fig. 8.163  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Septum interventriculare 3. Ventriculus dexter cordis 4. Atrium cordis dextrum 5. Atrium cordis sinistrum 6. Bulbus aortae

Fig. 8.165  3D MIP reconstruction 1. Aorta ascendens 2. Truncus pulmonalis 3. Arteria pulmonalis sinistra 4. Arteria pulmonalis dextra 5. Aorta descendens

8.16 Tetralogy of Fallot

Fig. 8.166  3D MIP reconstruction 1. Ventriculus dexter cordis 2. Atrium cordis dextrum 3. Vena cava superior 4. Vena jugularis interna dextra 5. Vena brachiocephalica sinistra 6. Vena jugularis interna sinistra 7. Arcus aortae 8. Truncus pulmonalis

Fig. 8.167  3D MIP reconstruction 1. Aorta descendens 2. MAPCA 3. Arteria subclavia sinistra

339

Fig. 8.168  3D MIP reconstruction 1. Aorta descendens 2. MAPCA

Fig. 8.169  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Atrium cordis sinistrum 3. Atrial septal defect 4. Septum interatriale 5. Atrium cordis dextrum

340

8  Congenital Cardiac Malformations in Children

8.16.2 Tetralogy of Fallot: Postoperation

Fig. 8.170  3D VRT reconstruction 1. Aorta descendens 2. Aorta ascendens 3. Arteria pulmonalis sinistra 4. Vena brachiocephalica sinistra 5. Vena cava superior

8.16 Tetralogy of Fallot

Fig. 8.171  3D VRT reconstruction 1. Aorta descendens 2. Arteria carotis communis sinistra 3. Truncus brachiocephalicus 4. Systemico-pulmonary shunt 5. Arcus aortae 6. Arteria pulmonalis dextra 7. Vena pulmonalis superior dextra 8. Vena pulmonalis inferior dextra 9. Vena cava superior 10. Vena jugularis interna dextra 11. Vena jugularis interna sinistra 12. Arteria subclavia sinistra

341

Fig. 8.172  3D VRT reconstruction 1. Right outflow tract 2. Truncus pulmonalis 3. Arteria pulmonalis sinistra 4. Aorta ascendens

342

Fig. 8.173  3D VRT reconstruction 1. Aorta descendens 2. Systemico-pulmonary shunt 3. Truncus brachiocephalicus 4. Arteria subclavia sinistra 5. Arteria carotis communis sinistra 6. Arteria carotis communis dextra 7. Arteria subclavia dextra

Fig. 8.174  3D MIP reconstruction 1. Atrium cordis dextrum 2. Vena cava superior 3. Systemico-pulmonary shunt 4. Arteria pulmonalis dextra 5. Arteria pulmonalis sinistra 6. Truncus brachiocephalicus 7. Arcus aortae

8  Congenital Cardiac Malformations in Children

Fig. 8.175  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Bulbus aortae 3. Truncus pulmonalis 4. Stenosis of the left pulmonary artery 5. Arteria pulmonalis sinistra 6. Aorta descendens 7. Vena cava superior 8. Atrium cordis dextrum

Fig. 8.176  3D MIP reconstruction 1. Arteria pulmonalis sinistra 2. Stenosis of the left pulmonary artery 3. Vena cava superior 4. Arcus aortae

8.16 Tetralogy of Fallot

Fig. 8.177  3D MIP reconstruction 1. Bulbus aortae 2. Ventricular septal defect 3. Ventriculus sinister cordis 4. Ventriculus dexter cordis

Fig. 8.178  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Atrium cordis dextrum 4. Atrium cordis sinistrum 5. Bulbus aortae 6. Ventricular septal defect 7. Aorta descendens

343

Fig. 8.179  3D MIP reconstruction 1. Ventricular septal defect 2. Bulbus aortae 3. Truncus pulmonalis 4. Systemico-pulmonary shunt 5. Truncus brachiocephalicus 6. Atrium cordis dextrum 7. Ventriculus dexter cordis 8. Ventriculus sinister cordis

344

8  Congenital Cardiac Malformations in Children

8.17 S  ingle Atrium. Pulmonary Artery Aneurysm. Complete Situs Inversus. Dextrocardia. Left Superior Vena Cava. Left Aortic Arch with Aberrant Right Subclavian Artery Arising from Kommerell Diverticulum Fig. 8.180  3D VRT reconstruction 1. Ventriculus dexter cordis 2. Dilated right outflow tract 3. Vena cava superior dextra 4. Vena cava superior sinistra 5. Truncus pulmonalis 6. Arcus aortae 7. Arteria carotis communis dextra 8. Arteria carotis communis sinistra 9. Arteria subclavia dextra

8.17 Single Atrium. Pulmonary Artery Aneurysm. Complete Situs Inversus. Dextrocardia. Left Superior…

Fig. 8.181  3D VRT reconstruction 1. Ventriculus dexter cordis 2. Single atrium 3. Dilated right outflow tract 4. Stenotic lesion at the level of pulmonary valve 5. Vena cava superior dextra 6. Truncus pulmonalis (dilated) 7. Aorta ascendens 8. Auricula atrii sinistra 9. Arteria carotis communis dextra 10. Arteria carotis communis sinistra 11. Arcus aortae

Fig. 8.182  3D VRT reconstruction 1. Dilated right outflow tract 2. Stenotic lesion at the level of pulmonary valve 3. Truncus pulmonalis 4. Vena cava superior dextra 5. Vena cava superior sinistra 6. Aorta ascendens 7. Aorta descendens 8. Vena cava inferior

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Fig. 8.183  3D VRT reconstruction 1. Aorta descendens 2. Vena cava inferior 3. Vena pulmonalis inferior sinistra 4. Vena pulmonalis inferior dextra 5. Vena cava superior sinistra 6. Vena cava superior dextra 7. Truncus pulmonalis 8. Arteria pulmonalis sinistra 9. Arteria pulmonalis dextra 10. Arteria subclavia sinistra 11. Arteria carotis communis sinistra 12. Arteria carotis communis dextra 13. Arteria subclavia dextra

8  Congenital Cardiac Malformations in Children

Fig. 8.184  3D VRT reconstruction 1. Aorta descendens 2. Single atrium 3. Arteria pulmonalis sinistra 4. Arteria pulmonalis dextra 5. Vena cava superior sinistra 6. Vena cava superior dextra 7. Arteria subclavia sinistra 8. Arteria carotis communis sinistra 9. Arteria carotis communis dextra 10. Arteria subclavia dextra 11. Diverticulum Kommerell

8.17 Single Atrium. Pulmonary Artery Aneurysm. Complete Situs Inversus. Dextrocardia. Left Superior…

Fig. 8.185  3D VRT reconstruction 1. Single atrium 2. Arteria pulmonalis sinistra 3. Arteria pulmonalis dextra 4. Vena cava superior sinistra 5. Vena cava superior dextra Arrow: incomplete interatrial septum

Fig. 8.187  3D MIP reconstruction 1. Single atrium 2. Ventriculus dexter cordis 3. Ventriculus sinister cordis

