MDCT and virtual angioscopy in spontaneous aortocaval fistula.
Aortocaval fistula is a rare, less than 1%, but life threatening complication, of abdominal aortic aneurysm. Mortality is high but prompt recognition of the fistula can reduce mortality rate. The multidetector row CT (MDCT) findings in a 69-year-old patient with a complex medical history characterized by previous episodes of myocardial ischemia, is reported. MDCT shows an early homogeneous enhancement of the inferior vena cava, slightly dilated at the liver level and markedly narrowed above the renal vein due to aneurysm compression. The patient underwent to emergency laparotomy but died during surgery for cardiac arrest. MDCT allows a prompt recognition of the fistula and different computerized reconstruction techniques as maximum intensity projection (MIP), multiplanar reformatting (MPR) and virtual angioscopy (VA) added imaging information for surgery.
Salerno
Sergio
S
Sezione di Radiologia DIBIMEL, Policlinico Università di Palermo, Via Cardinale Rampolla 1, Palermo 90142, Italy. sergio.salerno@unipa.it
Romano
Ida
I
De Luca
Teresa
T
Lo Casto
Antonio
A
D000368:Aged; D017546:Angioscopy / Q000379:methods*; D001011:Aorta / Q000473:pathology* / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001027:Aortography / Q000379:methods; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D017809:Fatal Outcome; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D010690:Phlebography / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface; D014656:Vascular Surgical Procedures; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery