Endovascular occlusion of pulmonary arteriovenous malformations with the ArtVentive Endoluminal Occlusion System™

Abstract

PURPOSEWe aimed to evaluate the imaging features of bile duct adenoma (BDA) on ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI). METHODSRetrospective search in our institution database was performed for histologically confirmed BDA. Their imaging studies before histologic confirmation were reviewed. The search identified seven adults (mean age, 52.9 years) with histologically proven single BDA each. US (n=3), CT (n=5), and MRI (n=3) were performed before histologic confirmation. Additionally, a systematic English literature review for BDA and reported imaging findings since 2000 was also conducted using the following search criteria "bile duct adenoma, peribiliary hamartoma, biliary adenoma, CT, ultrasound, MRI" (date range: 01/01/2000 through 08/31/2016). The imaging findings of those cases reported were summarized and compared with our series. RESULTSAll seven individual nodules were well circumscribed. Five lesions were located in the right hepatic lobe and two in the left hepatic lobe. On US, lesions appeared hypoechoic (n=2) and hyperechoic (n=1). BDA was hypodense on unenhanced CT images (n=1). On MRI, BDA were hypointense on T1 (n=3), hyperintense on T2 (n=3), and hyperintense on diffusion-weighted images (n=2). On contrast-enhanced CT and MRI, BDAs showed arterial phase hyperenhancement that persisted on portal venous/delayed phase images. CONCLUSIONBDA demonstrates characteristic arterial phase hyperenhancement that persisted into the portal venous and delayed phases on CT and MRI, which may be useful in differentiating from other hepatic lesions.You may cite this article as: Chuy JA, Garg I, Graham RP, VanBuren WM, Venkatesh SK. Imaging features of bile duct adenoma: case series and review of literature. Diagn Interv Radiol 2018; 24:249-254.

Approach to Pulmonary Arteriovenous Malformations: A Comprehensive Update

“…Sometimes, the large amount of flow in the AVM can prevent occlusion or lead to later recanalization of the AVP; the addition of one or more coils proximal to the plug can help prevent this occurrence [61]. Compared to coils, AVPs appear to have a lower risk of device migration [3,97]. Vascular plugs may also have less metallic artifact compared to coils, which can be advantageous when evaluating treated PAVMs on follow-up imaging [3].…”

Orthotopic Liver Transplantation for Hereditary Hemorrhagic Telangiectasia and MEN Type I Syndrome - Case Report and Review of Literature

“…PAVMs can be either discrete or diffuse; the latter are defined by involvement of all segmental or subsegmental arteries of at least one lobe (38). Depending on the number of arteries feeding the PAVM, there can be either simple (1 vessel), or complex (multiple feeding arteries) PAVMs (39).…”

Successful endovascular treatment of a spontaneous bleeding accessory spleen: A case report

“…Celiac trunk angiography was performed with a 5 Fr vascular introducer (Cook Medical, Bloomington, Indiana), followed by selective catheterization of residual splenic artery by using a cobra catheter (Merit Medical, South Jordan, Utah) and a microcatheter Progreat 2.7 Fr., (Terumo, Shibuya - ku , Tokyo , Japan ). Celiac angiogram demonstrated normal branching pattern [4]. Selective digital subtraction angiography of the splenic artery showed 2 hypertrophic artery branches [5] arising from the residual portion of the splenic artery and feeding the accessory spleen hilus [6] (Figs.…”