Fig. 8.186  3D MIP reconstruction 1. Ventriculus dexter cordis 2. Ventriculus sinister cordis 3. Single atrium Fig. 8.188  3D MIP reconstruction 1. Dilated right outflow tract 2. Stenotic lesion at the level of pulmonary valve 3. Truncus pulmonalis 4. Single atrium

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348

Fig. 8.189  3D MIP reconstruction 1. Single atrium 2. Vena cava superior sinistra 3. Vena cava inferior 4. Arcus aortae 5. Truncus pulmonalis 6. Ventriculus sinister cordis 7. Ventriculus dexter cordis

Fig. 8.190  3D MIP reconstruction 1. Arteria carotis communis dextra 2. Arcus aortae 3. Diverticulum Kommerell 4. Trachea 5. Vena cava superior dextra 6. Vena cava superior sinistra

8  Congenital Cardiac Malformations in Children

Fig. 8.191  3D MIP reconstruction 1. Vena cava superior dextra 2. Vena cava superior sinistra 3. Arcus aortae 4. Arteria carotis communis dextra

8.18 Severe Hypoplastic Aortic Arch. Patent Ductus Arteriosus

349

8.18 S  evere Hypoplastic Aortic Arch. Patent Ductus Arteriosus Fig. 8.192  3D VRT reconstruction 1. Ventriculus dexter cordis 2. Truncus pulmonalis 3. Atrium cordis dextrum 4. Aorta ascendens 5. Vena cava superior 6. Truncus brachiocephalicus 7. Arteria carotis communis dextra 8. Arteria carotis communis sinistra 9. Hypoplastic aortic arch 10. Arteria subclavia sinistra

350

Fig. 8.193  3D VRT reconstruction 1. Truncus pulmonalis 2. Aorta ascendens 3. Hypoplastic aortic arch 4. Truncus brachiocephalicus 5. Arteria carotis communis dextra 6. Arteria carotis communis sinistra 7. Arteria subclavia sinistra 8. Aorta descendens

8  Congenital Cardiac Malformations in Children

Fig. 8.194  3D VRT reconstruction 1. Truncus pulmonalis 2. Patent ductus arteriosus 3. Hypoplastic aortic arch 4. Aorta ascendens 5. Truncus brachiocephalicus 6. Arteria subclavia sinistra 7. Arteria carotis communis sinistra 8. Arteria carotis communis dextra 9. Arteria subclavia dextra 10. Aorta descendens

Fig. 8.195  3D VRT reconstruction 1. Truncus pulmonalis 2. Patent ductus arteriosus 3. Aorta descendens 4. Hypoplastic aortic arch 5. Arteria subclavia sinistra

8.18 Severe Hypoplastic Aortic Arch. Patent Ductus Arteriosus

Fig. 8.196  3D VRT reconstruction 1. Aorta descendens 2. Hypoplastic aortic arch 3. Hypoplastic aortic arch 4. Aorta ascendens

Fig. 8.197  3D VRT reconstruction 1. Truncus pulmonalis 2. Aorta descendens 3. Patent ductus arteriosus 4. Hypoplastic aortic arch 5. Hypoplastic aortic arch 6. Aorta ascendens

Fig. 8.198  3D curved MIP reconstruction 1. Aorta ascendens 2. Truncus pulmonalis 3. Hypoplastic aortic arch 4. Patent ductus arteriosus 5. Aorta descendens

Fig. 8.199  3D MIP reconstruction 1. Aorta ascendens 2. Hypoplastic aortic arch 3. Aorta descendens 4. Patent ductus arteriosus 5. Truncus pulmonalis

351

352

8  Congenital Cardiac Malformations in Children

8.19 A  nomalous Right Pulmonary Venous Return (Sinus Venosus)

Fig. 8.200  3D VRT reconstruction 1. Ventriculus dexter cordis 2. Truncus pulmonalis 3. Arcus aortae 4. Vena cava superior

8.19 Anomalous Right Pulmonary Venous Return (Sinus Venosus)

Fig. 8.201  3D VRT reconstruction 1. Aorta descendens 2. Arteria pulmonalis sinistra 3. Arteria pulmonalis dextra 4. Atrium cordis sinistrum 5. Vena pulmonalis inferior dextra 6. Vena pulmonalis inferior sinistra

Fig. 8.202  3D VRT reconstruction 1. Vena pulmonalis inferior dextra 2. Vena pulmonalis superior dextra 3. Atrium cordis sinistrum 4. Vena pulmonalis superior sinistra 5. Vena pulmonalis inferior sinistra 6. Vena cava superior Arrow: Septum interatriale

Fig. 8.203  3D VRT reconstruction 1. Vena cava superior 2. Vena pulmonalis superior dextra 3. Vena pulmonalis inferior dextra 4. Vena cava inferior 5. Atrium cordis sinistrum 6. Vena pulmonalis inferior sinistra 7. Vena pulmonalis superior sinistra Arrow: Septum interatriale

Fig. 8.204  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Atrium cordis dextrum 4. Atrium cordis sinistrum 5. Atrial septal defect 6. Vena pulmonalis superior dextra 7. Vena cava inferior

353

354

8  Congenital Cardiac Malformations in Children

Fig. 8.205  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Atrium cordis dextrum 4. Atrium cordis sinistrum 5. Septum interatriale 6. Septum interventriculare

Fig. 8.207  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Atrium cordis dextrum 4. Vena pulmonalis inferior dextra 5. Atrium cordis sinistrum

Fig. 8.206  3D MIP reconstruction 1. Ventriculus dexter cordis 2. Atrium cordis dextrum 3. Vena pulmonalis superior dextra 4. Vena pulmonalis superior sinistra 5. Bulbus aortae

Fig. 8.208  3D MIP reconstruction 1. Ventriculus dexter cordis 2. Vena cava superior 3. Vena pulmonalis superior dextra

8.20  Total Anomalous Pulmonary Venous Return in Coronary Sinus

355

8.20 T  otal Anomalous Pulmonary Venous Return in Coronary Sinus 8.20.1 Total Anomalous Pulmonary Venous Return in Coronary Sinus: Preoperator

Fig. 8.209  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Truncus pulmonalis 4. Truncus brachiocephalicus 5. Vena cava inferior

356

Fig. 8.210  3D VRT reconstruction 1. Aorta descendens 2. Vena cava inferior 3. Vena pulmonalis dextra 4. Atrium cordis dextrum 5. Sinus coronarius 6. Arteria pulmonalis sinistra 7. Truncus pulmonalis 8. Arteria pulmonalis dextra 9. Arcus aortae

Fig. 8.211  3D VRT reconstruction 1. Aorta descendens 2. Arteria pulmonalis sinistra 3. Truncus pulmonalis 4. Arcus aortae (hypoplastic) 5. Arteria pulmonalis dextra 6. Vena pulmonalis dextra 7. Vena cava inferior

8  Congenital Cardiac Malformations in Children

Fig. 8.212  3D VRT reconstruction 1. Sinus coronarius 2. Vena pulmonalis sinistra 3. Vena pulmonalis dextra 4. Arteria pulmonalis sinistra 5. Truncus pulmonalis 6. Arteria pulmonalis dextra 7. Aorta ascendens 8. Atrium cordis dextrum

