Abdominal Great Vessels Research Articles

SPLENIC SEQUESTRATION SCINTIGRAPHY IN THE DOG: A COMPARISON OF DENATURING TECHNIQUES

Five mixed‐breed dogs underwent splenic sequestration scintigraphy following intravenous injection of 647.5 to 740 MBq (17.5–20 mCi) of 99mTechnetium labeled autologous red blood cells (RBCs) that had been chemically denatured using two μg of stannous chloride. Left lateral dynamic images were obtained for 20 minutes after injection. Regions of interest (ROI) were drawn around the splenic body and ventral extremity, ventral liver and caudal abdominal great vessels and time activity curves created. Count density information was obtained and uptake ratios were calculated for the spleen ROI/vessel ROI, liver ROI/vessel ROI and spleen ROI/liver ROI at 1, 2.5, 5, 10, 15 and 20 minutes after injection. Two additional studies using different RBC denaturing procedures were done in four of the five dogs. In the second study, the stannous chloride level was doubled to 4.0 μg, while in the third study, the RBCs were denatured by addition of 2.0 μg of stannous chloride and heating at 49°C for 15 minutes. Progressive splenic uptake of denatured RBCs was seen in all dogs during the first 15 to 20 minutes of each study, no matter which denaturing technique was utilized. Significant increases in the spleen ROI:/vessel ROI and spleen ROI:liver ROI ratios were obtained at 5, 10, 15 and 20 minutes when compared to the 1 minute values for each of the labeling techniques. A significant difference was not identified between the three ratios at 15 minutes between the three labeling techniques. There was a trend of increasing values for each ratio where 2.0 μg of stannous chloride technique being the lowest, 4.0 μg of stannous chloride having an intermediate value and the heated technique had the highest values. The heating technique resulted in higher liver activity and increased variability of the mean liver ROI/vessel ROI ratios at all times (1, 2.5, 5,10, and 15 minutes). Using a non‐linear least squares regression analysis, a double exponential equation fit the spleen ROI/vessel ROI and spleen ROI/liver ROI ratios for all three labeling techniques. Imaging of the spleen using all three techniques was acceptable, and a persistent blood pool image would allow for vascular imaging and cardiac gated studies 30 minutes after injection of the denatured, labeled autologous red blood cells. Veterinary Radiology & Ultrasound, Vol. 36, No. I, 1995, pp 57–63.

Discordance between abdominal and atrial arrangement in a case of complex congenital heart disease

The report describes a rare case of a complex congenital heart disease wherein the splenic status and the relationship of the suprarenal abdominal great vessels strongly suggested right isomerism, but atrial morphology demonstrated usual atrial arrangement. It emphasises the increasing recognition that the arrangement of the abdominal organs need not accurately reflect atrial arrangement.

Prenatal diagnosis of isomerism of the right atrial appendages

AbstractA complex malformation of the heart was diagnosed by fetal echocardiography at 27 weeks of gestation. The study of the relationship of the abdominal great vessels, showing the inferior caval vein anterior and to the left of the aorta, made possible the diagnosis of right isomerism. This inferential guide to the arrangement of the thoraco abdominal organs proves to be as valid in the fetus as it is in the neonate and child. The examination of the abdominal great vessels as part of the fetal scan is of great value, enabling us to counsel mothers appropriately in the light of the poor prognosis of neonates with isomerism of atrial appendages and complex intracardiac lesions.

Diagnosis of atrial situs by transesophageal echocardiography

In a prospective investigation, direct visualization of both atrial appendages was attempted during transesophageal echocardiographic studies in 132 patients with congenital heart disease. High quality cross-sectional images delineating the unique morphologic details of both atrial appendages were obtained in every patient. Abnormal cardiac position such as dextrocardia (four patients) or mesocardia (two patients) did not pose any problems for transesophageal assessment of both atrial appendages. Thus, direct diagnosis of atrial situs was possible in every patient. Atrial situs solitus was present in 127 patients studied. Three patients were found to have situs inversus, one had left atrial isomerism and one had right atrial isomerism. No patient with juxtaposed atrial appendages was encountered. All patients had prior subcostal ultrasound scans for assessment of the morphology and relation of the suprarenal abdominal great vessels and the related patterns of hepatic venous drainage.Patients with abnormal atrial situs had correlative high kilovoltage filter beam radiography for assessment of bronchus morphology. The results of situs determination obtained by either method were in agreement.In this series, transesophageal echocardiography allowed the direct and accurate visualization of both atrial appendages and the determination of atrial situs in all patients studied. Transesophageal echocardiography may prove to be the most reliable in vivo technique for determination of atrial situs.

Perirenal spaces: CT evidence for communication across the midline.

The perirenal spaces may communicate across the midline, anterior to the lower aorta and vena cava. The connecting channel has a relatively narrow anteroposterior dimension on computed tomographic (CT) scans, both in vivo and in injected cadavers. It may therefore be difficult to visualize on abdominal radiographs and may be mistaken for unopacified bowel on CT scans. The midline extension of perirenal fluid is usually contiguous to the lower abdominal great vessels anteriorly but does not surround them completely, possibly because of fibrous septa within the perivascular fat. Hematomas from ruptured aortic aneurysms extend mainly into the perirenal spaces. Thus, the lower abdominal great vessels are located, in effect, within the midline extension of these spaces. Superiorly, the perirenal spaces extend to the diaphragm, abutting the lateral and anterior margins of the psoas and quadratus lumborum muscles and the bare area of the liver. Inferiorly, perirenal collections appear to diverge into the pelvis, along the psoas muscles, ureters, and iliac vessels.

Ultrasonographic findings in the livers of patients with lepromatous leprosy.

Abdominal ultrasonography, including assessment of the liver, spleen, pancreas, great abdominal vessels, and kidneys, was carried out in seven patients with lepromatous leprosy, six patients with tuberculoid leprosy, and 32 healthy Congolese controls. Abnormal ultrasound findings were predominantly detected in the livers of patients with lepromatous leprosy and included an inhomogeneous echo texture of the hepatic parenchyma in all cases. Furthermore, six patients revealed echo-dense, partly irregular areas up to 1.5 cm X 3 cm in size distributed throughout the liver. These were associated with shadowing and were considered to contain calcium. No abnormal findings were encountered in controls or in patients with tuberculoid leprosy except for one patient with tuberculoid leprosy who had a rounded caudal liver edge. The sizes and volumes of liver, spleen, and kidneys were not different in the three groups.

Surgical Techniques for the Diseases of the Abdominal Great Vessels and the Main Branches Including the Iliac Vessels

Surgical Techniques for the Diseases of the Abdominal Great Vessels and the Main Branches Including the Iliac Vessels