Angiomyolipoma Findings: hypervascular renal mass multiple foci of contrast pooling = aneurysms Confirm diagnosis by detecting fat on CT ddx: NONE! This is an Aunt Minnie!

Leriche syndrome Findings: occlusion of the proximal left common iliac artery reconstitution distally by multiple collateral arteries causes: atherosclerosis traumatic radiation

Splenic vein thrombosis & portal-portal anastamosis (arc of Barkow) Findings: venous phase of splenic artery injection splenic vein thrombosis large collateral vessel from spleen to portal vein = portal-portal shunt causes: pancreatitis malignancy portal hypertension

Budd-Chiari Findings: markedly inhomogeneous enhancement of liver parenchyma transjugular wedged right hepatic venogram show a complex “spider web” network of tortous venous collaterals ddx: NONE! This is an Aunt Minnie!

Buerger’s disease Findings: mulitple abrupt segmental occlusions with “corkscrew collaterals” otherwise normal background appearance of vessels a.k.a. Thromboangitis obliterans inflammatory arteritis of unknown etiology small and medium sized artieries of extremities young me, cigarette smokers

Celiac axis occlusion & medial arcuate ligament Findings: opacification of the celiac vessels from an SMA injection collateral flow via the inferior pancreatico-duodenal arteries via the GDA characteristic appearance of celiac artery stenosis ddx: atherosclerosis

Great vessel stenoses Findings: Smooth narrowing of the multiple great vessels Aoritc involvement, too ddx: Takayasu's Bechet syndrome Giant cell arteritis Radiation vasculitis Williams syndrome

HCC & arterial – portal shunting Findings: focal increased vascularity in the left lobe = vascular tumor prominent and early opacification portal veins = arterial - portal shuting large round filling defect in main portal ven = thrombus / tumor invasion ddx: NONE! This is an Aunt Minnie!

Hypothenar hammer syndrome Findings: contour irregularity of the distal ulnar artery multiple distal occlusions of digital branches ddx: NONE! This is an Aunt Minnie!

Klatskin tumor Findings: percutaneous cholangiogram shows dilated intrahepatic biliary tree obstruction likely at the confluence of the biliary system ddx: choledocolithiasis other invasive tumor portal lymphadenopathy

Persistent sciatic artery Findings: anomalous arteries of the left leg: CFA is normal but profunda and SFA are smaller than normal large vessel arising from IIA continues into the leg ddx: NONE! This is an Aunt Minnie!

Posterior knee dislocation & popliteal artery occlusion Findings: complete posterior dislocation of the knee angiogram is diagnostic for popliteal artery injury thrombosis dissection transection try to cross with wire -- if unsuccessful -- surgery

Right aortic arch & aberrant left subclavian Findings: right sided arch with non-mirror image branching (four great vessels) 1) Lt common carotid 2) Rt common carotid 3) Rt subclavian 4) Lt subclavian ddx: NONE! This is an Aunt Minnie!

Splenic artery aneurysm Findings: KUB shows LUQ curvilinear signet ring calcifications celiac angiogram is diagnositc causes: portal hypertension pancreatitis pregnancy fibromuscular dysplasia (NOT hypertension)

Takayasu’s dz & bilateral subclavian steal Findings: large carotid arteris and occluded subclavian arteries reconstitution of flow from vertebral arteries on delayed image other causes: atherosclerosis trauma radiation

Venous thoracic outlet obstructon Findings: tight stenosis of the left subclavian vein multiple collaterals reconstitute left brachiocephaic vein causes cervical rib anomalous muscles post-traumatic changes Rx: surgical (NOT stent)

Traumatic aortic injury & active extravasation Findings: Widened mediastinum Obscuration of the aortic arch Aortagram is diagnostic Abrupt caliber change Irregular luminal contour Active extravasaton ddx: NONE! This is an Aunt Minnie!

Marfan-like syndrome & Type B aortic dissection Findings: Angiogram shows widened aorta and opacification of two channels Lt subclavian and vertebral arteries have a beaded, aneurysmal appearance ddx: Atherosclerosis Hypertension Pregnancy Ehlers-Danlos syndrome

Polyarteritis nodosa Findings: Selective angiogram of the right kidney shows multiple tiny aneurysms of the parenchymal arteries ddx: Mycotic aneurysms

Replaced right hepatic artery Findings: Right hepatic artery originates from the SMA Proper hepatic artery may also arise from SMA Normal variant Left hepatic artery may arise directly from common hepatic or gastric ddx: NONE! This is an Aunt Minnie!