Fig. 8.213  3D VRT reconstruction 1. Sinus coronarius 2. Vena pulmonalis sinistra 3. Vena pulmonalis dextra 4. Atrium cordis dextrum

8.20  Total Anomalous Pulmonary Venous Return in Coronary Sinus

Fig. 8.214  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Atrium cordis dextrum 4. Sinus coronarius 5. Vena pulmonalis sinistra 6. Vena pulmonalis dextra

Fig. 8.215  3D MIP reconstruction 1. Vena cava inferior 2. Atrium cordis dextrum 3. Vena pulmonalis dextra 4. Vena pulmonalis sinistra 5. Sinus coronarius

357

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8  Congenital Cardiac Malformations in Children

8.20.2 Total Anomalous Pulmonary Venous Return in Coronary Sinus: Postoperator

Fig. 8.216  3D VRT reconstruction

8.20  Total Anomalous Pulmonary Venous Return in Coronary Sinus

Fig. 8.217  3D VRT reconstruction 1. Left renal vein 2. Vena cava inferior 3. Vena cava superior (interrupted) 4. Aorta ascendens 5. Vena brachiocephalica dextra (thrombus in the vein) 6. Vena brachiocephalica sinistra

Fig. 8.219  3D VRT reconstruction 1. Vena cava inferior 2. Vena cava superior 3. Vena brachiocephalica dextra 4. Aorta ascendens Arrow: interrupted superior vena cava

Fig. 8.218  3D VRT reconstruction 1. Aorta ascendens 2. Vena cava inferior 3. Vena cava superior 4. Aorta ascendens 5. Vena brachiocephalica dextra (thrombus in the vein) 6. Vena brachiocephalica sinistra

Fig. 8.220  3D VRT reconstruction 1. Vena cava inferior 2. Vena azygos (dilated) 3. Arcus venae azygos (dilated) 4. Vena hemiazygos (dilated)

359

360

Fig. 8.221  3D VRT reconstruction 1. Atrium cordis sinistrum 2. Vena pulmonalis sinistra 3. Vena pulmonalis dextra 4. Arteria pulmonalis dextra 5. Arteria pulmonalis sinistra 6. Vena jugularis interna dextra 7. Vena jugularis interna sinistra Arrow: interrupted superior vena cava

8  Congenital Cardiac Malformations in Children

Fig. 8.223  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Atrium cordis sinistrum 3. Truncus pulmonalis 4. Thrombus in right brachiocephalic vein

Fig. 8.222  3D MIP reconstruction 1. Thrombus in right brachiocephalic vein

Fig. 8.224  3D MIP reconstruction 1. Vena cava inferior 2. Aorta abdominalis 3. Vena azygos (dilated)

8.20  Total Anomalous Pulmonary Venous Return in Coronary Sinus

Fig. 8.225  3D MIP reconstruction 1. Vena cava inferior 2. Vena renalis dextra (dilated) 3. Aorta descendens 4. Vena azygos

361

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8  Congenital Cardiac Malformations in Children

8.21 C  ommon Arterial Trunk. Pulmonary Trunk and Right Pulmonary Artery Stenosis. Left Pulmonary Artery from Aorta. Right Aortic Arch with Aberrant Left Subclavian Artery 8.21.1 Common Arterial Trunk. Pulmonary Trunk and Right Pulmonary Artery Stenosis. Left Pulmonary Artery from Aorta. Right Aortic Arch with Aberrant Left Subclavian Artery: Preoperator Fig. 8.226  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Aorta ascendens 4. Arteria pulmonalis sinistra

8.21 Common Arterial Trunk. Pulmonary Trunk and Right Pulmonary Artery Stenosis. Left Pulmonary…

Fig. 8.227  3D VRT reconstruction 1. Aorta descendens 2. Arteria pulmonalis sinistra 3. Arteria pulmonalis dextra 4. Arteria subclavia sinistra

Fig. 8.229  3D VRT reconstruction 1. Aorta ascendens 2. Arteria pulmonalis sinistra 3. Ventriculus sinister cordis 4. Ventriculus dexter cordis

Fig. 8.230  3D MIP reconstruction 1. Ventriculus dexter cordis 2. Atrium cordis dextrum 3. Aorta descendens Fig. 8.228  3D VRT reconstruction 1. Aorta descendens 2. Arcus aortae 3. Arteria subclavia sinistra 4. Arteria carotis communis sinistra 5. Arteria carotis communis dextra 6. Arteria subclavia dextra 7. MAPCA

363

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8  Congenital Cardiac Malformations in Children

Fig. 8.233  3D MIP reconstruction 1. Aorta ascendens 2. Aorta descendens 3. Arteria pulmonalis sinistra Fig. 8.231  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Ventricular septal defect 4. Aorta ascendens

Fig. 8.234  3D MIP reconstruction 1. Aorta ascendens 2. Arcus aortae 3. Arteria subclavia sinistra 4. Trachea Fig. 8.232  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Ventricular septal defect 4. Arteria pulmonalis dextra 5. Stenotic lesion at the level of right pulmonary artery 6. Aorta ascendens 7. Arcus aortae 8. Stenotic lesion at the level of the pulmonary trunk

8.21 Common Arterial Trunk. Pulmonary Trunk and Right Pulmonary Artery Stenosis. Left Pulmonary…

Fig. 8.235  3D MIP reconstruction 1. Aorta ascendens 2. Aorta descendens 3. Vena pulmonalis superior sinistra 4. Vena cava superior

365

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8  Congenital Cardiac Malformations in Children

8.21.2 Common Arterial Trunk. Pulmonary Trunk and Right Pulmonary Artery Stenosis. Left Pulmonary Artery from Aorta. Right Aortic Arch with Aberrant Left Subclavian Artery: Postoperator

Fig. 8.236  3D VRT reconstruction 1. Aorta ascendens 2. Valved conduit for RVOT 3. Pulmonary valve 4. Aorta descendens

8.21 Common Arterial Trunk. Pulmonary Trunk and Right Pulmonary Artery Stenosis. Left Pulmonary…

Fig. 8.237  3D VRT reconstruction 1. Valved conduit for RVOT 2. Ventriculus dexter cordis 3. Arteria pulmonalis sinistra 4. Aorta ascendens

Fig. 8.238  3D VRT reconstruction 1. Ventriculus dexter cordis 2. Ventriculus sinister cordis 3. Valved conduit for RVOT 4. Pulmonary valve 5. Arteria pulmonalis sinistra 6. Arteria subclavia sinistra 7. Arteria subclavia dextra 8. Arteria carotis communis dextra 9. Arteria carotis communis sinistra 10. Aorta ascendens

367

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8  Congenital Cardiac Malformations in Children

Fig. 8.241  3D MIP reconstruction 1. Arcus aortae 2. Arteria carotis communis sinistra 3. Arteria subclavia sinistra 4. Trachea

Fig. 8.239  3D VRT reconstruction 1. Ventriculus dexter cordis 2. Valved conduit for RVOT 3. Pulmonary valve 4. Atrium cordis dextrum 5. Aorta descendens

