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Vascular Calcifications and Aneurysms
Michael P. Federle, MD, FACR; Kathleen E. Jacobs, BA
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9

KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        TERMINOLOGY

        • Definitions

          • Arterial calcifications are usually indicative of atherosclerosis or diabetic vasculopathy
          • Venous calcifications are thrombi or result from venous (usually portal) hypertension
          • Aneurysm implies significant dilation of vessel lumen with intact endothelial lining
            • Pseudoaneurysm = dilated lumen without intact lining (e.g., result of arterial injury from trauma, pancreatitis, etc.)

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Microscopic Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Treatment

                              DIAGNOSTIC CHECKLIST

                              • Image Interpretation Pearls

                                Selected References

                                1. Ikeda O et al: Nonoperative management of unruptured visceral artery aneurysms: treatment by transcatheter coil embolization. J Vasc Surg. 47(6):1212-9, 2008
                                2. Lee WK et al: Infected (mycotic) aneurysms: spectrum of imaging appearances and management. Radiographics. 28(7):1853-68, 2008
                                3. Liu Q et al: Detection of anomalous splenic artery aneurysms with three-dimensional contrast-enhanced MR angiography. Abdom Imaging. Epub ahead of print, 2008
                                4. Liu Q et al: Visceral artery aneurysms: evaluation using 3D contrast-enhanced MR angiography. AJR Am J Roentgenol. 191(3):826-33, 2008
                                5. Kalko Y et al: Visceral artery aneurysms. Heart Surg Forum. 10(1):E24-9, 2007
                                6. Milot L et al: Giant aneurysm of the main hepatic artery secondary to hereditary hemorrhagic telangiectasia: 3D contrast-enhanced MR angiography features. Gastroenterol Clin Biol. 31(3):297-9, 2007
                                7. Rakita D et al: Spectrum of CT findings in rupture and impending rupture of abdominal aortic aneurysms. Radiographics. 27(2):497-507, 2007
                                8. Schwartz SA et al: CT findings of rupture, impending rupture, and contained rupture of abdominal aortic aneurysms. AJR Am J Roentgenol. 188(1):W57-62, 2007
                                9. Stavropoulos SW et al: Imaging techniques for detection and management of endoleaks after endovascular aortic aneurysm repair. Radiology. 243(3):641-55, 2007
                                10. Tulsyan N et al: The endovascular management of visceral artery aneurysms and pseudoaneurysms. J Vasc Surg. 45(2):276-83; discussion 283, 2007
                                11. Laganà D et al: Multimodal approach to endovascular treatment of visceral artery aneurysms and pseudoaneurysms. Eur J Radiol. 59(1):104-11, 2006
                                12. Nosher JL et al: Visceral and renal artery aneurysms: a pictorial essay on endovascular therapy. Radiographics. 26(6):1687-704; quiz 1687, 2006
                                13. Ouwendijk R et al: Vessel wall calcifications at multi-detector row CT angiography in patients with peripheral arterial disease: effect on clinical utility and clinical predictors. Radiology. 241(2):603-8, 2006
                                14. Karaman K et al: Endovascular stent graft treatment in a patient with splenic artery aneurysm. Diagn Interv Radiol. 11(2):119-21, 2005
                                15. Abedin M et al: Vascular calcification: mechanisms and clinical ramifications. Arterioscler Thromb Vasc Biol. 24(7):1161-70, 2004
                                16. Browne RF et al: Renal artery aneurysms: diagnosis and surveillance with 3D contrast-enhanced magnetic resonance angiography. Eur Radiol. 14(10):1807-12, 2004
                                17. Carr SC et al: Visceral artery aneurysm rupture. J Vasc Surg. 33(4):806-11, 2001
                                18. Guest AR et al: Assessment of the clinical utility of the rim and comet-tail signs in differentiating ureteral stones from phleboliths. AJR Am J Roentgenol. 177(6):1285-91, 2001
                                19. Gilfeather M et al: Gadolinium-enhanced ultrafast three-dimensional spoiled gradient-echo MR imaging of the abdominal aorta and visceral and iliac vessels. Radiographics. 17(2):423-32, 1997
                                20. Panayiotopoulos YP et al: Aneurysms of the visceral and renal arteries. Ann R Coll Surg Engl. 78(5):412-9, 1996
                                21. Ernst CB: Abdominal aortic aneurysm. N Engl J Med. 328(16):1167-72, 1993
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Top Differential Diagnoses

                                      TERMINOLOGY

                                      • Definitions

                                        • Arterial calcifications are usually indicative of atherosclerosis or diabetic vasculopathy
                                        • Venous calcifications are thrombi or result from venous (usually portal) hypertension
                                        • Aneurysm implies significant dilation of vessel lumen with intact endothelial lining
                                          • Pseudoaneurysm = dilated lumen without intact lining (e.g., result of arterial injury from trauma, pancreatitis, etc.)

