Active intrahepatic gadolinium extravasation following TIPS.
A 31-year-old male patient had a transjugular intrahepatic portal systemic shunt (TIPS) placed for acute Budd-Chiari syndrome secondary to paroxysmal nocturnal hemoglobinuria (PNH). Post-procedure, he was anticoagulated for his underlying paroxysmal nocturnal hemoglobinuria. After 11 days, he complained of upper abdominal pain and underwent magnetic resonance imaging (MRI). On immediate post-gadolinium spoiled-gradient-echo (SGE) images, active extravasation of gadolinium was depicted in one of two intrahepatic hematomas. Progression of layering of high signal gadolinium was shown from early to later phase post-gadolinium images. The active arterial bleeding was confirmed by conventional angiography performed immediately following the magnetic resonance imaging.
Hasegawa
S
S
Department of Radiology, Hamamatsu Medical Center, Japan.
Eisenberg
L B
LB
Semelka
R C
RC
D000208:Acute Disease; D000328:Adult; D000792:Angiography; D006502:Budd-Chiari Syndrome / Q000209:etiology / Q000601:surgery; D003287:Contrast Media / Q000008:administration & dosage*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000175:diagnosis* / Q000209:etiology; D005500:Follow-Up Studies; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006406:Hematoma / Q000175:diagnosis*; D006457:Hemoglobinuria, Paroxysmal / Q000150:complications; D006801:Humans; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging; D008297:Male; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000175:diagnosis
D003287:Contrast Media; D019786:Gadolinium DTPA