Fig. 8.240  3D MIP reconstruction 1. Aorta ascendens 2. Aorta descendens 3. Valved conduit for RVOT 4. Pulmonary valve 5. Arteria pulmonalis sinistra

Fig. 8.242  3D MIP reconstruction 1. Valved conduit for RVOT 2. Pulmonary valve 3. Arteria pulmonalis sinistra 4. Aorta ascendens 5. Aorta descendens 6. MAPCA

8.22 Gyant Left Atrium Aneurysm

369

8.22 Giant Left Atrial Aneurysm

Fig. 8.243  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Atrium cordis sinistrum (giant left atrial aneurysm) 3. Aorta ascendens 4. Aorta descendens

370

8  Congenital Cardiac Malformations in Children

Fig. 8.245  3D VRT reconstruction 1. Atrium cordis sinistrum (giant left atrial aneurysm) 2. Aorta ascendens 3. Arcus aortae 4. Aorta descendens

Fig. 8.244  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Atrium cordis sinistrum (giant left atrial aneurysm) 3. Arcus aortae 4. Aorta descendens

Fig. 8.246  3D VRT reconstruction 1. Ventriculus sinister cordis 2. Atrium cordis sinistrum (giant left atrial aneurysm) 3. Arcus aortae 4. Aorta descendens

8.22 Gyant Left Atrium Aneurysm

Fig. 8.247  3D MIP reconstruction 1. Aorta ascendens 2. Atrium cordis sinistrum (giant left atrial aneurysm) 3. Aorta descendens

Fig. 8.248  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Ventriculus dexter cordis 3. Atrium cordis sinistrum (giant left atrial aneurysm) 4. Aorta descendens

371

Fig. 8.249  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Atrium cordis sinistrum (giant left atrial aneurysm) 3. Aorta ascendens 4. Ventriculus dexter cordis

Fig. 8.250  3D MIP reconstruction 1. Ventriculus sinister cordis 2. Atrium cordis sinistrum (giant left atrial aneurysm) 3. Bulbus aortae 4. Aorta ascendens 5. Arcus aortae

9

CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Contents  natomic Variation of the Profound Venous System of the Lower A Limb

 375

 ost-thrombotic Syndrome After Deep Vein Thrombosis of the Right P Calf

 380

 ost-thrombotic Syndrome After Deep Vein Thrombosis of the Left P Calf with Varicose Dilatation of the Great Saphenous Vein

 387

 ost-thrombotic Syndrome After Deep Vein Thrombosis of the Right P Calf with Occlusion of the Anterior Tibial Veins and Varicose Dilatation of the Great Saphenous Vein

 393

 omplete Occlusion of Anterior and Fibular Veins and Occlusion C of the Distal 1/3 of the Posterior Tibial Veins of the Left Calf

 399

9.6

Acute Thrombosis of the Popliteal and Femoral Right Vein

 403

9.7

Occlusion of the Fibular Veins

 409

9.8

 cclusion of the Anterior Tibial Veins and Duplication of the Left O Femoral Vein

 414

 cclusion of the Anterior Tibial Veins and Acute Thrombosis O of the Right Great Saphenous Vein. Extrinsic Compression of Right External Iliac Vein by External Iliac Artery

 422

9.1 9.2 9.3 9.4

9.5

9.9

9.10 M  ay-Thurner Syndrome: Complete Occlusion of Common and External Left Iliac Vein, with Prepubic Collateral Circulation

 429

9.11 A  cute Thrombosis of the Left Popliteal and Left Femoral Vein with Open Cocket’s Perforators. Occlusion of the Left Anterior Tibial Veins  437 9.12 S  ame Patient with Repermeabilization of the Veins, After Treatment. Checkup After 2 Years. Occlusion of the Left Anterior Tibial Veins

© Springer Nature Switzerland AG 2019 G. D. Miclaus, H. Ples, Atlas of CT Angiography, https://doi.org/10.1007/978-3-030-16095-1_9

 442

373

374

9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media 9.13 C  omplete Occlusion of the Right Posterior Tibial and Fibular Veins, Occlusion of the Proximal 1/3 of the Right Popliteal Vein and Occlusion of the Right Femoral Vein

 447

9.14 M  ay-Thurner Syndrome. Occlusion of the Mid and Proximal 1/3 of Left Femoral Vein, Left Common Femoral Vein and External and Common Left Iliac Vein  

 451

9.1 Anatomic Variation of the Profound Venous System of the Lower Limb

9.1

375

Anatomic Variation of the Profound Venous System of the Lower Limb

Fig. 9.1  3D VRT reconstruction of the profound venous system of the right lower limb 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VvF) 3. Venae tibiales anteriores (VvTA) 4. Vena poplitea (VP)—duplication of popliteal vein 5. Vena femoralis (VF)—duplication of femoral vein 6. Vena iliaca externa (VIE)

Fig. 9.2  3D VRT reconstruction of the profound venous system of the right lower limb 1. Venae tibiales anteriores (VvTA) 2. Vena femoralis communis (VFC) 3. Vena iliaca externa (VIE) 4. Vena iliaca communis (VIC)

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.3  3D VRT reconstruction of the profound venous system of the right lower limb 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VvF) 3. Venae tibiales anteriores (VvTA) Fig. 9.4  3D VRT reconstruction of the profound venous system of the right lower limb 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VvF)

9.1 Anatomic Variation of the Profound Venous System of the Lower Limb

Fig. 9.5  3D VRT reconstruction of the profound venous system of the right lower limb 3. Venae tibiales anteriores (VvTA)

377

Fig. 9.6  3D VRT reconstruction of the profound venous system of the right lower limb 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VvF) 3. Venae tibiales anteriores (VvTA) 4. Vena poplitea (VP)—duplication of popliteal vein

378

9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.7  3D VRT reconstruction of the profound venous system of the right lower limb 4. Vena poplitea (VP)—duplication of popliteal vein 5. Vena femoralis (VF)—duplication of femoral vein

Fig. 9.8  3D VRT reconstruction of the profound venous system of the right lower limb 5. Vena femoralis (VF)—duplication of femoral vein 6. Vena femoralis communis (VFC)

9.1 Anatomic Variation of the Profound Venous System of the Lower Limb

379

Fig. 9.9  3D VRT reconstruction of the profound venous system of the right lower limb 5. Vena femoralis (VF)—duplication of femoral vein 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC)

Fig. 9.10  3D VRT reconstruction of the profound venous system of the right lower limb 5. Vena femoralis (VF)—duplication of femoral vein 6. Vena femoralis communis (VFC)

380

9.2

9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Post-thrombotic Syndrome After Deep Vein Thrombosis of the Right Calf

Fig. 9.11  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP)—partially occluded 2. Venae fibulares (VF)—partially occluded 3. Venae tibiales anteriores (VvTA) 4. Vena poplitea (VP) 5. Vena femoralis (VF) with fenestration in the mid-segment 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF)

Fig. 9.12  3D VRT reconstruction 3. Venae tibiales anteriores (VvTA) 5. Vena femoralis (VF) with fenestration in the mid-segment 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF)