                                      IMAGING

                                      • General Features

                                        • Radiographic Findings

                                          • CT Findings

                                            • MR Findings

                                              • Ultrasonographic Findings

                                                DIFFERENTIAL DIAGNOSIS

                                                  PATHOLOGY

                                                  • General Features

                                                    • Microscopic Features

                                                      CLINICAL ISSUES

                                                      • Presentation

                                                        • Demographics

                                                          • Treatment

                                                            DIAGNOSTIC CHECKLIST

                                                            • Image Interpretation Pearls

                                                              Selected References

                                                              1. Ikeda O et al: Nonoperative management of unruptured visceral artery aneurysms: treatment by transcatheter coil embolization. J Vasc Surg. 47(6):1212-9, 2008
                                                              2. Lee WK et al: Infected (mycotic) aneurysms: spectrum of imaging appearances and management. Radiographics. 28(7):1853-68, 2008
                                                              3. Liu Q et al: Detection of anomalous splenic artery aneurysms with three-dimensional contrast-enhanced MR angiography. Abdom Imaging. Epub ahead of print, 2008
                                                              4. Liu Q et al: Visceral artery aneurysms: evaluation using 3D contrast-enhanced MR angiography. AJR Am J Roentgenol. 191(3):826-33, 2008
                                                              5. Kalko Y et al: Visceral artery aneurysms. Heart Surg Forum. 10(1):E24-9, 2007
                                                              6. Milot L et al: Giant aneurysm of the main hepatic artery secondary to hereditary hemorrhagic telangiectasia: 3D contrast-enhanced MR angiography features. Gastroenterol Clin Biol. 31(3):297-9, 2007
                                                              7. Rakita D et al: Spectrum of CT findings in rupture and impending rupture of abdominal aortic aneurysms. Radiographics. 27(2):497-507, 2007
                                                              8. Schwartz SA et al: CT findings of rupture, impending rupture, and contained rupture of abdominal aortic aneurysms. AJR Am J Roentgenol. 188(1):W57-62, 2007
                                                              9. Stavropoulos SW et al: Imaging techniques for detection and management of endoleaks after endovascular aortic aneurysm repair. Radiology. 243(3):641-55, 2007
                                                              10. Tulsyan N et al: The endovascular management of visceral artery aneurysms and pseudoaneurysms. J Vasc Surg. 45(2):276-83; discussion 283, 2007
                                                              11. Laganà D et al: Multimodal approach to endovascular treatment of visceral artery aneurysms and pseudoaneurysms. Eur J Radiol. 59(1):104-11, 2006
                                                              12. Nosher JL et al: Visceral and renal artery aneurysms: a pictorial essay on endovascular therapy. Radiographics. 26(6):1687-704; quiz 1687, 2006
                                                              13. Ouwendijk R et al: Vessel wall calcifications at multi-detector row CT angiography in patients with peripheral arterial disease: effect on clinical utility and clinical predictors. Radiology. 241(2):603-8, 2006
                                                              14. Karaman K et al: Endovascular stent graft treatment in a patient with splenic artery aneurysm. Diagn Interv Radiol. 11(2):119-21, 2005
                                                              15. Abedin M et al: Vascular calcification: mechanisms and clinical ramifications. Arterioscler Thromb Vasc Biol. 24(7):1161-70, 2004
                                                              16. Browne RF et al: Renal artery aneurysms: diagnosis and surveillance with 3D contrast-enhanced magnetic resonance angiography. Eur Radiol. 14(10):1807-12, 2004
                                                              17. Carr SC et al: Visceral artery aneurysm rupture. J Vasc Surg. 33(4):806-11, 2001
                                                              18. Guest AR et al: Assessment of the clinical utility of the rim and comet-tail signs in differentiating ureteral stones from phleboliths. AJR Am J Roentgenol. 177(6):1285-91, 2001
                                                              19. Gilfeather M et al: Gadolinium-enhanced ultrafast three-dimensional spoiled gradient-echo MR imaging of the abdominal aorta and visceral and iliac vessels. Radiographics. 17(2):423-32, 1997
                                                              20. Panayiotopoulos YP et al: Aneurysms of the visceral and renal arteries. Ann R Coll Surg Engl. 78(5):412-9, 1996
                                                              21. Ernst CB: Abdominal aortic aneurysm. N Engl J Med. 328(16):1167-72, 1993