2. 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!

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

6. 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

8. 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!

10. 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

12. 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

14. 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

16. 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!

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

20. 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

22. 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!

24. 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

26. 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!

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

31. 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

33. 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)

36. 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!

38. 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

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

42. 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!