9.2 Post-thrombotic Syndrome After Deep Vein Thrombosis of the Right Calf

Fig. 9.13  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP)—partially occluded 3. Venae tibiales anteriores (VvTA) 9. Vena saphena magna (VSM) A. Varicose veins

Fig. 9.14  3D VRT reconstruction 2. Venae fibulares (VF)—partially occluded A. Varicose veins

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.15  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP)—partially occluded 2. Venae fibulares (VF)—partially occluded 3. Venae tibiales anteriores (VvTA) 4. Vena poplitea (VP) 9. Vena saphena magna (VSM) A. Varicose veins

Fig. 9.16  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) with fenestration in the mid-segment 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF)

Fig. 9.17  3D VRT reconstruction 10. Vena profunda femoris (VPF) A. Varicose veins

9.2 Post-thrombotic Syndrome After Deep Vein Thrombosis of the Right Calf

Fig. 9.18  3D VRT reconstruction 10. Vena profunda femoris (VPF) A. Varicose veins

Fig. 9.19  3D VRT reconstruction 6. Vena femoralis communis (VFC) 9. Vena saphena magna (VSM)

Fig. 9.20  3D VRT reconstruction 5. Vena femoralis (VF) with fenestration in the mid-segment 6. Vena femoralis communis (VFC) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF)

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.21  3D VRT reconstruction 5. Vena femoralis (VF) with fenestration in the mid-segment 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF) 11. Vena cava inferior (VCI)

Fig. 9.22  3D VRT reconstruction A. Varicose veins

9.2 Post-thrombotic Syndrome After Deep Vein Thrombosis of the Right Calf

Fig. 9.23  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP)—partially occluded 2. Venae fibulares (VF)—partially occluded 4. Vena poplitea (VP)

Fig. 9.24  3D MIP reconstruction 3. Venae tibiales anteriores (VvTA)

385

Fig. 9.25  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP)—partially occluded 2. Venae fibulares (VF)—partially occluded 4. Vena poplitea (VP)

Fig. 9.26  3D MIP reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) with fenestration in the mid-segment 9. Vena saphena magna (VSM)

386

9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.27  3D MIP reconstruction 6. Vena femoralis communis (VFC) 9. Vena saphena magna (VSM)

Fig. 9.28  3D MIP reconstruction 6. Vena femoralis communis (VFC) 9. Vena saphena magna (VSM)

9.3 Post-thrombotic Syndrome After Deep Vein Thrombosis of the Left Calf with Varicose Dilatation…

9.3

Post-thrombotic Syndrome After Deep Vein Thrombosis of the Left Calf with Varicose Dilatation of the Great Saphenous Vein

Fig. 9.29  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) A. Varicose veins

Fig. 9.30  3D VRT reconstruction 3. Venae tibiales anteriores (VvTA)—occluded 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI) A. Varicose veins

387

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.31  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) A. Varicose veins

Fig. 9.32  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) A. Varicose veins

9.3 Post-thrombotic Syndrome After Deep Vein Thrombosis of the Left Calf with Varicose Dilatation…

Fig. 9.33  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) A. Varicose veins

Fig. 9.34  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) A. Varicose veins

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.35  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 9. Vena saphena magna (VSM) A. Varicose veins

Fig. 9.36  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM)

9.3 Post-thrombotic Syndrome After Deep Vein Thrombosis of the Left Calf with Varicose Dilatation…

Fig. 9.37  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI)

Fig. 9.38  3D VRT reconstruction 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) A. Varicose veins

Fig. 9.39  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 5. Vena femoralis (VF)

Fig. 9.40  3D MIP reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) A. Varicose veins

391

392

9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.41  3D MIP reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC)

Fig. 9.43  3D MIP reconstruction 8. Vena iliaca communis (VIC) 11. Vena cava inferior (VCI)

Fig. 9.42  3D MIP reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC)

Fig. 9.44  3D MIP reconstruction 5. Vena femoralis (VF) 7. Vena iliaca externa (VIE)

9.4 Post-thrombotic Syndrome After Deep Vein Thrombosis of the Right Calf with Occlusion…

9.4

Post-thrombotic Syndrome After Deep Vein Thrombosis of the Right Calf with Occlusion of the Anterior Tibial Veins and Varicose Dilatation of the Great Saphenous Vein

Fig. 9.45  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 5. Vena femoralis (VF) A. Varicose veins

Fig. 9.46  3D VRT reconstruction 3. Venae tibiales anteriores (VvTA)—occluded 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) A. Varicose veins

393

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.47  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 9. Vena saphena magna (VSM)

Fig. 9.48  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 9. Vena saphena magna (VSM)

9.4 Post-thrombotic Syndrome After Deep Vein Thrombosis of the Right Calf with Occlusion…

Fig. 9.49  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 9. Vena saphena magna (VSM)

Fig. 9.50  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

395

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.52  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 9. Vena saphena magna (VSM) A. Varicose veins Fig. 9.51  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 9. Vena saphena magna (VSM) A. Varicose veins

Fig. 9.53  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM)

9.4 Post-thrombotic Syndrome After Deep Vein Thrombosis of the Right Calf with Occlusion…

Fig. 9.54  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI)

Fig. 9.56  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 9. Vena saphena magna (VSM)

Fig. 9.55  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF)

Fig. 9.57  3D MIP reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

397

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.58  3D MIP reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 9. Vena saphena magna (VSM)

Fig. 9.59  3D MIP reconstruction 7. Vena iliaca externa (VIE)

Fig. 9.60  3D MIP reconstruction 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC)

9.5 Complete Occlusion of Anterior and Fibular Veins and Occlusion of the Distal 1/3 of the Posterior…

9.5

Complete Occlusion of Anterior and Fibular Veins and Occlusion of the Distal 1/3 of the Posterior Tibial Veins of the Left Calf

Fig. 9.61  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF)—occluded 3. Venae tibiales anteriores (VvTA)—occluded 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) B. Incompetent perforator veins (IPVs)—Cocket’s perforator

Fig. 9.62  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI) B. Incompetent perforator veins (IPVs)—Cocket’s perforator

399

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.63  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF)—occluded 3. Venae tibiales anteriores (VvTA)—occluded 4. Vena poplitea (VP) 9. Vena saphena magna (VSM) B. Incompetent perforator veins (IPVs)—Cocket’s perforator

Fig. 9.64  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF)—occluded 3. Venae tibiales anteriores (VvTA)—occluded 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) B. Incompetent perforator veins (IPVs)—Cocket’s perforator

9.5 Complete Occlusion of Anterior and Fibular Veins and Occlusion of the Distal 1/3 of the Posterior…

Fig. 9.65  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) Fig. 9.67  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 4. Vena poplitea (VP) 9. Vena saphena magna (VSM) B. Incompetent perforator veins (IPVs)—Cocket’s perforator

Fig. 9.66  3D VRT reconstruction 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

401

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.70.  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 9. Vena saphena magna (VSM)

Fig. 9.68  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 9. Vena saphena magna (VSM) B. Incompetent perforator veins (IPVs)—Cocket’s perforator

Fig. 9.71  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI) Fig. 9.69  3D VRT reconstruction 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

