We report a case of symptomatic jugular venous reflux (JVR) with dilatation of left superior ophthalmic vein (SOV), mimicking cavernous dural arteriovenous fistula (AVF). Severe JVR was caused by an AVFfor hemodialysis access and the narrowing of the left brachiocephalic vein. In-flow signals were found from the left internal jugular vein to left SOV on magnetic resonance angiography, and T1-weighted image and T2-weighted images demonstrated flow voids in bilateral sigmoid sinuses and confluence of sinuses due to rapid retrograde venous flow. We would like to emphasize that the presence of in-flow signals/flow voids in the venous sinuses may be the key imaging clues to distinguish JVR with dilatation of the SOV from cDAVF.

Background Subpleural pulmonary interstitial emphysema is defined as the air in the subpleural portion of the lung, and the clinical relevance is not well understood. Purpose to evaluate the frequency, temporal course, risk factors, and clinical significance of subpleural pulmonary interstitial emphysema (PIE) in patients with pneumomediastinum resulting from ruptured alveoli and other causes. Material and Methods This was a retrospective study of 130 patients with pneumomediastinum on CT between January 2009 and December 2019 at 2 hospitals. Patients were divided into 3 groups as follows: spontaneous pneumomediastinum ( n = 101), pneumomediastinum due to blunt trauma ( n = 16), and pneumomediastinum due to another known cause ( n = 13). The frequencies of radiographic features (subpleural PIE, peribronchovascular PIE, pneumothorax, pulmonary fibrosis, and emphysematous changes) between the 3 groups were compared by the χ2 or Kruskal–Wallis test. Odds ratios were calculated to evaluate candidate risk factors for subpleural and peribronchovascular PIE. Results Subpleural PIE was observed in 0%, 15.8%, and 31.3% of patients with pneumomediastinum due to another cause, spontaneous mediastinum, and blunt trauma, respectively. In most patients, subpleural PIE resolved spontaneously (85.7% within 8 days). Two patients with pulmonary fibrosis showed recurrent subpleural PIE on follow-up. Young age showed increased risk for subpleural PIE (odds ratio [OR] 0.9, 95% confidence interval [CI] 0–0.99). Conclusion Subpleural PIE was only detected in patients with pneumomediastinum due to ruptured alveoli and resolved spontaneously and rapidly. Subpleural PIE may be one route the air from ruptured alveoli to the mediastinum.

Herein, we present a case of superior mesenteric artery (SMA) thrombus as a complication of stent placement for celiac stenosis and coil packing of a pancreaticoduodenal artery aneurysm. The SMA thrombus was likely caused by thromboembolism from the guiding sheath in the SMA without a continuous heparin flush. It was promptly treated with aspiration thrombectomy, and there was no mesenteric ischemia. To avoid thromboembolic complications, periprocedural prophylactic antithrombotic therapy should also have been performed because a complex procedure involving the pull-through technique was performed.

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The purpose of this study was to evaluate the effects of transcatheter arterial chemoembolization (TACE) on relapsed metastatic spinal cord compression (MSCC) after radiotherapy. Methods: From September 2014 to November 2018, 19 patients with 22 MSCC underwent TACE. We targeted the lesions with analgesic-resistant pain and neurologic deficit. The anticancer agents used were epirubicin, doxorubicin, and cisplatin, based on the primary lesion. In all cases, we performed TACE using Embosphere ® (300-500 mm) after intra-arterial infusion chemotherapy. We repeated TACE as needed. Blood flow was altered with microcoils, if necessary. The following endpoints were evaluated for all lesions: pain relief, improvement of neurologic deficit, and objective tumor response. We defined complete symptom relief (CSR) as an achievement of pain relief and improvement of neurologic deficit, partial symptom relief (PSR) as an achievement of pain relief or improvement of the neurologic deficit but not both, and no symptom relief (NSR) as persistent pain and neurologic deficit. We defined the clinical response rate as (CSR + PSR)/(CSR + PSR + NSR). Objective response was estimated as follows: We defined complete response (CR) as a >50% decrease in tumor size, partial response (PR) as a < 50% decrease in tumor size, and stable response (SR) as no change in tumor size at follow-up. We defined the objective response rate as (CR + PR)/(CR + PR + SR). Results: We performed TACE for 45 sessions for 22 lesions. The treatment sites were as follows: 12 thoracic spines, eight lumbar spines, and two cervical spines. The outcomes with TACE were a clinical response rate of 86% (CSR: 10, PSR: 1, and NSR: 3) and an objective response rate of 68% (CR: 3, PR: 12, and SR: 7). We observed no severe adverse events. Conclusion: We recommend TACE for better pain relief and improvement of neurologic deficits from relapsed MSCC after radiotherapy.