9.6 Acute Thrombosis of the Popliteal and Femoral Right Vein

9.6

Acute Thrombosis of the Popliteal and Femoral Right Vein

Fig. 9.72  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF)—occluded 3. Venae tibiales anteriores (VvTA)—occluded 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

Fig. 9.73  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM)

403

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.74  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 9. Vena saphena magna (VSM)

Fig. 9.75  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF)—occluded 3. Venae tibiales anteriores (VvTA)—occluded 4. Vena poplitea (VP) 9. Vena saphena magna (VSM)

Fig. 9.76  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

9.6 Acute Thrombosis of the Popliteal and Femoral Right Vein

Fig. 9.77  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

Fig. 9.79  3D VRT reconstruction 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

Fig. 9.78  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

Fig. 9.80  3D VRT reconstruction 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

405

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.81  3D VRT reconstruction 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

Fig. 9.82  3D MIP reconstruction 4. Vena poplitea (VP) Thrombus in popliteal vein

Fig. 9.83  3D MIP reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) Thrombus in popliteal vein

Fig. 9.84  3D MIP reconstruction 4. Vena poplitea (VP)—thrombus inside vein 5. Vena femoralis (VF)—thrombus inside vein

9.6 Acute Thrombosis of the Popliteal and Femoral Right Vein

Fig. 9.85  3D MIP reconstruction 4. Vena poplitea (VP)—thrombus inside vein 5. Vena femoralis (VF)—thrombus inside vein

Fig. 9.86  3D MIP reconstruction 4. Vena poplitea (VP)—thrombus inside vein 5. Vena femoralis (VF)—thrombus inside vein

Fig. 9.87  3D MIP reconstruction 5. Vena femoralis (VF)—thrombus inside vein 9. Vena saphena magna (VSM)

Fig. 9.88  3D MIP reconstruction 5. Vena femoralis (VF)—thrombus inside vein 9. Vena saphena magna (VSM)

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.89  3D MIP reconstruction 6. Vena femoralis communis (VFC) 9. Vena saphena magna (VSM)

9.7 Occlusion of the Fibular Veins

9.7

409

Occlusion of the Fibular Veins Fig. 9.90  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF)— occluded 3. Venae tibiales anteriores (VvTA) 4. Vena poplitea (VP) 5. Vena femoralis (VF)

410

9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.92  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF)—occluded 3. Venae tibiales anteriores (VvTA) 4. Vena poplitea (VP)

Fig. 9.91  3D VRT reconstruction 3. Venae tibiales anteriores (VvTA)—occluded 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 11. Vena cava inferior (VCI) Fig. 9.93  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF)—occluded 3. Venae tibiales anteriores (VvTA) 4. Vena poplitea (VP)

9.7 Occlusion of the Fibular Veins

411

Fig. 9.94  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 3. Venae tibiales anteriores (VvTA) 4. Vena poplitea (VP)

Fig. 9.96  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 3. Venae tibiales anteriores (VvTA) 4. Vena poplitea (VP) 5. Vena femoralis (VF)

Fig. 9.95  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF)—occluded 3. Venae tibiales anteriores (VvTA) 4. Vena poplitea (VP) 5. Vena femoralis (VF)

Fig. 9.97  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF)

412

9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.98  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 3. Venae tibiales anteriores (VvTA) 4. Vena poplitea (VP)

Fig. 9.100  3D MIP reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF)

Fig. 9.99  3D MIP reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF)

Fig. 9.101  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 3. Venae tibiales anteriores (VvTA)

9.7 Occlusion of the Fibular Veins

Fig. 9.102  3D MIP reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC)

413

Fig. 9.103  3D MIP reconstruction 8. Vena iliaca communis (VIC)

414

9.8

9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Occlusion of the Anterior Tibial Veins and Duplication of the Left Femoral Vein

Fig. 9.104  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 5. Vena femoralis (VF) with duplication (open arrow) 9. Vena saphena magna (VSM) B. Incompetent perforator veins (IPVs)—Cocket’s perforator

Fig. 9.105  3D VRT reconstruction 5. Vena femoralis (VF) with duplication 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI) B. Incompetent perforator veins (IPVs)—Cocket’s perforator

9.8 Occlusion of the Anterior Tibial Veins and Duplication of the Left Femoral Vein

Fig. 9.106  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 9. Vena saphena magna (VSM) B. Incompetent perforator veins (IPVs)—Cocket’s perforator

Fig. 9.107  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 9. Vena saphena magna (VSM) B. Incompetent perforator veins (IPVs)—Cocket’s perforator

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.109  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) with duplication (open arrow) 9. Vena saphena magna (VSM) Fig. 9.108  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 9. Vena saphena magna (VSM) B. Incompetent perforator veins (IPVs)—Cocket’s perforator

Fig. 9.110  3D VRT reconstruction 5. Vena femoralis (VF) with duplication (open arrow) 9. Vena saphena magna (VSM)

9.8 Occlusion of the Anterior Tibial Veins and Duplication of the Left Femoral Vein

Fig. 9.111  3D VRT reconstruction 5. Vena femoralis (VF) with duplication (open arrow) 9. Vena saphena magna (VSM)

Fig. 9.112  3D VRT reconstruction 5. Vena femoralis (VF) with duplication 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI)

Fig. 9.113  3D VRT reconstruction 5. Vena femoralis (VF) with duplication 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI)

417

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.114  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 9. Vena saphena magna (VSM)

Fig. 9.115  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 9. Vena saphena magna (VSM)

9.8 Occlusion of the Anterior Tibial Veins and Duplication of the Left Femoral Vein

Fig. 9.116  3D MIP reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) with duplication (open arrow) 9. Vena saphena magna (VSM)

Fig. 9.117  3D MIP reconstruction 5. Vena femoralis (VF) with duplication (open arrow)

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.118  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 5. Vena femoralis (VF) with duplication (open arrow) 9. Vena saphena magna (VSM)

Fig. 9.119  3D MIP reconstruction 5. Vena femoralis (VF) with duplication (open arrow) 6. Vena femoralis communis (VFC) 9. Vena saphena magna (VSM)

9.8 Occlusion of the Anterior Tibial Veins and Duplication of the Left Femoral Vein

Fig. 9.120  3D MIP reconstruction 5. Vena femoralis (VF) with duplication 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI)

Fig. 9.121  3D MIP reconstruction 5. Vena femoralis (VF) with duplication 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI)

421

422

9.9

9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Occlusion of the Anterior Tibial Veins and Acute Thrombosis of the Right Great Saphenous Vein. Extrinsic Compression of Right External Iliac Vein by External Iliac Artery

Fig. 9.122  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF) B. Incompetent perforator veins (IPVs)—Cocket’s perforator C. Thrombus in the vena saphena magna (VSM)

Fig. 9.123  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF) 11. Vena cava inferior (VCI) B. Incompetent perforator veins (IPVs)—Cocket’s perforator C. Thrombus in the vena saphena magna (VSM)

9.9 Occlusion of the Anterior Tibial Veins and Acute Thrombosis of the Right Great Saphenous Vein.…

Fig. 9.124  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 9. Vena saphena magna (VSM) B. Incompetent perforator veins (IPVs)—Cocket’s perforator

Fig. 9.125  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) B. Incompetent perforator veins (IPVs)—Cocket’s perforator

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.126  3D VRT reconstruction 4. Vena poplitea (VP) 9. Vena saphena magna (VSM) B. Incompetent perforator veins (IPVs)—Cocket’s perforator

Fig. 9.127  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF) C. Thrombus in the vena saphena magna (VSM)

9.9 Occlusion of the Anterior Tibial Veins and Acute Thrombosis of the Right Great Saphenous Vein.…

Fig. 9.128  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF) C. Thrombus in the vena saphena magna (VSM)

Fig. 9.129  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF) C. Thrombus in the vena saphena magna (VSM)

425

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.130  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF) 11. Vena cava inferior (VCI) C. Thrombus in the vena saphena magna (VSM) D. Extrinsic compression of right external iliac vein by external iliac artery

Fig. 9.131  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF) C. Thrombus in the vena saphena magna (VSM)

9.9 Occlusion of the Anterior Tibial Veins and Acute Thrombosis of the Right Great Saphenous Vein.…

Fig. 9.132  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF)

Fig. 9.133  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 5. Vena femoralis (VF)

Fig. 9.134  3D MIP reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF)

Fig. 9.135  3D MIP reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 9. Vena saphena magna (VSM) C. Thrombus in the vena saphena magna (VSM)

427

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.136  3D MIP reconstruction 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) C. Thrombus in the vena saphena magna (VSM)

Fig. 9.137  3D MIP reconstruction 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) C. Thrombus in the vena saphena magna (VSM)

Fig. 9.138  3D MIP reconstruction 5. Vena femoralis (VF) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) D. Extrinsic compression of right external iliac vein by external iliac artery

Fig. 9.139  3D MIP reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 9. Vena saphena magna (VSM) C. Thrombus in the vena saphena magna (VSM)

9.10 May-Thurner Syndrome: Complete Occlusion of Common and External Left Iliac Vein,…

9.10 May-Thurner Syndrome: Complete Occlusion of Common and External Left Iliac Vein, with Prepubic Collateral Circulation

Fig. 9.140  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF)

Fig. 9.141  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC)—contralateral (right) 7. Vena iliaca externa (VIE)—contralateral (right) 8. Vena iliaca communis (VIC)—contralateral (right) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI) 12. Confluens venosus subinguinalis (CVS) Arrow: prepubic collateral circulation

429

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.143  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 9. Vena saphena magna (VSM) B. Incompetent perforator veins (IPVs)—Cocket’s perforator Fig. 9.142  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 9. Vena saphena magna (VSM)

Fig. 9.144  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

9.10 May-Thurner Syndrome: Complete Occlusion of Common and External Left Iliac Vein,…

Fig. 9.145  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

Fig. 9.146  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF)

Fig. 9.147  3D VRT reconstruction 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF)

Fig. 9.148  3D VRT reconstruction 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF) 12. Confluens venosus subinguinalis (CVS) Arrow: prepubic collateral circulation

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Fig. 9.149  3D VRT reconstruction 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF) 12. Confluens venosus subinguinalis (CVS) Arrow: prepubic collateral circulation

Fig. 9.150  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC)—contralateral (right) 7. Vena iliaca externa (VIE)—contralateral (right) 8. Vena iliaca communis (VIC)—contralateral (right) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF) 11. Vena cava inferior (VCI) 12. Confluens venosus subinguinalis (CVS) Arrow: prepubic collateral circulation

9.10 May-Thurner Syndrome: Complete Occlusion of Common and External Left Iliac Vein,…

Fig. 9.151  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC)—contralateral (right) 7. Vena iliaca externa (VIE)—contralateral (right) 8. Vena iliaca communis (VIC)—contralateral (right) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI) 12. Confluens venosus subinguinalis (CVS) Arrow: prepubic collateral circulation

Fig. 9.152  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC)—contralateral (right) 7. Vena iliaca externa (VIE)—contralateral (right) 8. Vena iliaca communis (VIC)—contralateral (right) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI) 12. Confluens venosus subinguinalis (CVS) Arrow: prepubic collateral circulation

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Fig. 9.153  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC)—contralateral (right) 6′. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE)—contralateral (right) 8. Vena iliaca communis (VIC)—contralateral (right) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI) 12. Confluens venosus subinguinalis (CVS) Arrow: prepubic collateral circulation

Fig. 9.154  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 9. Vena saphena magna (VSM)

9.10 May-Thurner Syndrome: Complete Occlusion of Common and External Left Iliac Vein,…

Fig. 9.155  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

Fig. 9.156  3D MIP reconstruction 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) 10. Vena profunda femoris (VPF)

Fig. 9.157  3D MIP reconstruction 9. Vena saphena magna (VSM) Arrow: prepubic collateral circulation

Fig. 9.158  3D MIP reconstruction 9. Vena saphena magna (VSM) Arrow: prepubic collateral circulation

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Fig. 9.159  3D MIP reconstruction 6. Vena femoralis communis (VFC)—contralateral (right) 6′. Vena femoralis communis (VFC) 11. Vena cava inferior (VCI) Arrow: prepubic collateral circulation

Fig. 9.160.  3D MIP reconstruction 5. Vena femoralis (VF) 7. Vena iliaca externa (VIE)—contralateral (right) 8. Vena iliaca communis (VIC)—contralateral (right) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI)

Fig. 9.161  3D MIP reconstruction 7. Vena iliaca externa (VIE)—contralateral (right) 8. Vena iliaca communis (VIC)—contralateral (right) 11. Vena cava inferior (VCI)

9.11 Acute Thrombosis of the Left Popliteal and Left Femoral Vein with Open Cocket’s Perforators.…

9.11 Acute Thrombosis of the Left Popliteal and Left Femoral Vein with Open Cocket’s Perforators. Occlusion of the Left Anterior Tibial Veins

Fig. 9.162  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) B. Incompetent perforator veins (IPVs)—Cocket’s perforator

Fig. 9.163  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI)

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Fig. 9.164  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 9. Vena saphena magna (VSM) B. Incompetent perforator veins (IPVs)—Cocket’s perforator

Fig. 9.165  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

Fig. 9.166  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

Fig. 9.167  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

9.11 Acute Thrombosis of the Left Popliteal and Left Femoral Vein with Open Cocket’s Perforators.…

Fig. 9.168  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI)

Fig. 9.170  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) Arrow: thrombus in vein

Fig. 9.169  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF)

Fig. 9.171  3D MIP reconstruction 2. Venae fibulares (VF) 4. Vena poplitea (VP) 5. Vena femoralis (VF) Arrow: thrombus in vein

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Fig. 9.172  3D MIP reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) Arrow: thrombus in vein

Fig. 9.174  3D MIP reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) Arrow: thrombus in vein

Fig. 9.173  3D MIP reconstruction 5. Vena femoralis (VF)

Fig. 9.175  3D MIP reconstruction 5. Vena femoralis (VF) 8. Vena iliaca communis (VIC)

9.11 Acute Thrombosis of the Left Popliteal and Left Femoral Vein with Open Cocket’s Perforators.…

Fig. 9.176  3D MIP reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) Arrow: thrombus in vein

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9.12 Same Patient with Repermeabilization of the Veins, After Treatment. Checkup After 2 Years. Occlusion of the Left Anterior Tibial Veins

Fig. 9.177  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

Fig. 9.178  3D VRT reconstruction 2. Venae fibulares (VF) 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI)

9.12 Same Patient with Repermeabilization of the Veins, After Treatment. Checkup After 2 Years.…

Fig. 9.179  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP) 9. Vena saphena magna (VSM)

Fig. 9.180  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF)

Fig. 9.181  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

Fig. 9.182  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM)

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Fig. 9.183  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 9. Vena saphena magna (VSM) 12. Confluens venosus subinguinalis (CVS)

Fig. 9.184  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI) 12. Confluens venosus subinguinalis (CVS)

Fig. 9.185  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI) 12. Confluens venosus subinguinalis (CVS)

Fig. 9.186  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI) 12. Confluens venosus subinguinalis (CVS)

9.12 Same Patient with Repermeabilization of the Veins, After Treatment. Checkup After 2 Years.…

Fig. 9.187  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP)

Fig. 9.188  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 4. Vena poplitea (VP)

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Fig. 9.189  3D MIP reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) 12. Confluens venosus subinguinalis (CVS)

Fig. 9.191  3D MIP reconstruction 6. Vena femoralis communis (VFC) 9. Vena saphena magna (VSM)

Fig. 9.192  3D MIP reconstruction 7. Vena iliaca externa (VIE)

Fig. 9.190  3D MIP reconstruction 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) 12. Confluens venosus subinguinalis (CVS)

9.13 Complete Occlusion of the Right Posterior Tibial and Fibular Veins, Occlusion of the Proximal 1/3…

9.13 Complete Occlusion of the Right Posterior Tibial and Fibular Veins, Occlusion of the Proximal 1/3 of the Right Popliteal Vein and Occlusion of the Right Femoral Vein

Fig. 9.193  3D VRT reconstruction 3. Venae tibiales anteriores (VvTA) 4. Vena poplitea (VP) 9. Vena saphena magna (VSM) Arrowhead: collateral venous circulation (superficial venous system)

Fig. 9.194  3D VRT reconstruction 3. Venae tibiales anteriores (VvTA) 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) Arrowhead: collateral venous circulation (superficial venous system)

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.195  3D VRT reconstruction 3. Venae tibiales anteriores (VvTA) 4. Vena poplitea (VP) 9. Vena saphena magna (VSM) Arrowhead: collateral venous circulation (superficial venous system)

Fig. 9.196  3D VRT reconstruction 3. Venae tibiales anteriores (VvTA) 4. Vena poplitea (VP) 9. Vena saphena magna (VSM)

Fig. 9.197  3D VRT reconstruction 4. Vena poplitea (VP) 9. Vena saphena magna (VSM) Arrowhead: collateral venous circulation (superficial venous system)

9.13 Complete Occlusion of the Right Posterior Tibial and Fibular Veins, Occlusion of the Proximal 1/3…

Fig. 9.198  3D VRT reconstruction 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 9. Vena saphena magna (VSM) Arrowhead: collateral venous circulation (superficial venous system)

Fig. 9.199  3D MIP reconstruction 3. Venae tibiales anteriores (VvTA) 9. Vena saphena magna (VSM)

Fig. 9.200  3D MIP reconstruction 4. Vena poplitea (VP) 9. Vena saphena magna (VSM)

Fig. 9.201  3D MIP reconstruction 4. Vena poplitea (VP) 9. Vena saphena magna (VSM)

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Fig. 9.202  3D MIP reconstruction 9. Vena saphena magna (VSM)

9.14 May-Thurner Syndrome. Occlusion of the Mid and Proximal 1/3 of Left Femoral Vein, Left Common…

9.14 May-Thurner Syndrome. Occlusion of the Mid and Proximal 1/3 of Left Femoral Vein, Left Common Femoral Vein and External and Common Left Iliac Vein

Fig. 9.203  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 3. Venae tibiales anteriores (VvTA) 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) D. Dodd perforator

Fig. 9.204  3D VRT reconstruction 2. Venae fibulares (VF) 3. Venae tibiales anteriores (VvTA) 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 6′. Vena femoralis communis (VFC)—contralateral (right) 7′. Vena iliaca externa (VIE)—contralateral (right) 8′. Vena iliaca communis (VIC)—contralateral (right) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI) B. Incompetent perforator veins (IPVs)—Cocket’s perforator D. Dodd perforator Arrow: prepubic collateral circulation

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Fig. 9.205  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 9. Vena saphena magna (VSM)

Fig. 9.206  3D VRT reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 3. Venae tibiales anteriores (VvTA) 9. Vena saphena magna (VSM)

Fig. 9.207  3D VRT reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) D. Dodd perforator

Fig. 9.208  3D VRT reconstruction 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) D. Dodd perforator

9.14 May-Thurner Syndrome. Occlusion of the Mid and Proximal 1/3 of Left Femoral Vein, Left Common…

Fig. 9.209  3D VRT reconstruction 5. Vena femoralis (VF) 6. Vena femoralis communis (VFC) 7′. Vena iliaca externa (VIE)—contralateral (right) 8′. Vena iliaca communis (VIC)—contralateral (right) 9. Vena saphena magna (VSM) D. Dodd perforator Arrow: prepubic collateral circulation

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Fig. 9.210  3D VRT reconstruction 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 6′. Vena femoralis communis (VFC)—contralateral (right) 7′. Vena iliaca externa (VIE)—contralateral (right) 8′. Vena iliaca communis (VIC)—contralateral (right) 9. Vena saphena magna (VSM) 11. Vena cava inferior (VCI) Arrow: prepubic collateral circulation

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9  CT Phlebography of the Lower Limb with Antegrade Injection of the Contrast Media

Fig. 9.211  3D MIP reconstruction 1. Venae tibiales posteriores (VvTP) 2. Venae fibulares (VF) 3. Venae tibiales anteriores (VvTA)

Fig. 9.213  3D MIP reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) D. Dodd perforator

Fig. 9.214  3D MIP reconstruction 4. Vena poplitea (VP) 5. Vena femoralis (VF) 9. Vena saphena magna (VSM) D. Dodd perforator Fig. 9.212  3D MIP reconstruction 3. Venae tibiales anteriores (VvTA)

9.14 May-Thurner Syndrome. Occlusion of the Mid and Proximal 1/3 of Left Femoral Vein, Left Common…

Fig. 9.215  3D MIP reconstruction 6. Vena femoralis communis (VFC) 7. Vena iliaca externa (VIE) 8. Vena iliaca communis (VIC) 6′. Vena femoralis communis (VFC)—contralateral (right) 7′. Vena iliaca externa (VIE)—contralateral (right) 8′. Vena iliaca communis (VIC)—contralateral (right) 9. Vena saphena magna (VSM)

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Fig. 9.216  3D MIP reconstruction in transversal plane, depicting the compression of the left iliac common vein by the right iliac common artery 8. Vena iliaca communis (VIC) 11. Vena cava inferior (VCI) Arteria iliaca communis dextra